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.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
UNODC. World Drug Report 2013. United Nations publication (2012). e-ISBN: 978-92-1-055653-8
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
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)
Sawynok, J.: The therapeutic use of heroin: a review of the pharmacological literature. Can. J. Physiol. Pharmacol. 64(1), 1–6 (1986)
Stahl, S.M.: Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press, Cambridge (2008)
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)
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
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
Fuster, J.: Frontal lobe and cognitive development. J. Neurosychol. 31, 373–385 (2002)
Stuss, D.T., Levine, B.: Adult Clinical Neuropsychology: Lessons from studies of the frontal lobes. Ann. Rev. Psychol. 53, 401–433 (2002)
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)
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)
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
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
Verdejo, A.G., Bechara, A.: Neuropsicologia de las funciones ejecutivas. Psicoth 22(2), 227–235 (2010)
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)
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
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)
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
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
Bechara, A., Tranel, D., Damasio, H.: Characterization of the decision-making deficit of patients with ventromedial prefrontal cortex lesions. Brain 123, 2189–2202 (2000)
Damasio, A.R.: Descartes’ Error: Emotion, Reason, and the Human Brain. Grosset/Putnam, New York (1994)
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)
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)
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)
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)
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)
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)
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)
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)
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)
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)
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)
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)
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)
Dubois, B., Slachevsky, A., Litvan, I., Pillon, B.: The FAB: a frontal assessment battery at bedside. Neurology 55, 1621–1626 (2000)
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)
Rey, A.: L’examen clinique en psychologie (The psychological examination). Presses Universitaires de France, Paris (1958)
Toulouse, E., Pieron, H.: Prueba perceptiva y de atención. Tea Ediciones, Madrid, Spain (1986)
D’Elia, L., Satz, P., Uchiyama, C., White, T.: Color trails test professional manual. Psychological Assessment Resources, Odessa, FL (1996)
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)
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)
Beck, A.T., Steer, R.A., Brown, G.K.: BDI-II: Beck Depression Inventory Manual. Psychological Corporation, San Antonio (1996)
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)
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)
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)
Acknowledgments
The authors would like to thank to the clinical staff of Ares do Pinhal that participated in patients’ recruitment and data collection.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this paper
Cite this paper
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
Download citation
DOI: https://doi.org/10.1007/978-3-319-69694-2_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-69693-5
Online ISBN: 978-3-319-69694-2
eBook Packages: Computer ScienceComputer Science (R0)