在接受治疗的青少年中，脑岛白质体积通过增强动机与暴饮频率相关联。
Insula white matter volume linked to binge drinking frequency through enhancement motives in treated adolescents.
作者信息
Chung Tammy, Clark Duncan B
机构信息
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
出版信息
Alcohol Clin Exp Res. 2014 Jul;38(7):1932-40. doi: 10.1111/acer.12461. Epub 2014 Jun 13.
BACKGROUND
Given the insula's role in the representation of bodily states associated with hedonic (i.e., enhancement motives) and aversive (i.e., craving) aspects of substance use, this longitudinal study examined associations between insula structure (i.e., white matter [WM] and gray matter [GM] volume), enhancement motives for alcohol and cannabis use, craving for alcohol and marijuana, and alcohol and cannabis involvement in treated adolescents. Enhancement motives and craving, as conscious representations of bodily states associated with use, were hypothesized as mediators (i.e., linking mechanisms) of the association between insula volume and substance use.
METHODS
Adolescents (age 14 to 18, N = 30) recruited from substance use treatment reported on enhancement motives and obsession/craving for both alcohol and cannabis at baseline (near the start of treatment), and on alcohol and cannabis involvement (e.g., binge drinking, alcohol abuse/dependence symptom count) at baseline and over 1-year follow-up. Insula WM and GM volumes were determined using FreeSurfer.
RESULTS
Enhancement motives for drinking served as a link between left insula WM volume and frequency of binge drinking at baseline and 1-year follow-up. This novel finding is consistent with the insula's role in representing bodily states (e.g., "high" associated with binge drinking) that can motivate drinking behavior. Although right insula WM volume was positively correlated with obsession/craving for alcohol, and obsession/craving was positively correlated with alcohol outcomes, the indirect effect was not significant. Insula WM volume was not associated with cannabis-related variables. Insula GM volume was not associated with enhancement motives, obsession/craving, or alcohol involvement.
CONCLUSIONS
Enhancement motives for alcohol use, but not obsession/craving for alcohol, provided an important link between left insula WM volume and frequency of binge drinking in treated adolescents. Results are consistent with the insula's role in the processing of hedonic bodily states available to conscious awareness, particularly in the form of enhancement motives for alcohol use.
背景
鉴于脑岛在表征与物质使用的享乐（即增强动机）和厌恶（即渴望）方面相关的身体状态中所起的作用，这项纵向研究考察了脑岛结构（即白质[WM]和灰质[GM]体积）、酒精和大麻使用的增强动机、对酒精和大麻的渴望以及接受治疗的青少年的酒精和大麻使用情况之间的关联。增强动机和渴望作为与使用相关的身体状态的有意识表征，被假设为脑岛体积与物质使用之间关联的中介（即联系机制）。
方法
从物质使用治疗机构招募的青少年（年龄14至18岁，N = 30）在基线（治疗开始时）报告了对酒精和大麻的增强动机以及强迫观念/渴望，并在基线和1年随访期间报告了酒精和大麻使用情况（例如，暴饮、酒精滥用/依赖症状计数）。使用FreeSurfer确定脑岛白质和灰质体积。
结果
饮酒的增强动机在基线和1年随访时是左脑岛白质体积与暴饮频率之间的联系。这一新发现与脑岛在表征可激发饮酒行为的身体状态（例如，与暴饮相关的“兴奋”）中所起的作用一致。尽管右脑岛白质体积与对酒精的强迫观念/渴望呈正相关，且强迫观念/渴望与酒精使用结果呈正相关，但间接效应并不显著。脑岛白质体积与大麻相关变量无关。脑岛灰质体积与增强动机、强迫观念/渴望或酒精使用情况无关。
结论
酒精使用的增强动机而非对酒精的强迫观念/渴望，在接受治疗的青少年中是左脑岛白质体积与暴饮频率之间的重要联系。结果与脑岛在处理有意识的享乐身体状态中的作用一致，特别是以酒精使用的增强动机形式。
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