Kienast T, Wrase J, Heinz A
Klinik für Psychiatrie und Psychotherapie der Charité, CCM, Universitätsmedizin Berlin, Germany.
Fortschr Neurol Psychiatr. 2008 May;76 Suppl 1:S68-76. doi: 10.1055/s-2008-1038141.
Neuroimaging provides insight into the main biological mechanisms underlying drug and alcohol dependence. Cardinal symptoms of drug dependence are the development of tolerance against drug effects, withdrawal symptoms, drug craving, reduced control over drug intake and harmful consequences of drug consumption. Brain imaging studies support the hypothesis that tolerance development can be understood as a neuroadaptive mechanism to ensure homeostasis during chronic drug intake. When drug consumption is suddenly interrupted during detoxification, the loss of homeostasis can manifest as a withdrawal syndrome. While tolerance development reduces the effects of chronic drug intake, sensitization is a neuroadaptive process that increases the effects of a drug dose. Brain imaging studies indicate that sensitisation and drug craving are associated with neuroadaptive processes in the brain reward system. Harmful consequences of drug intake include neurotoxic effects on the central nervous system. Besides discussing brain imaging studies on the neurobiological correlates of drug dependence, this review also presents studies on vulnerability factors that predispose individuals to excessive drug intake.
神经影像学有助于深入了解药物和酒精依赖背后的主要生物学机制。药物依赖的主要症状包括对药物作用产生耐受性、出现戒断症状、渴望药物、对药物摄入的控制能力下降以及药物消费带来的有害后果。脑成像研究支持这样一种假说,即耐受性的发展可被理解为一种神经适应性机制,以确保在长期药物摄入期间维持体内平衡。在戒毒过程中,如果突然中断药物使用,体内平衡的丧失可能表现为戒断综合征。虽然耐受性的发展会降低长期药物摄入的影响,但敏化作用是一种神经适应性过程,会增强药物剂量的效果。脑成像研究表明,敏化作用和对药物的渴望与大脑奖赏系统中的神经适应性过程有关。药物摄入的有害后果包括对中枢神经系统的神经毒性作用。除了讨论关于药物依赖神经生物学相关性的脑成像研究外,本综述还介绍了关于使个体易出现过度药物摄入的易感性因素的研究。