Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Alcohol Clin Exp Res. 2011 Oct;35(10):1771-93. doi: 10.1111/j.1530-0277.2011.01540.x. Epub 2011 Jul 20.
Imaging techniques have been in widespread use in the scientific community for more than 3 decades. They facilitate noninvasive, in vivo studies of the human brain in both healthy and diseased persons. These brain-imaging techniques have contributed significantly to our understanding of the effects of alcohol abuse and dependence on structural and functional changes in the human brain. A systematic review summarizing these contributions has not previously been conducted, and this is the goal of the current paper.
The databases PubMed, PsycINFO, and PSYNDEX were searched using central key words. Fulfilling the inclusion criteria were 140 functional and structural imaging studies, together comprising data from more than 7,000 patients and controls. The structural imaging techniques we considered were cranial computerized tomography and various magnetic resonance imaging-based techniques, including voxel-based morphometry, deformation-based morphometry, diffusion tensor magnetic resonance imaging, and diffusion-weighted magnetic resonance imaging. The functional methods considered were magnetic resonance spectroscopy, positron emission tomography, single photon emission computed tomography, and functional magnetic resonance imaging.
Results from studies using structural imaging techniques have revealed that chronic alcohol use is accompanied by volume reductions of gray and white matter, as well as microstructural disruption of various white matter tracts. These changes are partially reversible following abstinence. Results from functional imaging methods have revealed metabolic changes in the brain, lower glucose metabolism, and disruptions of the balance of neurotransmitter systems. Additionally, functional imaging methods have revealed increased brain activity in the mesocorticolimbic system in response to alcohol-themed pictures relative to nondrug-associated stimuli, which might be of predictive value with regard to relapse.
There has been tremendous progress in the development of imaging technologies. Use of these technologies has clearly demonstrated the structural and functional brain abnormalities that can occur with chronic alcohol use. The study of the alcoholic brain provides an heuristic model which furthers our understanding of neurodegenerative changes in general, as well as their partial reversibility with sustained abstinence. Additionally, functional imaging is poised to become an important tool for generating predictions about individual brain functioning, which can then be used as a basis for personalized medicine.
影像学技术在科学界已经广泛应用了 30 多年。它们促进了对健康人和患者大脑的非侵入性、体内研究。这些脑成像技术极大地促进了我们对酗酒和依赖对人脑结构和功能变化的影响的理解。以前没有进行过总结这些贡献的系统综述，这也是当前论文的目标。
使用中心关键词在 PubMed、PsycINFO 和 PSYNDEX 数据库中进行搜索。符合纳入标准的是 140 项功能和结构成像研究，共包括 7000 多名患者和对照者的数据。我们考虑的结构成像技术包括颅计算机断层扫描和各种基于磁共振成像的技术，包括基于体素的形态测量学、基于变形的形态测量学、弥散张量磁共振成像和弥散加权磁共振成像。考虑的功能方法包括磁共振波谱学、正电子发射断层扫描、单光子发射计算机断层扫描和功能磁共振成像。
使用结构成像技术的研究结果表明，慢性酒精使用伴随着灰质和白质体积的减少，以及各种白质束的微观结构中断。这些变化在禁欲后部分是可逆的。功能成像方法的结果表明大脑代谢变化，葡萄糖代谢降低，神经递质系统平衡中断。此外，功能成像方法还显示，与非药物相关刺激相比，酒精主题图片会引起中脑边缘奖赏系统的大脑活动增加，这可能对复发具有预测价值。
成像技术的发展取得了巨大进展。这些技术的使用清楚地表明，慢性酒精使用会导致大脑的结构和功能异常。对酒精性大脑的研究提供了一个启发式模型，进一步加深了我们对神经退行性变化的理解，以及它们在持续禁欲后的部分可逆性。此外，功能成像有望成为预测个体大脑功能的重要工具，然后可以将其用作个性化医疗的基础。
