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下前额叶和海马体积及弥散张量成像差异反映了酒精使用障碍戒断个体的结构和功能异常。

Lower Prefrontal and Hippocampal Volume and Diffusion Tensor Imaging Differences Reflect Structural and Functional Abnormalities in Abstinent Individuals with Alcohol Use Disorder.

机构信息

Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York.

Computational Neuroimaging Laboratories of the Center for Biomedical Imaging and Neuromodulation (C-BIN), The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York.

出版信息

Alcohol Clin Exp Res. 2018 Oct;42(10):1883-1896. doi: 10.1111/acer.13854. Epub 2018 Aug 17.

Abstract

BACKGROUND

Alcohol use disorder (AUD) is known to have adverse effects on brain structure and function. Multimodal assessments investigating volumetric, diffusion, and cognitive characteristics may facilitate understanding of the consequences of long-term alcohol use on brain circuitry, their structural impairment patterns, and their impact on cognitive function in AUD.

METHODS

Voxel- and surface-based volumetric estimations, diffusion tensor imaging (DTI), and neuropsychological tests were performed on 60 individuals: 30 abstinent individuals with AUD (DSM-IV) and 30 healthy controls. Group differences in the volumes of cortical and subcortical regions, fractional anisotropy (FA), axial and radial diffusivities (AD and RD, respectively), and performance on neuropsychological tests were analyzed, and the relationship among significantly different measures was assessed using canonical correlation.

RESULTS

AUD participants had significantly smaller volumes in left pars orbitalis, right medial orbitofrontal, right caudal middle frontal, and bilateral hippocampal regions, lower FA in 9 white matter (WM) regions, and higher FA in left thalamus, compared to controls. In AUD, lower FA in 6 of 9 WM regions was due to higher RD and due to lower AD in the left external capsule. AUD participants scored lower on problem-solving ability, visuospatial memory span, and working memory. Positive correlations of prefrontal cortical, left hippocampal volumes, and FA in 4 WM regions with visuospatial memory performance and negative correlation with lower problem-solving ability were observed. Significant positive correlation between age and FA was observed in bilateral putamen.

CONCLUSIONS

Findings showed specific structural brain abnormalities to be associated with visuospatial memory and problem-solving ability-related impairments observed in AUD. Higher RD in 6 WM regions suggests demyelination, and lower AD in left external capsule suggests axonal loss in AUD. The positive correlation between FA and age in bilateral putamen may reflect accumulation of iron depositions with increasing age.

摘要

背景

已知酒精使用障碍(AUD)对大脑结构和功能有不良影响。采用多模态评估方法,研究容积、弥散和认知特征,有助于了解长期饮酒对大脑回路的影响,以及它们的结构损伤模式及其对 AUD 患者认知功能的影响。

方法

对 60 名个体(30 名 AUD 患者和 30 名健康对照者)进行体素和表面容积估计、弥散张量成像(DTI)和神经心理学测试。分析了皮质和皮质下区域容积、各向异性分数(FA)、轴向和径向弥散度(AD 和 RD)以及神经心理学测试表现的组间差异,并使用典型相关评估显著不同的指标之间的关系。

结果

与对照组相比,AUD 参与者左侧眶额下回、右侧内侧眶额回、右侧额中回后部、双侧海马区域的容积明显较小,9 个白质(WM)区域的 FA 较低,左侧丘脑的 FA 较高。在 AUD 中,6 个 WM 区域的 FA 较低,是由于 RD 较高和左侧外囊 AD 较低所致。AUD 参与者在解决问题能力、视空间记忆广度和工作记忆方面的得分较低。前额皮质、左侧海马体积和 4 个 WM 区域的 FA 与视空间记忆表现呈正相关,与解决问题能力呈负相关。双侧壳核的 FA 与年龄呈显著正相关。

结论

研究结果表明,特定的结构性脑异常与 AUD 患者观察到的视空间记忆和解决问题能力相关的损伤有关。6 个 WM 区域的 RD 较高提示脱髓鞘,左侧外囊的 AD 较低提示 AUD 中的轴突丢失。双侧壳核的 FA 与年龄之间的正相关可能反映了随着年龄的增长铁沉积的积累。

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