Dept of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, J5, 68159 Mannheim, Germany.
Horm Behav. 2011 Nov;60(5):644-50. doi: 10.1016/j.yhbeh.2011.08.017. Epub 2011 Sep 16.
There is growing evidence from preclinical studies for an involvement of orexins (ORX) in the regulation of stress, affectivity and addictive behavior. The aim of our study was to gather corresponding clinical data and to elucidate the relationships between alcohol withdrawal stress, ORX plasma concentration and psychopathology. A consecutive sample of thirty-four alcohol-dependent inpatients was included in the study. Blood was drawn at onset of withdrawal and following 2 weeks of controlled abstinence in order to assess ORX, ACTH and cortisol plasma concentrations. In parallel, we assessed clinically relevant psychological distress symptoms applying the Brief Symptom Inventory (BSI). We found a significant positive correlation between ORX and global distress indices of the BSI (p ≤ 0.05). In a regression model, ORX concentration during acute withdrawal explained 24% of the variance of symptom severity (p<0.01). No association with craving, ACTH or cortisol plasma concentration was detected. Our results suggest an involvement of ORX in the affective dysregulation seen commonly in alcohol dependent patients during alcohol withdrawal. Moreover, the effects on global distress indices as well as the earlier studied effects on reinstatement of drug seeking behaviors may point on an involvement of ORX in impaired brain stress systems.
越来越多的临床前研究证据表明，食欲素（ORX）参与了应激、情感和成瘾行为的调节。我们的研究旨在收集相应的临床数据，并阐明酒精戒断应激、ORX 血浆浓度与精神病理学之间的关系。本研究纳入了 34 名连续的酒精依赖住院患者。在戒断开始时和 2 周的受控禁欲后抽取血液，以评估 ORX、ACTH 和皮质醇的血浆浓度。同时，我们应用简明症状量表（BSI）评估了相关的临床心理困扰症状。我们发现 ORX 与 BSI 的总体困扰指数呈显著正相关（p≤0.05）。在回归模型中，急性戒断期间的 ORX 浓度可以解释症状严重程度 24%的差异（p<0.01）。未发现与渴求、ACTH 或皮质醇血浆浓度有关。我们的研究结果表明，ORX 参与了酒精依赖患者在酒精戒断期间常见的情感失调。此外，对整体困扰指数的影响以及之前研究中对药物寻求行为复燃的影响可能表明 ORX 参与了受损的大脑应激系统。
