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Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment
Authors:Mieke H.J. Schulte  Janna Cousijn  Tess E. den Uyl  Anna E. Goudriaan  Wim van den Brink  Dick J. Veltman  Thelma Schilt  Reinout W. Wiers
Affiliation:1. Addiction, Development, and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands;2. Amsterdam Institute for Addiction Research (AIAR), Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;3. Arkin Mental Health Care, Amsterdam, The Netherlands;4. VU University Medical Center, Amsterdam, The Netherlands;5. Department of Developmental Psychology and Psychonomics, Utrecht University, Utrecht, The Netherlands
Abstract:

Background

Substance Use Disorders (SUDs) have been associated with impaired neurocognitive functioning, which may (partly) improve with sustained abstinence. New treatments are emerging, aimed at improving cognitive functions, and being tested. However, no integrated review is available regarding neurocognitive recovery following sustained abstinence.

Objectives

In this review, results from prospective studies on neurocognitive recovery using neuropsychological assessments before and after sustained abstinence from SUDs are summarized and discussed.

Results

Thirty-five prospective studies were selected for this review, including twenty-two alcohol, three cannabis, four cocaine, three (meth)amphetamine, and three opioid studies. Results suggest that some cognitive functions (partially) recover after sustained abstinence, and that there are predictors of an unfavorable course such as poly-substance use and number of previous detoxifications.

Conclusions

Prospective studies indicate that sustained abstinence after SUDs generally results in (partial) neurocognitive recovery. However, a final answer regarding full recovery awaits prospective studies with neurocognitive assessments before, during, and after sustained abstinence from SUDs. New interventions that might enhance neurocognitive recovery after abstinence are discussed, including neurocognitive training, medication and neuromodulation.
Keywords:Addiction   Clinical implications   Neuropsychology   Recovery   Substance dependence
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