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Cognitive Improvement via mHealth for Patients Recovering from Substance Use Disorder

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ICTs for Improving Patients Rehabilitation Research Techniques (REHAB 2015)

Abstract

Heroin addiction has a negative impact on cognitive functions, which may also contribute to poorer treatment outcomes in drug addition. Traditional cognitive rehabilitation approaches suffer from limited motivational appeal and are relatively cumbersome to carry out. Thus, we report a study testing the efficacy of an alternative mHealth approach using tablets and serious games to stimulate cognitive functions in recovering addicts. This approach was tested in a sample 14 male heroin addicts undergoing a rehabilitation program for heroin addiction as inpatients at a local NGO. The exercises for cognitive training were based on serious games running on tablets. The results showed improvements in cognitive functioning between baseline and follow-up assessments in frontal lobe functions, verbal memory and sustained attention, as well as in some aspects of cognitive flexibility, decision-making and depression. Patients in cognitive training had a higher proportion of positive outcomes related to indicators of verbal memory cognitive flexibility than patients not in training. Overall results are promising but still require randomized control trials to determine the efficiency of this approach as an alternative to cognitive rehabilitation programs in heroin addicts.

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References

  1. UNODC. World Drug Report 2013. United Nations publication (2012). e-ISBN: 978-92-1-055653-8

    Google Scholar 

  2. NSDUH. National Survey on Drug Use and Health 2012. Substance Abuse and Mental Health Data Archive (SAMHDA) (2012). http://doi.org/10.3886/ICPSR34933.v2

  3. Oldendorf, W.H., Hyman, S., Braun, L., Oldendorf, S.Z.: Blood-brain barrier: penetration of morphine, codeine, heroin, and methadone after carotid injection. Science 178(4064), 984–986 (1972)

    Article  Google Scholar 

  4. Sawynok, J.: The therapeutic use of heroin: a review of the pharmacological literature. Can. J. Physiol. Pharmacol. 64(1), 1–6 (1986)

    Article  Google Scholar 

  5. Stahl, S.M.: Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press, Cambridge (2008)

    Google Scholar 

  6. Schmidt, A., Borgwardt, S., Gerber, H., Wiesbeck, G.A., Schmid, O., Riecher-Rössler, A., Smieskova, R., Lang, U.E., Walter, M.: Acute effects of heroin on negative emotional processing: relation of amygdala activity and stress-related responses. Biol. Psychiatry 76(4), 289–296 (2014)

    Article  Google Scholar 

  7. Cheng, G.L.F., Zeng, H., Leung, M.K., Zhang, H.-J., Lau, B.M.W., Liu, Y.-P., et al.: Heroin abuse accelerates biological aging: a novel insight from telomerase and brain imaging interaction. Trans. Psychiatry 3, e260 (2013). doi:10.1038/tp.2013.36

    Article  Google Scholar 

  8. Goldstein, R.Z., Volkow, N.D.: Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implication. Nat. Rev. Neurosci. 12(11), 652–669 (2011). doi:10.1038/nrn3119

    Article  Google Scholar 

  9. Fuster, J.: Frontal lobe and cognitive development. J. Neurosychol. 31, 373–385 (2002)

    Google Scholar 

  10. Stuss, D.T., Levine, B.: Adult Clinical Neuropsychology: Lessons from studies of the frontal lobes. Ann. Rev. Psychol. 53, 401–433 (2002)

    Article  Google Scholar 

  11. Ersche, K.D., Clark, L., London, M., Robbins, T.W., Sahakian, B.J.: Profile of executive and memory function associated with amphetamine and opiate dependence. Neuropsychopharmacology 31(5), 1036–1047 (2006)

    Article  Google Scholar 

  12. Pirastu, M., Fais, R., Messina, M., Bini, V., Spiga, S., Falconieri, D., Diana, M.: Impaired decision-making in opiate-dependent subjects: effect of pharmacological therapies. Drug Alcohol. Depend. 83, 163–168 (2006)

    Article  Google Scholar 

  13. Gurber, S.A., Silveri, M.M., Yurgelun-Todd, D.A.: Neuropsychological consequences of opiate use. Neuropsychol. Rev. 17, 299–315 (2007). doi:10.1007/s11065-007-9041-y

    Article  Google Scholar 

  14. Miyake, A., Friedman, N.P., Emerson, M., Witzki, X., Howerter, A.: The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cog. Psychol. 41, 49–100 (2000). doi:10.1006/cogp.1999.0734

    Article  Google Scholar 

  15. Verdejo, A.G., Bechara, A.: Neuropsicologia de las funciones ejecutivas. Psicoth 22(2), 227–235 (2010)

    Google Scholar 

  16. Brand, M., Roth-Bauer, M., Driessen, M., Markowitsch, H.J.: Executive functions and risky decision-making in patients with opiate dependence. Drug Alcohol. Depend. 97(1–2), 64–72 (2008)

    Article  Google Scholar 

  17. Al-Zahrani, M.A., Elsayed, Y.A.: The impacts of substance abuse and dependence on neuropsychological functions in a simple of patients from Saudi Arabia. Behav. Brain Functions 5, 48 (2009). doi:10.1186/1744-9081-5-48

    Article  Google Scholar 

  18. Fishbeina, D.H., Krupitskyb, E., Flannerya, B.A., Langevinc, D.J., Bobashevd, G., Verbitskaya, E., et al.: Neurocognitive characterizations of Russian heroin addicts without a significant history of other drug use. Drug Alcohol Depend. 90(1), 25–38 (2007)

    Google Scholar 

  19. Vassileva, J., Georgiev, S., Martin, E., Gonzalez, R., Segala, L.: Psychopathic heroin addicts are not uniformly impaired across neurocognitive domains of impulsivity. Drug Alcohol Depend. 114(2–3), 194–200 (2011). doi:10.1016/j.drugalcdep.2010.09.021

  20. Verdejo-Garcia, A., Bechara, A.: A somatic-marker theory of addiction. Neuropharmacology 56(Suppl. 1), 48–62 (2009). doi:10.1016/j.neuropharm.2008.07.035

    Article  Google Scholar 

  21. Bechara, A., Tranel, D., Damasio, H.: Characterization of the decision-making deficit of patients with ventromedial prefrontal cortex lesions. Brain 123, 2189–2202 (2000)

    Article  Google Scholar 

  22. Damasio, A.R.: Descartes’ Error: Emotion, Reason, and the Human Brain. Grosset/Putnam, New York (1994)

    Google Scholar 

  23. Terán-Mendoza, O., Sira-Ramos, D., Guerrero-Alcedo, J., Arroyo-Alvarado, D.: Sintomatología frontal, estrés autopercibido y quejas subjetivas de memoria en adictos a sustancias. Revista de Neurología 62, 296–302 (2016)

    Google Scholar 

  24. Heather, N., Greeley, J.: Cue exposure in the treatment of drug dependence: the potential of a new method for preventing relapse. Drug Alcohol. Rev. 9(2), 155–168 (1990)

    Article  Google Scholar 

  25. Passetti, F., Clark, L., Mehta, M.A., Joyce, E., King, M.: Neuropsychological predictors of clinical outcome in opiate addiction. Drug Alcohol. Depend. 94, 82–91 (2008)

    Article  Google Scholar 

  26. Rezapour, T., Hatami, J., Farhoudian, A., Sofuoglu, M., Noroozi, A., Daneshmand, R., et al.: NEuro COgnitive REhabilitation for Disease of Addiction (NECOREDA) Program: From Development to Trial. Basic Clin. Neurosci. 6(4), 291–298 (2015)

    Google Scholar 

  27. Ruiz-Sánchez de León, J.M., Pedrero-Pérez, E.J., Rojo-Mota, G., Llanero-Luque, M., Puerta-García, C.: A proposal for a protocol of neuropsychological assessment for use in addictions. Rev. Neurol. 53(8), 483–493 (2011)

    Google Scholar 

  28. Clare, L., Woods, R.T.: Cognitive Training and Cognitive Rehabilitation for people with early-stage Alzheimer’s disease: a review. Neuropsychological Rehabil. 14, 385–401 (2004)

    Article  Google Scholar 

  29. Willis, S.L., Tennstedt, S.L., Marsiske, M., Ball, K., Elias, J., Koepke, K.M., Morris, J.N., Rebok, G.W., Unverzagt, F.W., Stoddard, A.M., Wright, E., ACTIVE Study Group: Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 296(23), 2805–2814 (2006)

    Google Scholar 

  30. Lange, B., Requejo, P., Flynn, S., Rizzo, A., Valero-Cuevas, F., Baker, L., Winstein, C.: The potential of virtual reality and gaming to assist successful aging with disability. Phys. Med. Rehabil. Clin. N Am. 21(2), 339–356 (2010)

    Article  Google Scholar 

  31. Gamito, P., Oliveira, J., Morais, D., Rosa, P., Saraiva, T.: Serious games for serious problems: from ludicus to therapeuticus. In: Kim, J.J. (ed.) Virtual Reality, pp. 527–548. InTech Publishing (2011)

    Google Scholar 

  32. Gamito, P., Oliveira, J., Morais, D., Rosa, P., Saraiva, T.: NeuAR – a look into AR applications in the neurosciences area. In: Nee, A., Ong, S. (eds.) Augmented Reality. INTECH, pp. 131–154 (2011)

    Google Scholar 

  33. Folstein, M.F., Folstein, S.E., McHugh, P.R.: Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12, 189–198 (1975)

    Article  Google Scholar 

  34. Stillman, A.N., Rowe, K.C., Arndt, S., Moser, D.J.: Anxious symptoms and cognitive function in non-demented older adults: an inverse relationship. Int. J. Geriatric Psychiatry 27(8), 792–798 (2012)

    Article  Google Scholar 

  35. Derogatis, L.R., Savitz, K.L.: The SCL-90-R and the Brief Symptom Inventory (BSI) in Primary Care. In: Maruish, M.E. (ed.) Handbook of Psychological Assessment in Primary Care Setting, vol. 236, pp. 297–334. Laurence Erlbaum Associates, Mahwah (2000)

    Google Scholar 

  36. Dubois, B., Slachevsky, A., Litvan, I., Pillon, B.: The FAB: a frontal assessment battery at bedside. Neurology 55, 1621–1626 (2000)

    Article  Google Scholar 

  37. Brucki, D., Makheiros, S., Okamoto, I., Bertolucci, P.: Dados normativos para o teste de fluência verbal categoria animais em nosso meio. (Normative data: category verbal fluency). Arquivos de Neuro-Psiquiatra 55(1), 56–61 (1997)

    Google Scholar 

  38. Rey, A.: L’examen clinique en psychologie (The psychological examination). Presses Universitaires de France, Paris (1958)

    Google Scholar 

  39. Toulouse, E., Pieron, H.: Prueba perceptiva y de atención. Tea Ediciones, Madrid, Spain (1986)

    Google Scholar 

  40. D’Elia, L., Satz, P., Uchiyama, C., White, T.: Color trails test professional manual. Psychological Assessment Resources, Odessa, FL (1996)

    Google Scholar 

  41. Heaton, R.K., Chelune, G.J., Talley, J.L., Kay, G.G., Curtiss, G.: Wisconsin card sorting test (WCST) — manual revised and expanded. Psychological Assessment Resources, Odessa (1993)

    Google Scholar 

  42. Bechara, A., Damásio, A.R., Damásio, H., Anderson, S.W.: Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50(1–3), 7–15 (1994)

    Article  Google Scholar 

  43. Beck, A.T., Steer, R.A., Brown, G.K.: BDI-II: Beck Depression Inventory Manual. Psychological Corporation, San Antonio (1996)

    Google Scholar 

  44. Gamito, P., Oliveira, J., Lopes, P., Brito, R., Morais, D., Silva, D., Silva, A., Rebelo, S., Bastos, M., Deus, A.: Executive functioning in alcoholics following an mHealth cognitive stimulation program: randomized controlled trial. J. Med. Internet Res. 16(4), e102 (2014)

    Article  Google Scholar 

  45. Esteves, C.S., Oliveira, C.R., Moret-Tatay, C., Navarro-Pardo, E., De Carlia, G.A., Silva, I.G., et al.: honemic and semantic verbal fluency tasks: normative data for elderly Brazilians. Psychology/Psicologia Reflexão e Crítica 28(2), 350–355 (2015)

    Article  Google Scholar 

  46. Fernie, G., Tunney, R.J.: Some decks are better than others: The effect of reinforcer type and task instructions on learning in the Iowa gambling task. Brain Cogn. 60, 94–102 (2006)

    Article  Google Scholar 

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Acknowledgments

The authors would like to thank to the clinical staff of Ares do Pinhal that participated in patients’ recruitment and data collection.

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Correspondence to J. Oliveira .

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Rosa, B. et al. (2017). Cognitive Improvement via mHealth for Patients Recovering from Substance Use Disorder. In: Fardoun, H., R. Penichet, V., Alghazzawi, D., De la Guia, M. (eds) ICTs for Improving Patients Rehabilitation Research Techniques. REHAB 2015. Communications in Computer and Information Science, vol 665. Springer, Cham. https://doi.org/10.1007/978-3-319-69694-2_7

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  • DOI: https://doi.org/10.1007/978-3-319-69694-2_7

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