Gogliettino Alex R, Potenza Marc N, Yip Sarah W
Bates College, Lewiston, ME, United States.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; CASAColumbia, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Connecticut Mental Health Center, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States; Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States.
Drug Alcohol Depend. 2016 May 1;162:26-33. doi: 10.1016/j.drugalcdep.2016.02.015. Epub 2016 Feb 27.
Adolescence and young adulthood are critical vulnerability periods for initiation of tobacco smoking. White matter development is ongoing during this time and may be influenced by exposure to nicotine. Synthesis of findings from diffusion tensor imaging (DTI) studies of adolescent and young adult smokers may be helpful in understanding the relationship between neurodevelopment and initiation and progression of tobacco-use behaviors and in guiding further research.
A systematic literature review was conducted to identify DTI studies comparing adolescent and young adult (mean age <30 years) smokers versus nonsmokers. A total of 5 studies meeting inclusion criteria were identified. Primary study findings are reviewed and discussed within the context of neurodevelopment and in relation to findings from adult studies. Directions for further research are also discussed.
All identified studies reported increases in fractional anisotropy (FA) among adolescent/young adult smokers in comparison to non-smokers. Increased FA was most frequently reported in regions of the corpus callosum (genu, body and spenium), internal capsule and superior longitudinal fasciculus.
Findings of increased FA among adolescent/young adult smokers are contrary to those from most adult studies and thus raise the possibility of differential effects of nicotine on white matter across the lifespan. Further research including multiple time points is needed to test this hypothesis. Other areas warranting further research include DTI studies of e-cigarette use and studies incorporating measures of pubertal stage.
青少年期和青年期是开始吸烟的关键脆弱时期。在此期间，白质仍在发育，可能会受到尼古丁暴露的影响。综合青少年和青年吸烟者的扩散张量成像（DTI）研究结果，可能有助于理解神经发育与烟草使用行为的起始及进展之间的关系，并为进一步研究提供指导。
进行了一项系统的文献综述，以确定比较青少年和青年（平均年龄<30岁）吸烟者与非吸烟者的DTI研究。共确定了5项符合纳入标准的研究。在神经发育的背景下，并结合成人研究的结果，对主要研究结果进行了综述和讨论。还讨论了进一步研究的方向。
所有已确定的研究均报告，与非吸烟者相比，青少年/青年吸烟者的各向异性分数（FA）增加。FA增加最常出现在胼胝体（膝部、体部和压部）、内囊和上纵束区域。
青少年/青年吸烟者FA增加的研究结果与大多数成人研究的结果相反，因此增加了尼古丁在整个生命周期对白质产生不同影响的可能性。需要进一步开展包括多个时间点的研究来验证这一假设。其他需要进一步研究的领域包括电子烟使用的DTI研究以及纳入青春期阶段测量的研究。
