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早期禁欲期可卡因成瘾女性的神经营养因子:早年生活应激的作用

Neurotrophic factors in women with crack cocaine dependence during early abstinence: the role of early life stress.

作者信息

Viola Thiago W, Tractenberg Saulo G, Levandowski Mateus Luz, Pezzi Júlio Carlos, Bauer Moisés Evandro, Teixeira Antonio Lúcio, Grassi-Oliveira Rodrigo

机构信息

Centre of Studies and Research in Traumatic Stress, Post-Graduate Program in Psychology, Pontifical Catholic University of the Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

Post-Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.

出版信息

J Psychiatry Neurosci. 2014 May;39(3):206-14. doi: 10.1503/jpn.130027.

Abstract

BACKGROUND

Neurotrophic factors have been investigated in the pathophysiology of alcohol and drug dependence and have been related to early life stress driving developmental programming of neuroendocrine systems.

METHODS

We conducted a follow-up study that aimed to assess the plasma levels of glial cell line-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin-3 (NT3) and neurotrophin-4/5 (NT4/5) in crack users during 3 weeks of early abstinence in comparison with healthy controls. We performed a comprehensive clinical assessment in female inpatients with crack cocaine dependence (separated into 2 groups: participants with (CSA+) and without (CSA-) a history of childhood sexual abuse) and a group of nonuser control participants.

RESULTS

Our sample included 104 women with crack cocaine dependence and 22 controls; of the women who used crack cocaine, 22 had a history of childhood sexual abuse and 82 did not. The GDNF plasma levels in the CSA+ group increased dramatically during 3 weeks of detoxification. In contrast, those in the CSA- group showed lower and stable levels of GDNF under the same conditions. Compared with the control group, BDNF plasma levels remained elevated and NGF levels were reduced during early abstinence. We found no differences in NT3 and NT4/5 between the patients and controls. However, within-group analyses showed that the CSA+ group exhibited higher levels of NT4/5 than the CSA- group at the end of detoxification.

LIMITATIONS

Some of the participants were using neuroleptics, mood stabilizers or antidepressants; our sample included only women; memory bias could not be controlled; and we did not investigate the possible confounding effects of other forms of stress during childhood.

CONCLUSION

This study supports the association between early life stress and peripheral neurotrophic factor levels in crack cocaine users. During early abstinence, plasmastic GDNF and NT4/5 were the only factors to show changes associated with a history of childhood sexual abuse.

摘要

背景

神经营养因子已在酒精和药物依赖的病理生理学中得到研究,并与驱动神经内分泌系统发育编程的早期生活应激相关。

方法

我们进行了一项随访研究,旨在评估与健康对照相比,可卡因吸食者在早期戒断3周期间血浆中胶质细胞源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)、神经营养素-3(NT3)和神经营养素-4/5(NT4/5)的水平。我们对患有可卡因依赖的女性住院患者(分为两组:有童年性虐待史(CSA+)和无童年性虐待史(CSA-)的参与者)以及一组非使用者对照参与者进行了全面的临床评估。

结果

我们的样本包括104名患有可卡因依赖的女性和22名对照;在使用可卡因的女性中,22名有童年性虐待史,82名没有。CSA+组的GDNF血浆水平在戒毒3周期间显著升高。相比之下,CSA-组在相同条件下GDNF水平较低且稳定。与对照组相比,BDNF血浆水平在早期戒断期间仍保持升高,而NGF水平降低。我们发现患者和对照组之间的NT3和NT4/5没有差异。然而,组内分析表明,在戒毒结束时,CSA+组的NT4/5水平高于CSA-组。

局限性

一些参与者正在使用抗精神病药物、情绪稳定剂或抗抑郁药;我们的样本仅包括女性;无法控制记忆偏差;并且我们没有研究童年时期其他形式应激可能的混杂效应。

结论

本研究支持早期生活应激与可卡因使用者外周神经营养因子水平之间的关联。在早期戒断期间,血浆中的GDNF和NT4/5是仅有的显示与童年性虐待史相关变化的因子。

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