Buffalari Deanne M, See Ronald E
Department of Neuroscience, Medical University of South Carolina, Charleston, SC 29425, USA.
Curr Top Behav Neurosci. 2010;3:73-99. doi: 10.1007/7854_2009_18.
Psychostimulant addiction often consists of periods of sustained drug abstinence disrupted by periods of relapse and renewed heavy drug use. Prevention of relapse remains the greatest challenge to the successful treatment of drug addiction. Drug-associated cues are a primary trigger for relapse, as they can elicit intense craving for the drug. These cues become associated with the drug reward through Pavlovian learning processes that develop over multiple drug-cue pairings. The amygdala (AMY) is critical for such drug-related learning. Intrinsic and extrinsic circuitry position the AMY to integrate cue and drug-related information and influence drug-seeking and drug-taking behaviors. Animal models of conditioned drug reward, drug use, and relapse have confirmed the necessary role of the AMY for drug conditioned cues to control motivated behavior. Neurons within the AMY are responsive to the primary effects of psychostimulants, and more critically, they also respond to the presentation of drug-associated cues. The mechanisms by which conditioned cues come to influence drug-seeking behavior likely involve long-term plasticity and neuroadaptations within the AMY. A greater understanding of the associative learning mechanisms that depend upon the AMY and related limbic and cortical structures, and the process by which drug cues come to gain control over behavior that maintains the addictive state, will facilitate the development of more effective addiction treatments.
精神兴奋剂成瘾通常包括持续戒毒期,期间会被复发期和再次大量用药期打断。预防复发仍然是成功治疗药物成瘾的最大挑战。与药物相关的线索是复发的主要诱因,因为它们会引发对药物的强烈渴望。通过在多次药物-线索配对中形成的巴甫洛夫学习过程,这些线索与药物奖赏联系在一起。杏仁核(AMY)对于此类与药物相关的学习至关重要。内在和外在神经回路使杏仁核能够整合线索和与药物相关的信息,并影响觅药和用药行为。条件性药物奖赏、药物使用和复发的动物模型已经证实了杏仁核对药物条件线索控制动机行为的必要作用。杏仁核内的神经元对精神兴奋剂的主要作用有反应,更关键的是,它们也对药物相关线索的呈现做出反应。条件线索影响觅药行为的机制可能涉及杏仁核内的长期可塑性和神经适应性。更深入地了解依赖杏仁核及相关边缘和皮质结构的联想学习机制,以及药物线索对维持成瘾状态行为的控制过程,将有助于开发更有效的成瘾治疗方法。