Naqvi Nasir H, Morgenstern Jon
Division on Substance Abuse, Department of Psychiatry, Columbia University, New York, New York.
Department of Psychiatry, North Shore-Long Island Jewish Health System, Long Island, New York.
Alcohol Res. 2015;37(1):29-38.
Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.
研究人员已开始应用认知神经科学的概念和方法,来研究酒精使用障碍(AUD)治疗中的行为改变机制。本综述首先考察了运用临床和社会心理学方法进行的治疗机制研究的现状。接着从认知神经科学的角度总结了目前对成瘾病理生理学的理解。最后,综述了近期运用认知神经科学方法来理解AUD行为改变神经机制的研究工作,包括利用神经功能来预测复发和戒酒的研究;考察在当前基于证据的AUD行为干预中起作用的神经机制的研究;以及基于我们对AUD行为改变的神经和认知机制的新认识而开展的新型行为干预研究。本文强调,参与认知控制的前额叶皮质区域对参与酒精激励动机的皮质下区域的调节,可能是在AUD这些不同形式的行为改变中发挥作用的核心机制。我们还提出了一个多层次框架,用于将认知神经科学方法与更传统的方法相结合,以研究AUD治疗机制。