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[药物滥用患者中与腹内侧前额叶皮层相关的决策过程改变]

[Alterations in the decision making processes linked to the ventromedial prefrontal cortex in drug-abusing patients].

作者信息

Verdejo A, Aguilar de Arcos F, Pérez García M

机构信息

Departamento de Personalidad, Evaluación y Tratamiento Psicologia,Universidad de Granada,Granada, España.

出版信息

Rev Neurol. 2004;38(7):601-6.

Abstract

INTRODUCTION

The somatic marker hypothesis proposes that somatic signals guide the decision making processes in an adaptive sense for the organism. The processing of these somatic signals is linked to the ventromedial prefrontal cortex activity. The influence of somatic markers on decision making processes has been studied by means of the 'gambling task' (GT). Several studies using the GT in substance abusers have showed the existence of decision making impairments in these patients.

AIMS

To examine the performance in the GT of a Spanish sample of substance abusers; and to study the influence of clinically relevant variables: type of substance, years of abuse and abstinence period on GT performance.

PATIENTS AND METHODS

106 substance abusers patients during the dishabituation phase participated in the study. We administered a computerized version of the GT in a single individual session. We used descriptive analyses to study the patients' performance in the GT. Next we carried out multiple regression analyses to study the influence of the clinical variables on the GT performance.

RESULTS

A 76.4% of the sample patients showed impairments in the decision making processes measured by the GT. None of the clinical variables significantly predicted performance in the task.

CONCLUSIONS

These results suggest the existence of decision making impairments in substance abusers that may be related to pre morbid alterations, or to a neurotoxic effect of drugs of abuse on the activity of the ventromedial prefrontal cortex.

摘要

引言

躯体标记假说提出,躯体信号以一种对生物体具有适应性意义的方式引导决策过程。这些躯体信号的处理与腹内侧前额叶皮质的活动相关。躯体标记对决策过程的影响已通过“赌博任务”(GT)进行研究。多项针对药物滥用者使用GT的研究表明,这些患者存在决策障碍。

目的

研究一组西班牙药物滥用者样本在GT中的表现;并探讨临床相关变量(药物类型、滥用年限和戒断期)对GT表现的影响。

患者与方法

106名处于脱瘾阶段的药物滥用患者参与了本研究。我们在单次个体测试中使用了计算机化的GT。我们使用描述性分析来研究患者在GT中的表现。接下来,我们进行多元回归分析,以研究临床变量对GT表现的影响。

结果

76.4%的样本患者在通过GT测量的决策过程中表现出障碍。没有一个临床变量能显著预测任务表现。

结论

这些结果表明,药物滥用者存在决策障碍,这可能与病前改变或滥用药物对腹内侧前额叶皮质活动的神经毒性作用有关。

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