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戒断多药滥用者的大脑皮质和皮质下脑区的代谢异常:磁共振波谱成像。

Metabolic abnormalities in lobar and subcortical brain regions of abstinent polysubstance users: magnetic resonance spectroscopic imaging.

机构信息

Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.

出版信息

Alcohol Alcohol. 2013 Sep-Oct;48(5):543-51. doi: 10.1093/alcalc/agt056. Epub 2013 Jun 23.

Abstract

AIMS

The aim of the study was to explore neurometabolic and associated cognitive characteristics of patients with polysubstance use (PSU) in comparison with patients with predominant alcohol use using proton magnetic resonance spectroscopy.

METHODS

Brain metabolite concentrations were examined in lobar and subcortical brain regions of three age-matched groups: 1-month-abstinent alcohol-dependent PSU, 1-month-abstinent individuals dependent on alcohol alone (ALC) and light drinking controls (CON). Neuropsychological testing assessed cognitive function.

RESULTS

While CON and ALC had similar metabolite levels, persistent metabolic abnormalities (primarily higher myo-inositol) were present in temporal gray matter, cerebellar vermis and lenticular nuclei of PSU. Moreover, lower cortical gray matter concentration of the neuronal marker N-acetylaspartate within PSU correlated with higher cocaine (but not alcohol) use quantities and with a reduced cognitive processing speed.

CONCLUSIONS

These metabolite group differences reflect cellular/astroglial injury and/or dysfunction in alcohol-dependent PSU. Associations of other metabolite concentrations with neurocognitive performance suggest their functional relevance. The metabolic alterations in PSU may represent polydrug abuse biomarkers and/or potential targets for pharmacological and behavioral PSU-specific treatment.

摘要

目的

本研究旨在使用质子磁共振波谱(proton magnetic resonance spectroscopy),探索多种物质使用(polysubstance use,PSU)患者与主要使用酒精的患者之间的神经代谢和相关认知特征。

方法

对三组年龄匹配的患者的脑内代谢物浓度进行了研究:1 个月戒断的酒精依赖 PSU 患者、1 个月戒断的单纯酒精依赖(ALC)患者和少量饮酒对照(CON)。神经心理学测试评估了认知功能。

结果

CON 和 ALC 的代谢物水平相似,而 PSU 患者的颞叶灰质、小脑蚓部和豆状核仍存在持续的代谢异常(主要是更高的肌醇)。此外,PSU 患者皮质灰质中神经元标志物 N-乙酰天门冬氨酸的浓度较低,与可卡因(而非酒精)使用量较高以及认知加工速度降低有关。

结论

这些代谢物组的差异反映了酒精依赖 PSU 患者的细胞/星形胶质细胞损伤和/或功能障碍。其他代谢物浓度与神经认知表现的相关性表明了它们的功能相关性。PSU 中的代谢改变可能代表多药滥用的生物标志物,以及药物治疗和行为 PSU 特异性治疗的潜在靶点。

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