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纹状体功能障碍标志着先前存在的风险,而内侧前额叶功能障碍与酗酒者子女的问题饮酒有关。

Striatal dysfunction marks preexisting risk and medial prefrontal dysfunction is related to problem drinking in children of alcoholics.

机构信息

Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

Biol Psychiatry. 2010 Aug 1;68(3):287-95. doi: 10.1016/j.biopsych.2010.02.020. Epub 2010 Apr 22.

Abstract

BACKGROUND

Parental alcoholism substantially raises risk for offspring alcoholism, an effect thought to be mediated by a dysregulation in impulse control. Adult alcoholics have alterations in the frontostriatal system involved in regulating impulsive responses. However, it remains controversial whether these alterations reflect preexisting traits predisposing to problem alcohol use or are secondary to alcohol involvement.

METHODS

Sixty-one 16 to 22 year olds were tested using a go/no-go task during functional magnetic resonance imaging. Forty-one were family history positive (FH+), having at least one parent with a diagnosis of alcohol use disorder (AUD), and 20 were family history negative (FH-). Two FH+ subgroups were created to disentangle alcohol involvement from preexisting risk: the FH+ control group (n = 20) had low alcohol problems, differing from the FH- group only by family history. The FH+ problem group (n = 21) had high alcohol problems.

RESULTS

The ventral caudate deactivated during successful inhibition in the FH- but not the FH+ groups, regardless of problem alcohol involvement. Regression analyses showed that ventral caudate deactivation was related to fewer externalizing problems as well as to family history. Orbital and left medial prefrontal regions were deactivated in both the FH- and FH+ control groups but not the FH+ problem group. Activation in these regions was associated with alcohol and other drug use.

CONCLUSIONS

These findings suggest a preexisting abnormality in ventral striatal function in youth at risk for AUD, which may lead to inappropriate motivational responding, and suggest that with alcohol use, the prefrontal "control" mechanism loses efficiency, further dysregulating the frontostriatal motivational circuitry.

摘要

背景

父母酗酒会极大地增加子女酗酒的风险,这种效应被认为是通过冲动控制失调来介导的。成年酗酒者的额眶额皮质-纹状体系统发生改变,而该系统参与调节冲动反应。然而,这些改变是否反映了导致问题性饮酒的预先存在的特征,或者是酒精摄入的继发效应,仍存在争议。

方法

61 名 16 至 22 岁的个体在进行功能磁共振成像时接受了 Go/No-Go 任务测试。其中 41 名个体有家族酗酒史(FH+),即至少有一位父母被诊断为酒精使用障碍(AUD),20 名个体无家族酗酒史(FH-)。为了区分酒精摄入和预先存在的风险,创建了两个 FH+亚组:FH+对照组(n = 20)的酒精问题较低,仅与 FH-组存在家族史差异。FH+问题组(n = 21)的酒精问题较高。

结果

在 FH-组中,腹侧尾状核在成功抑制时失活,但在 FH+组中却没有,无论是否存在酒精问题。回归分析表明,腹侧尾状核失活与较少的外化问题以及家族史有关。眶额和左侧内侧前额叶区域在 FH-和 FH+对照组中失活,但在 FH+问题组中没有失活。这些区域的激活与酒精和其他药物的使用有关。

结论

这些发现表明,AUD 风险青少年的腹侧纹状体功能存在预先存在的异常,这可能导致不适当的动机反应,并表明随着酒精的使用,前额叶“控制”机制的效率降低,进一步扰乱了额眶额皮质-纹状体的动机回路。

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