Department of Psychopharmacology, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Addict Biol. 2009 Sep;14(4):384-96. doi: 10.1111/j.1369-1600.2009.00177.x.
Upon prolonged alcohol exposure, the behaviour of an individual can gradually switch from controlled to compulsive. Our review is focused on the neurobiological mechanisms that might underlie this transition as well as the factors that are influencing it. Animal studies suggest that temporally increased alcohol consumption during post-abstinence drinking is accompanied by a loss of flexibility of the behaviour and therefore, could serve as a model for compulsive alcohol drinking. However, studies using different alcohol-preferring rat lines in the post-abstinence drinking model suggest that high alcohol consumption does not necessarily lead to the development of compulsive drinking. This indicates the significance of genetic predisposition to compulsive behaviour. Neuroimaging data show that chronic alcohol consumption affects the activity of several brain regions such as the extrapyramidal motor system and several areas of the prefrontal cortex including the orbitofrontal and anterior cingulate cortex. Similar changes in brain activity is seen in patients suffering from obsessive-compulsive disorder at baseline conditions and during provocation of obsessive thoughts and urge to perform compulsive-like rituals. This indicates that dysfunction of these regions may be responsible for the expression of compulsive components of alcohol drinking behaviour. Several brain neurotransmitter systems seem to be responsible for the switch from controlled to compulsive behaviour. In particular, hypofunctioning of monoaminergic systems and hyperfunctioning of glutamatergic systems may play a role in compulsive alcohol drinking.
在长期饮酒后，个体的行为可能会逐渐从自控转变为强迫。我们的综述重点关注可能导致这种转变的神经生物学机制以及影响这种转变的因素。动物研究表明，在戒酒后的饮酒期间，时间上增加的酒精消费伴随着行为灵活性的丧失，因此可以作为强迫性饮酒的模型。然而，使用不同的酒精偏好大鼠品系在戒酒后饮酒模型中的研究表明，高酒精消费不一定会导致强迫性饮酒的发展。这表明强迫性行为的遗传易感性的重要性。神经影像学数据显示，慢性酒精消费会影响大脑的几个区域的活动，如锥体外系运动系统和前额叶皮层的几个区域，包括眶额皮质和前扣带皮层。在基线条件下和在引起强迫性思维和冲动进行强迫性行为的诱发下，患有强迫症的患者也会出现类似的大脑活动变化。这表明这些区域的功能障碍可能是导致酒精饮酒行为强迫成分表达的原因。几个脑神经递质系统似乎负责从自控行为到强迫行为的转变。特别是单胺能系统的功能低下和谷氨酸能系统的功能亢进可能在强迫性饮酒中起作用。
