Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.
Department of Radiology, University of Utah, Salt Lake City, Utah.
Alcohol Clin Exp Res. 2019 Feb;43(2):221-226. doi: 10.1111/acer.13931. Epub 2019 Jan 4.
Proton magnetic resonance spectroscopy ( H-MRS) studies have demonstrated abnormal levels of a variety of neurometabolites in inpatients/outpatients with alcohol use disorder (AUD) following acute alcohol withdrawal relative to healthy controls. In contrast, few studies have compared neurometabolite levels between less severe, treatment-naïve AUD individuals and light drinkers (LD) or related them to recent alcohol consumption. The present study compared neurometabolite levels between treatment-naïve AUD and LD individuals.
Twenty treatment-naïve individuals with AUD and 20 demographically matched LD completed an H-MRS scan, approximately 2.5 days following their last reported drink. H-MRS data were acquired in dorsal anterior cingulate (dACC) using a 2-dimensional J-resolved point-resolved spectroscopy sequence. dACC neurometabolite levels, with a focus on glutamate, glutamine, and GABA, were compared between AUD and LD participants. The associations between metabolite levels and recent drinking were explored.
AUD participants had significantly lower concentrations of GABA (Cohen's d = 0.79, p = 0.017) and glutamine (Cohen's d = 1.12, p = 0.005), but not glutamate (Cohen's d = 0.05, p = 0.893), relative to LD. As previously reported, AUD participants' glutamate and N-acetylaspartate concentrations were inversely associated with their number of heavy drinking days. In contrast, neither number of drinking (mean p = 0.56) nor heavy drinking (mean p = 0.47) days were associated with metabolite concentrations in LD.
The present study demonstrated significantly lower levels of prefrontal γ-aminobutyric acid and glutamine in treatment-naïve individuals with AUD relative to LD. Whether these findings reflect the neurotoxic consequence and/or neuroadaptive response of alcohol consumption versus a predrinking trait, and therefore a more durable neurochemical disturbance, awaits elucidation from longitudinal studies.
质子磁共振波谱（1 H-MRS）研究表明，与健康对照组相比，急性酒精戒断后，住院/门诊酒精使用障碍（AUD）患者存在多种神经代谢物水平异常。相比之下，很少有研究比较轻度、未经治疗的 AUD 个体与轻度饮酒者（LD）之间的神经代谢物水平，或将其与近期饮酒量联系起来。本研究比较了未经治疗的 AUD 和 LD 个体之间的神经代谢物水平。
20 名未经治疗的 AUD 患者和 20 名年龄匹配的 LD 患者完成了 1 H-MRS 扫描，大约在他们最后一次饮酒后 2.5 天。使用二维 J 分辨点分辨波谱序列在背侧前扣带回（dACC）采集 1 H-MRS 数据。比较 AUD 和 LD 参与者之间的 dACC 神经代谢物水平，重点关注谷氨酸、谷氨酰胺和 GABA。探索代谢物水平与近期饮酒的关系。
与 LD 相比，AUD 参与者的 GABA（Cohen's d=0.79，p=0.017）和谷氨酰胺（Cohen's d=1.12，p=0.005）浓度明显降低，但谷氨酸（Cohen's d=0.05，p=0.893）没有降低。与之前的报道一致，AUD 参与者的谷氨酸和 N-乙酰天冬氨酸浓度与他们的重度饮酒天数呈负相关。相反，LD 参与者的饮酒次数（平均 p=0.56）和重度饮酒天数（平均 p=0.47）均与代谢物浓度无关。
本研究表明，与 LD 相比，未经治疗的 AUD 患者前额叶γ-氨基丁酸和谷氨酰胺水平明显降低。这些发现是反映了酒精摄入的神经毒性后果和/或神经适应性反应，还是反映了饮酒前的特征，因此是更持久的神经化学紊乱，有待纵向研究阐明。
