奖赏相关脑反应与大麻线索暴露的渴求相关物：一项寻求治疗的大麻依赖受试者的初步研究。
Reward-related brain response and craving correlates of marijuana cue exposure: a preliminary study in treatment-seeking marijuana-dependent subjects.
机构信息
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
出版信息
J Addict Med. 2013 Jan-Feb;7(1):8-16. doi: 10.1097/ADM.0b013e318273863a.
OBJECTIVE
: Determining the brain substrates underlying the motivation to abuse addictive drugs is critical for understanding and treating addictive disorders. Laboratory neuroimaging studies have demonstrated differential activation of limbic and motivational circuitry (eg, amygdala, hippocampus, ventral striatum, insula, and orbitofrontal cortex) triggered by cocaine, heroin, nicotine, and alcohol cues. The literature on neural responses to marijuana cues is sparse. Thus, the goals of this study were to characterize the brain's response to marijuana cues, a major motivator underlying drug use and relapse, and determine whether these responses are linked to self-reported craving in a clinically relevant population of treatment-seeking marijuana-dependent subjects.
METHODS
: Marijuana craving was assessed in 12 marijuana-dependent subjects using the Marijuana Craving Questionnaire-Short Form. Subsequently, blood oxygen level dependent functional magnetic resonance imaging data were acquired during exposure to alternating 20-second blocks of marijuana-related versus matched nondrug visual cues.
RESULTS
: Brain activation during marijuana cue exposure was significantly greater in the bilateral amygdala and the hippocampus. Significant positive correlations between craving scores and brain activation were found in the ventral striatum and the medial and lateral orbitofrontal cortex (P < 0.0001).
CONCLUSIONS
: This study presents direct evidence for a link between reward-relevant brain responses to marijuana cues and craving and extends the current literature on marijuana cue reactivity. Furthermore, the correlative relationship between craving and brain activity in reward-related regions was observed in a clinically relevant sample (treatment-seeking marijuana-dependent subjects). Results are consistent with prior findings in cocaine, heroin, nicotine, and alcohol cue studies, indicating that the brain substrates of cue-triggered drug motivation are shared across abused substances.
目的
确定导致滥用成瘾性药物的大脑基质对于理解和治疗成瘾障碍至关重要。实验室神经影像学研究表明，可卡因、海洛因、尼古丁和酒精线索会引发边缘和动机回路（例如杏仁核、海马体、腹侧纹状体、脑岛和眶额皮层）的不同激活。关于大麻线索引起的神经反应的文献很少。因此，本研究的目的是描述大麻线索引起的大脑反应，大麻线索是药物使用和复发的主要动机，并确定这些反应是否与寻求治疗的大麻依赖患者的临床相关人群中自我报告的渴望有关。
方法
使用大麻渴望问卷短表评估 12 名大麻依赖者的大麻渴望。随后，在暴露于大麻相关和匹配的非药物视觉线索的 20 秒交替块期间，获取血氧水平依赖功能磁共振成像数据。
结果
在双侧杏仁核和海马体中，大麻线索暴露期间的大脑激活明显更大。在腹侧纹状体和内侧和外侧眶额皮层中，发现渴望评分与大脑激活之间存在显著的正相关（P < 0.0001）。
结论
本研究提供了直接证据，证明大麻线索引起的与奖励相关的大脑反应与渴望之间存在联系，并扩展了大麻线索反应性的现有文献。此外，在临床相关样本（寻求治疗的大麻依赖者）中观察到渴望和与奖励相关区域的大脑活动之间的相关关系。结果与可卡因、海洛因、尼古丁和酒精线索研究中的先前发现一致，表明线索触发的药物动机的大脑基质在滥用物质中是共享的。
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