{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:35:03Z","timestamp":1788348903511,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Benzodiazepine (BDZ) misuse is a growing health problem, with 1\u20132% of patients under BDZ treatment meeting the criteria for use disorder or dependence. Although BDZ addiction potential has been known for decades, much remains unknown its effects on brain functions. The aim of this study was to assess the neuropsychological and neurophysiological profile of a group of chronic insomniacs taking long-term high doses of benzodiazepine. We recruited 17 consecutive patients admitted to our third-level Sleep Medicine Unit for drug discontinuation (7 males, mean age 49.2 \u00b1 11.2 years, mean education 13.7 \u00b1 3.9 years, mean daily diazepam-equivalent BDZ: 238.1 \u00b1 84.5 mg) and 17 gender\/age-matched healthy controls (7 males, mean age 46.8 \u00b1 14.1 years, mean education 13.5 \u00b1 4.5 years). We performed a full neuropsychological evaluation of all subjects and recorded their scalp event-related potentials (Mismatch-Passive Oddball-Paradigm and Active Oddball P300 Paradigm). Patients with chronic insomnia and BDZ use disorder showed a profound frontal lobe executive dysfunction with significant impairment in the cognitive flexibility domain, in face of a preserved working, short and long-term memory. In patients, P300 amplitude tended to be smaller, mainly over the frontal regions, compared to controls. BDZ use disorder has a severe cognitive impact on chronic insomnia patients. Long-term high-dose BDZ intake should be carefully evaluated and managed by clinicians in this specific patient population, especially in relation to risky activities.<\/jats:p>","DOI":"10.3390\/brainsci13030375","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T02:31:55Z","timestamp":1677033115000},"page":"375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Electrophysiological and Neuropsychological Indices of Cognitive Dysfunction in Patients with Chronic Insomnia and Severe Benzodiazepine Use Disorder"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-9657","authenticated-orcid":false,"given":"Anna","family":"Castelnovo","sequence":"first","affiliation":[{"name":"Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Civic Hospital of Lugano, Via Tesserete 46, 6900 Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"},{"name":"University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Miano","sequence":"additional","affiliation":[{"name":"Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Civic Hospital of Lugano, Via Tesserete 46, 6900 Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-3065","authenticated-orcid":false,"given":"Raffaele","family":"Ferri","sequence":"additional","affiliation":[{"name":"Sleep Research Centre, Oasi Research Institute\u2014IRCCS, 94018 Troina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Raggi","sequence":"additional","affiliation":[{"name":"Unit of Neurology, G.B. Morgagni\u2013L. Pierantoni Hospital, 47121 Forl\u00ec, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0960-4938","authenticated-orcid":false,"given":"Michelangelo","family":"Maestri","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Neurological Clinic, University of Pisa, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Bottasini","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Anelli","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Zucconi","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza","family":"Castronovo","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Ferini-Strambi","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1849-7196","authenticated-orcid":false,"given":"Mauro","family":"Manconi","sequence":"additional","affiliation":[{"name":"Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Civic Hospital of Lugano, Via Tesserete 46, 6900 Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"},{"name":"Department of Neurology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"ref_1","unstructured":"American Academy of Sleep Medicine (2014). 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