Holgate Joan Y, Bartlett Selena E
Institute of Health and Biomedical Innovation, Translational Research Institute, Queensland University of Technology, 37 Kent St, Woolloongabba, Queensland 4102, Australia.
Brain Sci. 2015 Jun 30;5(3):258-74. doi: 10.3390/brainsci5030258.
Stress is a major driving force in alcohol use disorders (AUDs). It influences how much one consumes, craving intensity and whether an abstinent individual will return to harmful alcohol consumption. We are most vulnerable to the effects of stress during early development, and exposure to multiple traumatic early life events dramatically increases the risk for AUDs. However, not everyone exposed to early life stress will develop an AUD. The mechanisms determining whether an individual's brain adapts and becomes resilient to the effects of stress or succumbs and is unable to cope with stress remain elusive. Emerging evidence suggests that neuroplastic changes in the nucleus accumbens (NAc) following early life stress underlie the development of AUDs. This review discusses the impact of early life stress on NAc structure and function, how these changes affect cholinergic signaling within the mesolimbic reward pathway and the role nicotinic acetylcholine receptors (nAChRs) play in this process. Understanding the neural pathways and mechanism determining stress resilience or susceptibility will improve our ability to identify individuals susceptible to developing AUDs, formulate cognitive interventions to prevent AUDs in susceptible individuals and to elucidate and enhance potential therapeutic targets, such as the nAChRs, for those struggling to overcome an AUD.
应激是酒精使用障碍(AUDs)的主要驱动力。它影响饮酒量、渴望强度以及戒酒者是否会重新开始有害的饮酒行为。在早期发育过程中,我们最容易受到应激的影响,而早年经历多次创伤性事件会显著增加患酒精使用障碍的风险。然而,并非每个经历过早年应激的人都会患上酒精使用障碍。决定个体大脑是适应并对应激影响产生恢复力,还是屈服并无法应对应激的机制仍然不清楚。新出现的证据表明,早年应激后伏隔核(NAc)的神经可塑性变化是酒精使用障碍发展的基础。这篇综述讨论了早年应激对伏隔核结构和功能的影响,这些变化如何影响中脑边缘奖赏通路内的胆碱能信号传导,以及烟碱型乙酰胆碱受体(nAChRs)在这一过程中所起的作用。了解决定应激恢复力或易感性的神经通路和机制,将提高我们识别易患酒精使用障碍个体的能力,制定认知干预措施以预防易感个体患酒精使用障碍,并阐明和增强潜在的治疗靶点,如nAChRs,以帮助那些努力克服酒精使用障碍的人。