London Edythe D, Kohno Milky, Morales Angelica M, Ballard Michael E
Departments of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90024; Departments of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, California 90024; Departments of Brain Research Institute, University of California, Los Angeles, Los Angeles, California 90024.
Departments of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90024.
Brain Res. 2015 Dec 2;1628(Pt A):174-85. doi: 10.1016/j.brainres.2014.10.044. Epub 2014 Nov 4.
Despite aggressive efforts to contain it, methamphetamine use disorder continues to be major public health problem; and with generic behavioral therapies still the mainstay of treatment for methamphetamine abuse, rates of attrition and relapse remain high. This review summarizes the findings of structural, molecular, and functional neuroimaging studies of methamphetamine abusers, focusing on cortical and striatal abnormalities and their potential contributions to cognitive and behavioral phenotypes that can serve to promote compulsive drug use. These studies indicate that individuals with a history of chronic methamphetamine abuse often display several signs of corticostriatal dysfunction, including abnormal gray- and white-matter integrity, monoamine neurotransmitter system deficiencies, neuroinflammation, poor neuronal integrity, and aberrant patterns of brain connectivity and function, both when engaged in cognitive tasks and at rest. More importantly, many of these neural abnormalities were found to be linked with certain addiction-related phenotypes that may influence treatment response (e.g., poor self-control, cognitive inflexibility, maladaptive decision-making), raising the possibility that they may represent novel therapeutic targets.
尽管人们积极努力遏制甲基苯丙胺使用障碍，但它仍是一个重大的公共卫生问题；由于通用行为疗法仍是甲基苯丙胺滥用治疗的主要手段，治疗中断和复发率仍然很高。本综述总结了甲基苯丙胺滥用者的结构、分子和功能神经影像学研究结果，重点关注皮质和纹状体异常及其对认知和行为表型的潜在影响，这些表型可能促使强迫性药物使用。这些研究表明，有慢性甲基苯丙胺滥用史的个体在进行认知任务和休息时，往往表现出皮质纹状体功能障碍的多种迹象，包括灰质和白质完整性异常、单胺神经递质系统缺陷、神经炎症、神经元完整性差以及大脑连接和功能的异常模式。更重要的是，这些神经异常中的许多被发现与某些可能影响治疗反应的成瘾相关表型有关（例如，自我控制能力差、认知灵活性不足、适应不良的决策），这增加了它们可能代表新治疗靶点的可能性。
