Paulus Martin P, Stewart Jennifer L, Haase Lori
Department of Psychiatry, University of California San Diego , La Jolla, CA , USA ; Psychiatry Service, VA San Diego Healthcare System , La Jolla, CA , USA.
Front Psychiatry. 2013 Oct 18;4:137. doi: 10.3389/fpsyt.2013.00137.
There is emerging evidence that individuals with drug addiction have dysfunctions in brain systems that are important for interoceptive processing, which include, among others, the insular and the anterior cingulate cortices. These individuals may not be expending sufficient neural resources to process perturbations of the interoceptive state but may exert over-activation of these systems when processing drug-related stimuli. As a consequence, insufficient detection and processing of interoceptive state changes may result in inadequate anticipation and preparation to adapt to environmental challenges, e.g., adapt to abstinence in the presence of withdrawal symptoms. Here, we integrate interoceptive dysfunction in drug-addicted individuals, with the neural basis for meditation and exercise to develop a heuristic to target the interoceptive system as potential treatments for drug addiction. First, it is suggested that mindfulness-based approaches can modulate both interoceptive function and insular activation patterns. Second, there is an emerging literature showing that the regulation of physical exercise in the brain involves the insula and anterior cingulate cortex and that intense physical exercise is associated with a insula changes that may provide a window to attenuate the increased interoceptive response to drug-related stimuli. It is concluded that the conceptual framework of interoceptive dysfunctions in drug addiction and the experimental findings in meditation and exercise provide a useful approach to develop new interventions for drug addiction.
越来越多的证据表明，药物成瘾者大脑中对内感受处理至关重要的系统存在功能障碍，其中包括脑岛和前扣带回皮层等。这些个体可能没有投入足够的神经资源来处理内感受状态的扰动，但在处理与药物相关的刺激时，这些系统可能会过度激活。因此，对内感受状态变化的检测和处理不足可能导致对环境挑战的预期和准备不足，例如在出现戒断症状时适应戒断。在此，我们将药物成瘾个体的内感受功能障碍与冥想和运动的神经基础相结合，以开发一种启发式方法，将内感受系统作为药物成瘾的潜在治疗靶点。首先，有人提出基于正念的方法可以调节内感受功能和脑岛激活模式。其次，越来越多的文献表明，大脑中体育锻炼的调节涉及脑岛和前扣带回皮层，剧烈的体育锻炼与脑岛变化有关，这可能为减弱对与药物相关刺激的内感受反应增加提供一个窗口。得出的结论是，药物成瘾中内感受功能障碍的概念框架以及冥想和运动的实验结果为开发药物成瘾的新干预措施提供了一种有用的方法。
