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[线索诱导的酒精渴望。神经生物学关联及临床相关性]

[Cue-induced alcohol craving. Neurobiological correlates and clinical relevance].

作者信息

Wrase J, Grüsser S M, Heinz A

机构信息

Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Germany.

出版信息

Nervenarzt. 2006 Sep;77(9):1051-2, 1055-8, 1060-3. doi: 10.1007/s00115-006-2067-1.

Abstract

If there is no further intervention, relapse rates in detoxified alcoholics are high, up to 85%, even after complete remission of bodily withdrawal symptoms. It has been suggested that one relevant mechanism contributing to the relapse risk is the exposure to stimuli (cues) that have regularly been associated with alcohol intake. Such stimuli can become conditioned cues that elicit alcohol craving and intake as conditioned responses. Current brain imaging studies indicate that dysfunction of dopaminergic, glutamatergic, and opioidergic neurotransmission in the brain reward system (ventral striatum including the nucleus accumbens) is associated with alcohol craving and brain activation elicited by alcohol-associated pictures. These findings point to specific indications for psychotherapeutic and additive pharmacological treatment options.

摘要

如果不进行进一步干预,戒酒者的复发率很高,即使身体戒断症状完全缓解,复发率仍高达85%。有人认为,导致复发风险的一个相关机制是接触经常与饮酒相关的刺激(线索)。此类刺激可成为条件线索,引发对酒精的渴望并促使饮酒成为条件反应。目前的脑成像研究表明,大脑奖赏系统(包括伏隔核的腹侧纹状体)中多巴胺能、谷氨酸能和阿片样物质能神经传递功能障碍与对酒精的渴望以及由酒精相关图片引发的大脑激活有关。这些发现为心理治疗和辅助药物治疗方案指明了具体方向。

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