Department of Psychology, Queens College, City University of New York, Flushing, NY, USA.
Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA.
Addiction. 2017 Sep;112(9):1567-1577. doi: 10.1111/add.13839. Epub 2017 May 12.
To understand processes placing individuals at risk for stimulant (amphetamine and cocaine) use disorder.
Longitudinal study.
University of California, San Diego Department of Psychiatry, CA, USA.
Occasional stimulant users (OSU; n = 184) underwent a baseline clinical interview and a functional magnetic resonance imaging (fMRI) session. On the basis of a follow-up clinical interview completed 3 years later, OSU (n = 147) were then categorized as problem stimulant users (PSU: n = 36; those who developed stimulant use disorders in the interim) or desisted stimulant users (DSU: n = 74; those who stopped using). OSU who did not meet criteria for PSU or DSU (n = 37) were included in dimensional analyses.
fMRI blood oxygen level-dependent (BOLD) contrast percentage signal change from baseline collected during a Paper-Scissors-Rock task was examined during three decision-making conditions, those resulting in: (1) wins, (2) ties and (3) losses. These data were used as dependent variables in categorical analyses comparing PSU and DSU, as well as dimensional analyses including interim drug use as predictors, controlling for baseline drug use.
PSU exhibited lower anterior cingulate, middle insula, superior temporal, inferior parietal, precuneus and cerebellum activation than DSU across all three conditions (significant brain clusters required > 19 neighboring voxels to exceed F = 5.58, P < 0.01 two-tailed; all Cohen's d > 0.83). Higher interim marijuana use was linked to lower pre-central and superior temporal activation during choices resulting in wins (> 19 neighboring voxels to exceed t = 2.61, P < 0.01 two-tailed; R change > 0.11).
Individuals who transition from stimulant use to stimulant use disorder appear to show alterations in neural processing of stimulus valuation and outcome monitoring, patterns also evident in chronic stimulant use disorder. Attenuated anterior cingulate and insular processing may constitute a high-risk neural processing profile, which could be used to calculate risk scores for individuals experimenting with stimulants.
了解将个体置于兴奋剂（安非他命和可卡因）使用障碍风险中的过程。
纵向研究。
美国加利福尼亚大学圣地亚哥分校精神病学系。
偶发性兴奋剂使用者（OSU；n=184）接受了基线临床访谈和功能磁共振成像（fMRI）检查。根据 3 年后完成的后续临床访谈，OSU（n=147）随后分为问题兴奋剂使用者（PSU：n=36；在此期间出现兴奋剂使用障碍）或停止使用兴奋剂的使用者（DSU：n=74；停止使用兴奋剂）。未达到 PSU 或 DSU 标准的 OSU（n=37）被纳入维度分析。
在石头剪刀布任务期间采集的基线血液氧水平依赖性（BOLD）对比百分比信号变化的 fMRI，在三个决策条件下进行检查，这些条件导致：（1）获胜，（2）平局和（3）失败。这些数据被用作分类分析的因变量，比较 PSU 和 DSU，以及包括中期药物使用作为预测因子的维度分析，控制基线药物使用。
与 DSU 相比，PSU 在所有三种情况下的前扣带回、中脑岛、上颞叶、下顶叶、楔前叶和小脑激活均较低（显著的脑簇需要 > 19 个相邻体素才能超过 F = 5.58，P < 0.01 双侧；所有 Cohen's d > 0.83）。较高的中期大麻使用与获胜选择时的前中央和上颞叶激活降低有关（> 19 个相邻体素超过 t = 2.61，P < 0.01 双侧；R 变化 > 0.11）。
从兴奋剂使用转为兴奋剂使用障碍的个体似乎表现出对刺激价值和结果监测的神经处理改变，这些模式也存在于慢性兴奋剂使用障碍中。减弱的前扣带和岛叶处理可能构成高风险的神经处理特征，可以用来计算尝试兴奋剂的个体的风险评分。
