Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, P. O. box 12 21 20, 68072 Mannheim, Germany.
Eur Arch Psychiatry Clin Neurosci. 2013 Apr;263(3):197-203. doi: 10.1007/s00406-012-0319-6. Epub 2012 May 9.
Experimental social neuroscience has shown that being socially excluded is processed in the anterior cingulate cortex (ACC). We hypothesize that a chronic form of social exclusion resembling one aspect of social stigmatization is associated with altered neural plasticity reflected by neurometabolic alterations in the ACC. To test this hypothesis, a highly stigmatized patient group of heroin addicts (N = 15) during opiate maintenance therapy rated a questionnaire about being stigmatized, and neurometabolic markers in the ACC were determined using (1)H MR spectroscopy. We found a negative correlation between discrimination experience and N-acetylaspartate (NAA), indicating attenuated neuron functioning in the anterior cingulate cortex in those patients reporting high discrimination experience. Furthermore, perceived stigmatization showed an association with anxiety that was mediated by NAA. Although the correlative analysis cannot give evidence for a causal relationship, the relation of NAA in the ACC and discrimination experience indicates a malfunction of the neural system involved in cognitive control over emotionally relevant social stimuli in discrimination reporting heroin addicts. Further research is needed to elucidate factors associated with chronic stigmatization.
实验社会神经科学表明，社会排斥是在前扣带皮层（ACC）中进行处理的。我们假设，一种类似于社会污名化的慢性社会排斥形式与 ACC 中的神经代谢改变所反映的神经可塑性改变有关。为了验证这一假设，我们对接受阿片类药物维持治疗的海洛因成瘾者（N=15）这一高度污名化的患者群体进行了一项关于被污名化的问卷调查，并使用（1）H 磁共振波谱（1H MRS）来测定 ACC 中的神经代谢标志物。我们发现，歧视体验与 N-乙酰天门冬氨酸（NAA）呈负相关，这表明那些报告高歧视体验的患者的前扣带皮层的神经元功能减弱。此外，感知到的污名化与焦虑有关，而 NAA 介导了这种关系。虽然相关分析不能证明因果关系，但 ACC 中的 NAA 与歧视体验之间的关系表明，在报告海洛因成瘾者的歧视时，参与认知控制情绪相关社会刺激的神经系统出现了功能障碍。需要进一步的研究来阐明与慢性污名化相关的因素。
