Contreras M, Ceric F, Torrealba F
Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Neurol. 2008;47(9):471-6.
According to the model of emotions, feelings have their origin in the conscious perception of body changes produced in response to an emotional stimulus. These changes are perceived thanks to the fact that they are represented in the brain by the interoceptive system. During abstinence, addicts experience intense feelings of ill-being that drive them to consume drugs. The purpose of this review is to discuss the role played by the interoceptive system, and more especially the insular cortex, in the perception of the negative feelings that characterise abstinence.
The continuous processing of interoceptive signals in the insular cortex is what accounts for the conscious appreciation of the body changes that accompany an emotional state. Temporary inactivation of the insular cortex suppresses the search for drugs in addicted rats. Neuroimaging studies reveal an increase in the neuronal activity in the insular cortex and in other areas of the brain while addicts are experiencing the craving to consume drugs. Likewise, nicotine addicts who suffer a brain injury that affects the insular cortex give up smoking easily because they lose the desire to do it. The temporary suppression of neuronal activity in the insular cortex in human addicts by means of non-invasive techniques could be a new therapy to treat the craving to consume drugs.
The insular cortex is essential in the perception of the emotional states and in orienting behaviour to match the needs of the body. New therapies that have the insular cortex as their target could be developed to mitigate craving.
根据情绪模型，情感源于对因情绪刺激而产生的身体变化的有意识感知。由于这些变化通过内感受系统在大脑中得以呈现，所以它们能够被感知到。在戒断期间，成瘾者会体验到强烈的不适感受，这驱使他们去吸食毒品。本综述的目的是探讨内感受系统，尤其是岛叶皮质，在感知戒断特征性负面情绪中所起的作用。
岛叶皮质对内感受信号的持续处理，解释了对伴随情绪状态的身体变化的有意识认知。暂时使岛叶皮质失活会抑制成瘾大鼠对毒品的寻觅。神经影像学研究显示，当成瘾者渴望吸食毒品时，岛叶皮质及大脑其他区域的神经元活动会增强。同样，患有影响岛叶皮质的脑损伤的尼古丁成瘾者会轻易戒烟，因为他们失去了吸烟的欲望。通过非侵入性技术暂时抑制人类成瘾者岛叶皮质中的神经元活动，可能成为一种治疗毒品渴望的新疗法。
岛叶皮质在感知情绪状态以及引导行为以满足身体需求方面至关重要。可以开发以岛叶皮质为靶点的新疗法来减轻渴望。
