Hägele Claudia, Friedel Eva, Kienast Torsten, Kiefer Falk
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
Neuropsychobiology. 2014;70(2):67-76. doi: 10.1159/000364825. Epub 2014 Oct 30.
Alcohol dependence is one of the leading contributors to the burden of disease in the world. A range of genetic and environmental risk factors has been identified to date, and preclinical and clinical studies including imaging studies have identified neuronal networks involved in the development of alcohol dependence.
We review genetic and environmental risk factors for the development of alcohol addiction as well as structural and neuronal changes, including their transmitter systems, due to regular alcohol intake.
Stress as well as family background and, in juveniles, the peer group could be identified as environmental risk factors for alcohol dependence. Heritability is estimated at around 50%, and it seems to be comparable in women and men. There is ongoing research on a broad range of putative endophenotypes such as tolerance of the effects of alcohol intake or personal traits like 'impulsivity'. On the neurobiological level, chronic alcohol intake seems to render mesolimbic circuits hypersensitive to alcohol and alter the motivational reward system including dopaminergic neurotransmission.
Environmental and genetic risk factors, and especially their interaction, facilitate the development of alcohol dependence. Ongoing alcohol intake results in profound alterations of neuronal systems crucial for motivation, learning, memory and cognition control. Future studies should further combine the knowledge of neurobiological mechanisms and risk factors to develop new prevention strategies.
酒精依赖是全球疾病负担的主要促成因素之一。迄今为止，已确定了一系列遗传和环境风险因素，包括影像学研究在内的临床前和临床研究已经确定了参与酒精依赖发展的神经网络。
我们综述了酒精成瘾发展的遗传和环境风险因素，以及由于经常饮酒导致的结构和神经元变化，包括其递质系统。
压力以及家庭背景，在青少年中还有同龄人群体，可被确定为酒精依赖的环境风险因素。遗传度估计约为50%，在女性和男性中似乎相当。目前正在对广泛的假定内表型进行研究，例如对酒精摄入影响的耐受性或“冲动性”等个人特质。在神经生物学层面，长期饮酒似乎使中脑边缘回路对酒精高度敏感，并改变包括多巴胺能神经传递在内的动机奖赏系统。
环境和遗传风险因素，尤其是它们之间的相互作用，促进了酒精依赖的发展。持续饮酒会导致对动机、学习、记忆和认知控制至关重要的神经元系统发生深刻改变。未来的研究应进一步结合神经生物学机制和风险因素的知识，以制定新的预防策略。
