Center for Imaging of Neurodegenerative Diseases (114M), San Francisco Veterans Administration Medical Center, San Francisco, California 94121, USA.
J Stud Alcohol Drugs. 2010 Mar;71(2):278-89. doi: 10.15288/jsad.2010.71.278.
This study compared baseline metabolite levels in components of the brain reward system among individuals who remained abstinent and those who resumed hazardous alcohol consumption after treatment for alcohol dependence.
Fifty-one treatment-seeking alcohol-dependent individuals (abstinent for approximately 7 days [SD = 3]) and 26 light-drinking nonsmoking controls completed 1.5-T proton magnetic resonance spectroscopic imaging, yielding regional concentrations of N-acetylaspartate, choline-containing compounds, creatine-containing compounds, and myoinositol. Metabolite levels were obtained in the following component of the brain reward system: dorsolateral prefrontal cortex, anterior cingulate cortex, insula, superior corona radiata, and cerebellar vermis. Alcohol-dependent participants were followed over a 12-month period after baseline study (i.e., at 7 days of abstinence [SD = 3]) and were classified as abstainers (no alcohol consumption; n = 18) and resumers (any alcohol consumption; n = 33) at follow-up. Baseline metabolite levels in abstainers and resumers and light-drinking nonsmoking controls were compared in the above regions of interest.
Resumers demonstrated significantly lower baseline N-acetylaspartate concentrations than light-drinking nonsmoking controls and abstainers in all regions of interest. Resumers also exhibited lower creatine-containing-compound concentrations than abstainers in the dorsolateral prefrontal cortex, superior corona radiata, and cerebellar vermis. Abstainers did not differ from light-drinking nonsmoking controls on baseline metabolite concentrations in any region of interest.
The significantly decreased N-acetylaspartate and creatine-containing-compound concentrations in resumers suggest compromised neuronal integrity and abnormalities in cellular bioenergetics in major neocortical components and white-matter interconnectivity of the brain reward pathway. The lack of metabolite differences between abstainers and light-drinking nonsmoking controls suggests premorbid factors potentially contributed to the baseline brain metabolite abnormalities observed in resumers.
本研究比较了酒精依赖治疗后继续戒酒和重新开始危险饮酒个体的大脑奖励系统各成分的基线代谢物水平。
51 名寻求治疗的酒精依赖个体（戒酒约 7 天[SD=3]）和 26 名轻度饮酒不吸烟的对照者完成了 1.5-T 质子磁共振波谱成像，得出了 N-乙酰天冬氨酸、含胆碱化合物、肌酸化合物和肌醇的区域浓度。在大脑奖励系统的以下组成部分中获得了代谢物水平：背外侧前额叶皮质、前扣带皮质、脑岛、上放射冠和小脑蚓部。在基线研究后（即，在戒酒的第 7 天[SD=3]）对酒精依赖参与者进行了为期 12 个月的随访，并在随访时将他们分类为戒酒者（无饮酒；n=18）和重新饮酒者（任何饮酒；n=33）。在上述感兴趣区域比较了戒酒者和重新饮酒者以及轻度饮酒不吸烟者对照者的基线代谢物水平。
重新饮酒者在所有感兴趣区域的基线 N-乙酰天冬氨酸浓度均显著低于轻度饮酒不吸烟者对照者和戒酒者。重新饮酒者在背外侧前额叶皮质、上放射冠和小脑蚓部的肌酸化合物浓度也低于戒酒者。戒酒者在任何感兴趣区域的基线代谢物浓度均与轻度饮酒不吸烟者对照者无差异。
重新饮酒者的 N-乙酰天冬氨酸和肌酸化合物浓度显著降低，表明大脑奖励通路的主要新皮质成分和白质连接的神经元完整性受损和细胞能量代谢异常。戒酒者与轻度饮酒不吸烟者对照者之间代谢物差异缺乏表明，发病前因素可能导致重新饮酒者观察到的基线大脑代谢物异常。
