RESUMO
Methanol poisoning leads to lesions in the basal ganglia and subcortical white matter, as well as to demyelination and atrophy of the optic nerve. However, information regarding cognitive deficits in a large methanol sample is lacking. The principal aim of the present study was to identify the cognitive sequelae of methanol poisoning and their morphological correlates. A sample of 50 patients (METH; age 48 ± 13 years), 3-8 months after methanol poisoning, and 57 control subjects (CS; age 49 ± 13 years) were administered a neuropsychological battery. Forty-six patients were followed in 2 years' perspective. Patients additionally underwent 1.5T magnetic resonance imaging (MRI). Three biochemical and toxicological metabolic markers and a questionnaire regarding alcohol abuse facilitated the classification of 24 patients with methanol poisoning without alcohol abuse (METHna) and 22 patients with methanol poisoning and alcohol abuse (METHa). All groups were compared to a control group of similar size, and matched for age, education, premorbid intelligence level, global cognitive performance, and level of depressive symptoms. Using hierarchical multiple regression we found significant differences between METH and CS, especially in executive and memory domains. METHa showed a similar pattern of cognitive impairment with generally more severe executive dysfunction. Moreover, all METH patients with extensive involvement on brain MRI (lesions in ≥2 anatomical regions) had a more severe cognitive impairment. From a longitudinal perspective, we did not find any changes in their cognitive functioning after 2 years' follow-up. Our findings suggest that methanol poisoning is associated with executive dysfunction and explicit memory impairment, supposedly due to basal ganglia dysfunction and disruption of frontostriatal circuitry proportional to the number of brain lesions, and that these changes are persistent after 2 years' follow-up.
Assuntos
Transtornos Cognitivos/induzido quimicamente , Transtornos Cognitivos/diagnóstico por imagem , Função Executiva , Transtornos da Memória/induzido quimicamente , Transtornos da Memória/diagnóstico por imagem , Metanol/intoxicação , Adulto , Idoso , Transtornos Cognitivos/psicologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de TempoRESUMO
Illegal drugs represent substantial health, social, legal and economical risks both for individuals and the whole society. Since 1989 the Czech drug scene has changed rapidly; these changes have resulted in an establishment of new market-based drug scene similar to other western European countries. Authors summarise basic data on the whole spectrum of drug users groups and emphasise that the concept of drug users as patients in treatment or as criminal offenders only was wrong. So-called recreational drug users are the most prevalent and from the research point of view the least studied group of users mostly without any contact with treatment services or criminal justice system. Drug information system introduced in the Czech Republic four years ago is presented; this system allows comparison with other European countries. It covers surveys on drug use among general and school population, studies on prevalence estimates of problem drug use, treatment demands, drug related infectious diseases and drug related deaths. Data on drug related crime, drug consumption and drug seizing are briefly presented.