O'Halloran Laura, Nymberg Charlotte, Jollans Lee, Garavan Hugh, Whelan Robert
School of Psychology, Trinity College Dublin, Dublin, Ireland.
Department for Neuroscience, Karolinska Institute, Stockholm, Sweden.
Addiction. 2017 Apr;112(4):719-726. doi: 10.1111/add.13629. Epub 2016 Dec 5.
Dysfunction in brain regions underlying impulse control, reward processing and executive function have been associated previously with adolescent alcohol misuse. However, identifying pre-existing neurobiological risk factors, as distinct from changes arising from early alcohol-use, is difficult. Here, we outline how neuroimaging data can identify the neural predictors of adolescent alcohol-use initiation and misuse by using prospective longitudinal studies to follow initially alcohol-naive individuals over time and by neuroimaging adolescents with inherited risk factors for alcohol misuse.
A comprehensive narrative of the literature regarding neuroimaging studies published between 2010 and 2016 focusing on predictors of adolescent alcohol use initiation and misuse.
Prospective, longitudinal neuroimaging studies have identified pre-existing differences between adolescents who remained alcohol-naive and those who transitioned subsequently to alcohol use. Both functional and structural grey matter differences were observed in temporal and frontal regions, including reduced brain activity in the superior frontal gyrus and temporal lobe, and thinner temporal cortices of future alcohol users. Interactions between brain function and genetic predispositions have been identified, including significant association found between the Ras protein-specific guanine nucleotide releasing factor 2 (RASGRF2) gene and reward-related striatal functioning.
Neuroimaging predictors of alcohol use have shown modest utility to date. Future research should use out-of-sample performance as a quantitative measure of a predictor's utility. Neuroimaging data should be combined across multiple modalities, including structural information such as volumetrics and cortical thickness, in conjunction with white-matter tractography. A number of relevant neurocognitive systems should be assayed; particularly, inhibitory control, reward processing and executive functioning. Combining a rich magnetic resonance imaging data set could permit the generation of neuroimaging risk scores, which could potentially yield targeted interventions.
先前已有研究表明，冲动控制、奖赏处理和执行功能相关脑区的功能障碍与青少年酒精滥用有关。然而，要区分出酒精使用初期就已存在的神经生物学风险因素与早期饮酒导致的变化并非易事。在此，我们概述了神经影像学数据如何通过前瞻性纵向研究对起初未饮酒的个体进行长期跟踪，以及对具有酒精滥用遗传风险因素的青少年进行神经成像，从而识别青少年酒精使用起始和滥用的神经预测因素。
对2010年至2016年间发表的有关神经影像学研究的文献进行全面叙述，重点关注青少年酒精使用起始和滥用的预测因素。
前瞻性纵向神经影像学研究已发现，未饮酒的青少年与后来开始饮酒的青少年之间存在预先存在的差异。在颞叶和额叶区域观察到了功能和结构灰质的差异，包括额上回和颞叶的大脑活动减少，以及未来饮酒者颞叶皮质变薄。已确定脑功能与遗传易感性之间的相互作用，包括在Ras蛋白特异性鸟嘌呤核苷酸释放因子2（RASGRF2）基因与奖赏相关的纹状体功能之间发现显著关联。
迄今为止，酒精使用的神经影像学预测因素效用有限。未来的研究应以样本外表现作为预测因素效用的定量指标。神经影像学数据应结合多种模式，包括体积测量和皮质厚度等结构信息，以及白质纤维束成像。应检测一些相关的神经认知系统；特别是抑制控制、奖赏处理和执行功能。结合丰富的磁共振成像数据集可能会生成神经影像学风险评分，这可能会带来有针对性的干预措施。
