Stewart Jennifer L, May April C, Aupperle Robin L, Bodurka Jerzy
Laureate Institute for Brain Research, Tulsa, OK, United States.
Department of Community Medicine, University of Tulsa, Tulsa, OK, United States.
Front Psychiatry. 2019 Mar 7;10:117. doi: 10.3389/fpsyt.2019.00117. eCollection 2019.
The United States is in the midst of an opioid epidemic and lacks a range of successful interventions to reduce this public health burden. Many individuals with opioid use disorder (OUD) consume drugs to relieve physical and/or emotional pain, a pattern that may increasingly result in death. The field of addiction research lacks a comprehensive understanding of physiological and neural mechanisms instantiating this cycle of in OUD, resulting in limited interventions that successfully promote abstinence and recovery. Given the urgency of the opioid crisis, the present review highlights faulty brain circuitry and processes associated with OUD within the context of the (1). This model underscores processes as crucial to the maintenance and exacerbation of chronic substance use together with and processes. This review focuses on cross-sectional as well as longitudinal studies of relapse and treatment outcome that employ magnetic resonance imaging (MRI), functional near-infrared spectroscopy (fNIRs), brain stimulation methods, and/or electroencephalography (EEG) explored in frequency and time domains (the latter measured by event-related potentials, or ERPs). We discuss strengths and limitations of this neuroimaging work with respect to study design and individual differences that may influence interpretation of findings (e.g., opioid use chronicity/recency, comorbid symptoms, and biological sex). Lastly, we translate gaps in the OUD literature, particularly with respect to processes, into future research directions involving operant and classical conditioning involving aversion/stress. Overall, opioid-related stimuli may lessen their hold on frontocingulate mechanisms implicated in as a function of prolonged abstinence and that degree of frontocingulate impairment may predict treatment outcome. In addition, longitudinal studies suggest that brain stimulation/drug treatments and prolonged abstinence can change brain responses during and to reduce salience of drug cues, which may attenuate further craving and relapse. Incorporating this neuroscience-derived knowledge with the may offer a useful plan for delineating specific neurobiological targets for OUD treatment.
美国正处于阿片类药物流行之中，且缺乏一系列成功的干预措施来减轻这一公共卫生负担。许多患有阿片类药物使用障碍（OUD）的人使用药物来缓解身体和/或情感疼痛，这种模式可能越来越多地导致死亡。成瘾研究领域对在OUD中形成这种循环的生理和神经机制缺乏全面的了解，导致成功促进戒断和康复的干预措施有限。鉴于阿片类药物危机的紧迫性，本综述在[具体模型名称未给出]的背景下强调了与OUD相关的错误脑回路和过程。该模型强调[具体过程未明确]过程对于慢性物质使用的维持和加剧以及[其他未明确过程]和[其他未明确过程]过程至关重要。本综述重点关注采用磁共振成像（MRI）、功能近红外光谱（fNIRs）、脑刺激方法和/或在频域和时域中探索的脑电图（EEG）（后者通过事件相关电位或ERP测量）的复发和治疗结果的横断面以及纵向研究。我们讨论了这项神经影像学工作在研究设计和可能影响研究结果解释的个体差异（例如阿片类药物使用的慢性/近期性、共病症状和生物性别）方面的优势和局限性。最后，我们将OUD文献中的差距，特别是在[具体过程未明确]过程方面的差距，转化为涉及操作性和经典条件作用（包括厌恶/压力）的未来研究方向。总体而言，与阿片类药物相关的刺激可能会随着长期戒断而减轻其对涉及[具体过程未明确]的前额扣带机制的控制，并且前额扣带损伤的程度可能预测治疗结果。此外，纵向研究表明，脑刺激/药物治疗和长期戒断可以改变在[具体过程未明确]和[具体过程未明确]期间的脑反应，以降低药物线索的显著性，这可能会减弱进一步的渴望和复发。将这种源自神经科学的知识与[具体内容未明确]相结合，可能为确定OUD治疗的特定神经生物学靶点提供一个有用的计划。
