Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
Center for Imaging of Neurodegenerative Diseases (CIND), Veterans Administration Medical Center, San Francisco, California.
Alcohol Clin Exp Res. 2018 Jun;42(6):1062-1072. doi: 10.1111/acer.13757. Epub 2018 May 22.
Widespread brain atrophy in alcohol-dependent individuals (ALC) has been consistently documented in pathological and magnetic resonance imaging (MRI) studies. Longitudinal MRI studies have shown that the regional brain volume losses in ALC are partially reversible during abstinence from alcohol. The goal of this study was to determine volume reductions in cortical and subcortical regions functionally important to substance use behavior and their changes during short-term (1 week to 1 month) and long-term abstinence (1 to 7 months) from alcohol. The regions of interest (ROIs) were as follows: anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), insula, amygdala, and hippocampus.
A total of 85 unique ALC were assessed at 1 week (n = 65), 1 month (n = 82), and 7 months (n = 36) of abstinence. In addition, 17 light/nondrinking healthy controls (CON) were assessed at baseline and follow-up over a 10-month interval. Regional brain volumes were derived from FreeSurfer. Cross-sectional statistical analyses using 1-way analysis of variance or Fisher's exact test were applied to identify group differences. Longitudinal statistical analyses using linear mixed models were applied to identify regional volume increases and nonlinear volume recovery trajectories.
We demonstrated significant regional volume reductions in ACC, DLPFC, and hippocampus. Older age was associated with smaller DLPFC and OFC, and higher average monthly drinking over 1 year prior to study was associated with smaller OFC. We also demonstrated significant volume increases of all ROIs except amygdala in ALC and significant nonlinear volume recovery trajectories of DLPFC, OFC, and insula.
Results showed significant volume reductions in key regions of the executive control, salience, and emotion networks in ALC at entry into treatment and significant volume increases during short-term and long-term abstinence that were nonlinear over the entire abstinence period for the DLPFC, OFC, and insula. This gray matter plasticity during alcohol abstinence may have important neurobiological and neurocognitive implications in ALC, and it may contribute to an individual's ability to maintain abstinence from alcohol at different phases.
在病理学和磁共振成像 (MRI) 研究中，一直有研究表明，酒精依赖个体 (ALC) 存在广泛的脑萎缩。纵向 MRI 研究表明，在戒酒后，ALC 的区域性脑体积损失部分是可逆的。本研究的目的是确定对物质使用行为有重要功能的皮质和皮质下区域的体积减少及其在短期（1 周至 1 个月）和长期（1 至 7 个月）戒酒后的变化。感兴趣区域 (ROI) 如下：前扣带皮层 (ACC)、背外侧前额叶皮层 (DLPFC)、眶额皮层 (OFC)、岛叶、杏仁核和海马体。
共有 85 名独特的 ALC 在戒酒后 1 周（n=65）、1 个月（n=82）和 7 个月（n=36）时进行评估。此外，17 名轻度/不饮酒的健康对照者 (CON) 在 10 个月的随访期间进行了基线和随访评估。使用 FreeSurfer 得出脑区体积。使用单因素方差分析或 Fisher 精确检验进行横截面统计分析，以确定组间差异。使用线性混合模型进行纵向统计分析，以确定区域体积增加和非线性体积恢复轨迹。
我们证明了在 ACC、DLPFC 和海马体中存在明显的区域性体积减少。年龄较大与 DLPFC 和 OFC 较小有关，而研究前 1 年平均每月饮酒量较高与 OFC 较小有关。我们还证明了除杏仁核外，所有 ROI 的体积都有显著增加，DLPFC、OFC 和岛叶的体积恢复轨迹是非线性的。
结果表明，在进入治疗时，ALC 的执行控制、突显和情绪网络的关键区域存在明显的体积减少，在短期和长期戒酒后，除杏仁核外，所有 ROI 的体积都有显著增加，DLPFC、OFC 和岛叶的体积恢复轨迹是非线性的。在酒精戒断期间，这种灰质可塑性可能对 ALC 具有重要的神经生物学和神经认知意义，并可能有助于个体在不同阶段保持戒酒。
