Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Neurosci Res. 2012 Dec;74(3-4):169-76. doi: 10.1016/j.neures.2012.08.003. Epub 2012 Aug 23.
Acute and chronic consumption of alcohol have direct effects on central nervous system by altering predominantly gamma-aminobutyric acidergic and glutamatergic neurotransmission. Abnormalities in these neurotransmitter systems can be demonstrated by changes in cortical excitability parameters assessed with transcranial magnetic stimulation (TMS). Furthermore, integrated approaches utilizing TMS combined with electroencephalography (EEG) enable the evaluation of the focal effects of alcohol on the human cortex, providing useful information, different from that obtained using other functional brain imaging modalities. Alcohol was found to modulate EEG responses evoked by motor-cortex TMS, predominantly at the right prefrontal cortex, indicating that ethanol alters the functional connectivity between motor and prefrontal areas. Alcohol decreases amplitudes of EEG responses of anterior parts of the cortex after left prefrontal TMS, suggesting a decrease of prefrontal cortical excitability. High-frequency repetitive TMS (rTMS) revealed significant changes in short-term plasticity of the primary motor cortex after acute ethanol intake and in patients with chronic alcohol abuse. TMS findings also support the recently emerged theory that abnormal function of glutamate receptors plays a relevant role in the development of alcohol dependence and manifestation of the alcohol withdrawal syndrome. Finally, initial studies provide evidence that non-invasive brain stimulation techniques (rTMS and transcranial direct current stimulation) might represent a potential therapeutic tool to reduce alcohol craving. Future studies with larger sample size evaluating the clinical effects of these neuromodulatory approaches are required to confirm and extend the preliminary findings.
急性和慢性饮酒通过改变主要的γ-氨基丁酸能和谷氨酸能神经递质传递对中枢神经系统有直接影响。这些神经递质系统的异常可以通过经颅磁刺激（TMS）评估的皮质兴奋性参数的变化来证明。此外，利用 TMS 结合脑电图（EEG）的综合方法可以评估酒精对人类皮质的局部影响，提供有用的信息，与使用其他功能脑成像方式获得的信息不同。研究发现，酒精可调节运动皮质 TMS 诱发的脑电图反应，主要在右前额叶皮层，表明乙醇改变了运动和前额叶区域之间的功能连接。酒精降低了左前额叶 TMS 后皮质前部的脑电图反应幅度，表明前额叶皮质兴奋性降低。高频重复 TMS（rTMS）显示，急性乙醇摄入后初级运动皮质的短期可塑性以及慢性酒精滥用患者的短期可塑性发生了显著变化。TMS 研究结果也支持了最近出现的理论，即谷氨酸受体的异常功能在酒精依赖的发展和酒精戒断综合征的表现中起着重要作用。最后，初步研究提供了证据，表明非侵入性脑刺激技术（rTMS 和经颅直流电刺激）可能是一种潜在的治疗工具，可以减少对酒精的渴望。需要进行更大样本量的未来研究来评估这些神经调节方法的临床效果，以确认和扩展初步发现。
