Spanagel R
Abteilung Psychopharmakologie, Zentralinstitut für Seelische Gesundheit.
Fortschr Neurol Psychiatr. 2003 Jul;71 Suppl 1:S33-5. doi: 10.1055/s-2003-40503.
New animal models have been developed which mimic several aspects of alcoholism. These models provide the basis to study the neurobiological mechanisms of "addicted behaviour". At least two different neurobiological pathways which are involved in the development and maintenance of addicted behaviour have been identified. The first pathway involves the opioidergic system and probably the mesolimbic dopaminergic system and may induce alcohol craving and relapse due to the mood enhancing, positive reinforcing effects of alcohol consumption. A second pathway involves several components of the glutamatergic system (in particular NMDA receptors) and may induce alcohol craving and relapse by negative motivational states including withdrawal and stress. In particular conditioned withdrawal and stress-induced relapse are mediated by a hypertrophic glutamatergic system. Thus it has recently been shown that the NMDA receptor modulator acamprosate inhibits conditioned abstinence behaviour in rats. Although more systematic work is needed to fully define these different neurobiological pathways involved in addicted behaviour, preclinical studies have identified low affinity non-competitive NMDA receptor antagonists as a novel potential generation of anti-relapse compounds and clinical studies have already been initiated in order to test these compounds in alcoholic patients.
已经开发出了模拟酗酒若干方面的新动物模型。这些模型为研究“成瘾行为”的神经生物学机制提供了基础。至少已经确定了两条与成瘾行为的发展和维持有关的不同神经生物学途径。第一条途径涉及阿片样物质系统,可能还涉及中脑边缘多巴胺能系统,并且由于饮酒带来的情绪增强、积极强化作用,可能会诱发对酒精的渴望和复吸。第二条途径涉及谷氨酸能系统的几个组成部分(特别是N-甲基-D-天冬氨酸受体),并且可能通过包括戒断和压力在内的负性动机状态诱发对酒精的渴望和复吸。特别是条件性戒断和应激诱导的复吸是由肥大的谷氨酸能系统介导的。因此,最近已经表明,N-甲基-D-天冬氨酸受体调节剂阿坎酸抑制大鼠的条件性戒酒行为。尽管需要开展更系统的工作来全面界定这些与成瘾行为有关的不同神经生物学途径,但临床前研究已确定低亲和力非竞争性N-甲基-D-天冬氨酸受体拮抗剂是新一代潜在的抗复吸化合物,并且已经启动了临床研究以便在酒精成瘾患者中测试这些化合物。