Economidou Daina, Pelloux Yann, Robbins Trevor W, Dalley Jeffrey W, Everitt Barry J
Behavioral and Clinical Neuroscience Institute, University of Cambridge, Downing St, Cambridge CB2 3EB, United Kingdom.
Biol Psychiatry. 2009 May 15;65(10):851-6. doi: 10.1016/j.biopsych.2008.12.008. Epub 2009 Feb 1.
Relapse is a hallmark feature of cocaine addiction and a main challenge for treatment strategies. Human studies indicate a link between impulsivity and increased susceptibility to relapse.
Rats were screened for high (HI) and low impulsivity (LI) on the 5-choice serial reaction time task. The HI and LI rats were trained to self-administer cocaine under a seeking-taking chained schedule: responses on the seeking lever resulted in presentation of the taking lever, responding upon which resulted in cocaine reinforcement. After the establishment of stable responding, an intermittent punishment schedule was introduced: completion of the seeking link resulted in the random presentation of either the taking lever or a mild footshock. This resulted in a progressive decrease in cocaine-seeking approaching abstinence. Relapse was assessed 7 days after punishment, during which responding on the seeking lever resulted in the presentation of the cocaine-associated stimuli (i.e., in the absence of cocaine or footshock).
The HI and LI animals significantly reinstated the cocaine-seeking response after a single phase of seeking punishment. However, after a second punishment phase only the HI rats reinitiated suppressed seeking responses and relapsed, an effect that was facilitated by prior extended cocaine access. In a preliminary study we found that the selective noradrenaline reuptake inhibitor, atomoxetine, a drug known to reduce impulsivity, prevented the reinstatement of cocaine-seeking.
Impulsivity pre-dating drug abuse increases the susceptibility to relapse after abstinence. Medications targeting impulsivity might have utility as treatment interventions for relapse prevention and the promotion of abstinence.
复吸是可卡因成瘾的一个标志性特征,也是治疗策略面临的主要挑战。人体研究表明冲动性与复吸易感性增加之间存在联系。
在5选择连续反应时任务中对大鼠进行高冲动性(HI)和低冲动性(LI)筛选。HI和LI大鼠在寻求 - 获取链式程序下接受可卡因自我给药训练:在寻求杆上的反应会导致呈现获取杆,对获取杆的反应会导致可卡因强化。在建立稳定反应后,引入间歇性惩罚程序:完成寻求环节会随机呈现获取杆或轻度足部电击。这导致寻求可卡因行为逐渐减少,接近戒断状态。在惩罚7天后评估复吸情况,在此期间,在寻求杆上的反应会导致呈现与可卡因相关的刺激(即,在没有可卡因或足部电击的情况下)。
HI和LI动物在单一阶段的寻求惩罚后显著恢复了寻求可卡因的反应。然而,在第二个惩罚阶段后,只有HI大鼠重新开始抑制的寻求反应并复吸,先前延长的可卡因获取促进了这种效应。在一项初步研究中,我们发现选择性去甲肾上腺素再摄取抑制剂托莫西汀(一种已知可降低冲动性的药物)可防止寻求可卡因行为的恢复。
药物滥用之前的冲动性会增加戒断后复吸的易感性。针对冲动性的药物可能作为预防复吸和促进戒断的治疗干预措施具有效用。