Аннотация:
Introduction. The brain reward system is a complex of structures of the nervous system that regulates behavior, providing a person with a sense of pleasure and positive emotions for a successfully completed action or decision. A number of studies of the brain reward system focus on the cognitive decision-making process and the connection of its disorders with the leading symptoms of various kinds of mental pathologies, including alcohol dependence.
Aim: to study the cognitive domains of the brain reward system in patients with alcohol addiction using gambling tests, as well as to assess the influence of alcohol consumption patterns and clinical and dynamic characteristics of patients on them.
Methods. The study involved 50 patients: 39 men and 11 women with alcohol use disorders. As a control group, 32 mentally healthy subjects were examined without signs of alcohol abuse and dependence: 24 men and 8 women. To assess the cognitive domains of the brain reward system, the Cambridge Gambling Task and the Iowa Gambling Task from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used.
Results. The indicator «quality of decisions made» was lower in patients with alcohol dependence compared to the control (p < 0.001). Also, higher indicators of «decision-making time» (p < 0.001) and «risk-taking» (p < 0.001) were found in the group of patients. The results of the Iowa gaming test indicate that people with alcohol addiction have a deficit of emotional learning in situations of uncertainty, which was manifested by the wrong choice during decision-making – patients more often chose decks with a large reward, despite large fines when choosing these decks (p = 0.004). Among the significant factors that influenced the cognitive domains of the brain reward system in patients with alcohol dependence were the frequency of alcohol consumption, the daily volume of alcohol consumption, as well as the length of alcohol dependence.
Conclusion. In patients with alcohol dependence, the cognitive domains of the brain reward system significantly deteriorate. The severity of cognitive deficits is determined by the frequency, amount and duration of alcoholism. In this regard, it is necessary to take into account the cognitive aspect of patients with alcohol dependence in order to adapt their treatment and alleviate their difficulties in everyday life.
Ключевые слова:
alcohol use disorders; reward system; decision-making; cognitive functions.