University of California San Diego, Department of Psychiatry, 8939 Villa La Jolla Drive, Suite 230, La Jolla, CA 92037, USA.
Drug Alcohol Depend. 2013 Aug 1;131(3):238-46. doi: 10.1016/j.drugalcdep.2013.05.029. Epub 2013 Jun 25.
Mechano-receptive C-fiber (MR-CF) stimulation via slow stroking of C-fiber rich skin areas can be used to probe the relationship between reward and interoception. Individuals with substance use disorders show impaired reward processing, and dysfunctional interoceptive processing of MR-CF may contribute to this dysfunction. This study predicted that methamphetamine dependent (MD) individuals would exhibit altered responses to MR-CF stimulation in brain regions important for interoception.
Recently abstinent MD (n=25) and comparison (CTL, n=17) subjects received a pleasant interoceptive stimulus ("Soft Touch" consisting of a slow brush stroke) to the palm or forearm during functional magnetic resonance imaging. Subjects were provided with cues signaling stimulation to examine anticipatory and stimulus-related processing. Subjective responses were measured using visual analog scales (VAS).
Groups were similar on behavioral performance and ratings of the interoceptive stimuli, yet MD exhibited lower anterior insula, dorsal striatum, and thalamus activation than CTL, across anticipation and soft touch conditions. The lower the anterior insula activation, the faster the reaction time across conditions in MD, whereas the opposite pattern was evident in CTL. Striatal activation in MD was greater than CTL during anticipation, but lower during soft touch. Greater striatal attenuation was associated with higher VAS pleasantness ratings of soft touch.
MD expend fewer brain processing resources during soft touch, a form of positively-valenced interoceptive stimuli, in brain areas that are important for both interoception and reward. Future studies will ascertain if sustained abstinence from methamphetamine use can normalize aberrant neural interoceptive processing.
通过对富含 C 纤维的皮肤区域进行缓慢轻抚,对机械敏感的 C 纤维(MR-CF)进行刺激,可用于探究奖励与内脏感觉之间的关系。物质使用障碍患者的奖励加工受损,而对 MR-CF 的内脏感觉加工功能障碍可能促成了这种功能障碍。本研究预测,甲基苯丙胺依赖(MD)个体在对内脏感觉重要的脑区中,对 MR-CF 刺激的反应会发生改变。
最近戒断的 MD(n=25)和对照组(CTL,n=17)个体在功能磁共振成像期间接受手掌或前臂的舒适内脏感觉刺激(“Soft Touch”,由缓慢的刷动组成)。为检查预期和刺激相关的处理,向被试提供了刺激提示。使用视觉模拟量表(VAS)测量主观反应。
两组在行为表现和内脏感觉刺激的评分上相似,但 MD 在预期和软触摸条件下,内侧前脑岛、背侧纹状体和丘脑的激活水平均低于 CTL。MD 个体的内侧前脑岛激活水平越低,各条件下的反应时间越快,而 CTL 则呈现出相反的模式。在预期过程中,MD 的纹状体激活高于 CTL,但在软触摸过程中则相反。纹状体的衰减越大,软触摸的 VAS 愉悦度评分越高。
在对重要的内脏感觉和奖励都很重要的脑区中,MD 个体在软触摸(一种正性内脏感觉刺激)期间消耗的大脑处理资源较少。未来的研究将确定是否可以通过长期戒断甲基苯丙胺来使异常的神经内脏感觉处理正常化。