Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
Neurosci Biobehav Rev. 2013 Nov;37(9 Pt A):2037-46. doi: 10.1016/j.neubiorev.2013.04.007. Epub 2013 Apr 27.
Cocaine remains one of the most addictive substances of abuse and one of the most difficult to treat. Although increasingly sophisticated experimental and technologic advancements in the last several decades have yielded a large body of clinical and preclinical knowledge on the direct effects of cocaine on the brain, we still have a relatively incomplete understanding of the neurobiological processes that occur when drug use is discontinued. The goal of this manuscript is to review both clinical and preclinical data related to abstinence from cocaine and discuss the complementary conclusions that emerge from these different levels of inquiry. This commentary will address observed alterations in neural function, neural structure, and neurotransmitter system regulation that are present in both animal models of cocaine abstinence and data from recovering clinical populations. Although these different levels of inquiry are often challenging to integrate, emerging data discussed in this commentary suggest that from a structural and functional perspective, the preservation of cortical function that is perhaps the most important biomarker associated with extended abstinence from cocaine.
可卡因仍然是最容易使人上瘾的滥用物质之一，也是最难治疗的物质之一。尽管在过去几十年中，实验和技术的不断进步为可卡因对大脑的直接影响提供了大量的临床和临床前知识，但我们仍然对药物戒断时发生的神经生物学过程的了解相对不完整。本文的目的是回顾与可卡因戒断相关的临床和临床前数据，并讨论这些不同层次的研究得出的补充结论。本评论将讨论在可卡因戒断的动物模型和来自康复临床人群的数据中存在的神经功能、神经结构和神经递质系统调节的观察到的改变。虽然这些不同层次的研究通常很难整合，但本评论中讨论的新数据表明，从结构和功能的角度来看，皮质功能的保留可能是与延长可卡因戒断最相关的最重要的生物标志物。
