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暗示引起的大脑活动和物质使用障碍的治疗结果:元分析

Bryn Evohr¹, Sean Wenzel¹, Nicole Chen¹

¹Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston.

JAMA network open

|December 11, 2025

概括

这次元分析发现,对物质线索的反应中大脑活动可以预测物质使用障碍 (SUDs) 的治疗成功. 某些特定的大脑区域,如胰岛,在治疗后反应性降低,这表明了潜在的恢复生物标志物.

科学领域:

神经科学是一个神经科学.
成研究研究成研究
医疗成像医学成像

背景情况:

药物使用障碍 (SUD) 的复发率很高,影响全球数百万人.
暗示引起的大脑活动是治疗成功的潜在指标,但与结果相关的特定大脑区域仍未确定.
功能磁共振成像 (fMRI) 提供了一种方法来研究大脑对物质线索的反应.

研究的目的:

系统地审查和对基于fMRI的SUD治疗中暗示反应性的现有文献进行元分析.
为了确定暗示反应是否可以作为SUD治疗反应的预测生物标志物.
为了确定治疗后的神经变化,可能作为反应生物标志物.

主要方法:

在主要数据库 (PubMed,PsycINFO,Embase,Cochrane) 进行了全面的系统搜索,直到2023年5月.
包括了涉及成人接受SUD治疗并报告fMRI暗示反应和结果的研究.
基于种子的d绘图与对象图像的变换 (SDM-PSI) 用于元分析,随机效应模型生成统计激活图.

主要成果:

分析了51项研究 (1787名参与者),揭示了 cingulate gyrus,中额头环,尾状环和岛状环中持续的暗示诱导激活.
低基线线索反应性在insula和 cingulate预测了更好的治疗结果 (14项研究).
在治疗后 (25项研究) 观察到前带带状,尾带状,带状和胰岛的暗示反应性显著降低,胰岛显示出预测和响应生物标志物潜力.

结论:

这一元分析确定了在SUDs的成年人中由物质线索持续激活的特定大脑区域.
这些地区,特别是岛屿,显示出作为治疗结果的预测和响应生物标志物候选者的潜力.
基于大脑的生物标志物可以显著地告知和个性化SUD治疗干预措施.

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