Caldiroli Alice, Serati Marta, Buoli Massimiliano
Department of Psychiatry, University of Milan, Milan, Italy.
J Nerv Ment Dis. 2018 Aug;206(8):644-656. doi: 10.1097/NMD.0000000000000861.
The general purpose of this review is to present an updated literature overview of neurobiological/clinical aspects of Internet addiction (IA), particularly of overlaps and differences with bipolar affective disorder (BPAD). Articles with clinical/neurobiological aspects of IA or similarities/differences with BPAD as main topics, from 1990 to present and written in English language, were included. Comorbidity between IA and other psychiatric disorders, including BPAD, is common. Dysfunctions in dopaminergic pathways have been found both in IA and in mood disorders. Most of investigations in IA support a chronic hypodopaminergic dysfunctional state in brain reward circuit and an excessive reward experience during mood elevation. Neuroimaging studies show prefrontal cortex abnormalities shared between addictive and bipolar patients. BPAD and IA present numerous overlaps, such as polymorphisms in nicotinic receptors genes, anterior cingulate/prefrontal cortex abnormalities, serotonin/dopamine dysfunctions, and good response to mood stabilizers. The future is to clarify diagnostic criteria to better define the IA/BPAD relationship.
本综述的总体目的是提供关于网络成瘾（IA）神经生物学/临床方面的最新文献综述，特别是关于其与双相情感障碍（BPAD）的重叠和差异。纳入了以IA的临床/神经生物学方面或与BPAD的异同作为主要主题、于1990年至今撰写的英文文章。IA与包括BPAD在内的其他精神障碍之间的共病很常见。在IA和情绪障碍中均发现了多巴胺能通路功能障碍。大多数关于IA的研究支持大脑奖赏回路中存在慢性多巴胺能功能低下状态以及情绪高涨期间存在过度奖赏体验。神经影像学研究显示成瘾患者和双相情感障碍患者之间存在前额叶皮质异常。BPAD和IA存在诸多重叠之处，如尼古丁受体基因多态性、前扣带回/前额叶皮质异常、5-羟色胺/多巴胺功能障碍以及对心境稳定剂反应良好。未来的方向是明确诊断标准，以更好地界定IA与BPAD之间的关系。
