在双极性障碍和酒精使用障碍同时发生时,酒精暗示处理
William H Mellick, Bryan K Tolliver1, Helena M Brenner1
1Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston.
JAMA psychiatry
|August 9, 2023
概括
患有双相情感障碍和酒精使用障碍 (BD+AUD) 同时发生的个体对酒精暗示的脑反应呈现. 这种奖励回路功能障碍与冲动性和欲望的增加有关,这表明了新的治疗目标.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一种精神病学.
- 成 药物 药物 药物 药物
背景情况:
- 奖励回路功能障碍与双相情感障碍和酒精使用障碍 (BD+AUD) 的同时发生有关.
- 这一领域仍未得到充分研究,特别是在患有这两种疾病的个体中,关于酒精提示奖励处理.
研究的目的:
- 调查BD+AUD患者与AUD或BD患者相比,BD+AUD患者的酒精暗示处理不同.
- 在BD+AUD.同时发生的背景下,识别奖励处理的神经相关物.
主要方法:
- 一项横截面病例对照研究使用功能磁共振成像 (fMRI) 与视觉酒精暗示反应范式.
- 参与者包括BD+AUD,AUD单独,BD单独和健康对照的人,所有这些都是经过禁欲期后评估的.
- 分析重点关注全脑活动和特定感兴趣的区域,将神经反应与渴望和冲动性等行为指标相关联.
主要成果:
- 在右下额头和胰岛中观察到显著的BD × AUD相互作用,在BD + AUD组中显示活性降低.
- 与其他组相比,BD+AUD患者的背上条纹体活化也显著降低.
- 这些低活化与BD+AUD队列中较高的冲动性和强迫性嗜酒相关.
结论:
- 在BD+AUD中,奖励功能障碍可能涉及淡的奖励反应能力和缺乏抑制控制之间的相互作用.
- 在右下额头和胰岛的酒精暗示反应性降低可能作为BD+AUD的生物标志物.
- 这些发现表明药理干预的潜在治疗目标,旨在通过解决与冲动性相关的神经机制来改善执行控制.
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