title: Executive dysfunction in chronic cocaine users: an exploratory study.
abstract: BACKGROUND
  Chronic cocaine use is associated with some executive deficits. We assessed executive functions using ecologically valid tests in chronic cocaine users.
  
  
  OBJECTIVE
  To investigate the relationship between executive deficits and three measures of severity of cocaine use: years of use, quantity used, and frequency of use.
  
  
  METHODS
  Twenty-four cocaine users were compared with twenty-seven community controls. We used Student's t-test and Chi-squared to compare means and categorical variables, respectively. Linear regression analyses for the adjusted comparative analysis between cases and controls, and severity of cocaine use among cocaine users were performed.
  
  
  RESULTS
  Chronic cocaine users performed worse on measures of attention and working memory (Forward and Backward Digit Span, p<.001), set-shifting abilities (difference score between the Trail Making B and A, TMB-A, p=.006), cognitive test of mental flexibility and response inhibition (Rule Shift Cards) (p<.001), and prefrontal functioning (Wisconsin Card Sorting Test, WCST, p=.023) than controls. Years of cocaine use were associated with deficits in the Backward Digit Span (p=.041; CI 95%: -.760 to -.002), the TMB-A (p=.026; CI 95%: .687 to 9.761), the Zoo Map (p=.034; CI 95%: -.480 to -.021), and the Rule Shift Cards (p=.006; CI 95%: -.836 to -.164), among others. Quantity of cocaine use was associated with executive deficits measured by the Forward Digit Span (p=.007; CI 95%: -.727 to -.133), the TMB-A (p=.021; CI 95%: 5.304-57.945), and the number of perseverative errors in the WSCT (p=.002; CI 95%: -10.654 to -2.800). Frequency of cocaine was associated with deficits in the Backward Digit Span (p=.042; CI 95%: -1.548 to -.030).
  
  
  CONCLUSIONS
  Chronic use of cocaine is associated with executive deficits, which may influence patients' functionality, prognosis, and therapeutic failure.
authors.affiliation: San Blas Mental Health Center, Calle Castillo de Uclés 35-37, 28037 Madrid, Spain. amagur@yahoo.com
authors.forename: Agustín
authors.initials: A
authors.lastname: Madoz-Gúrpide
authors.forename: Hilario
authors.initials: H
authors.lastname: Blasco-Fontecilla
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-García
authors.forename: Enriqueta
authors.initials: E
authors.lastname: Ochoa-Mangado
mesh_terms: D000328:Adult; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D035061:Control Groups; D018450:Disease Progression; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects; D056344:Executive Function / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D018765:Dopamine Uptake Inhibitors; D003042:Cocaine