Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
Neuroscience Program, SRI International, Menlo Park, California.
J Neurosci Res. 2022 May;100(5):1140-1158. doi: 10.1002/jnr.24423. Epub 2019 Apr 22.
This article provides an overview of recent advances in understanding the effects of alcohol use disorders (AUD) on the brain from the perspective of magnetic resonance imaging (MRI) research in preclinical models and clinical studies. As a noninvasive investigational tool permitting assessment of morphological, metabolic, and hemodynamic changes over time, MRI offers insight into the dynamic course of alcoholism beginning with initial exposure through periods of binge drinking and escalation, sobriety, and relapse and has been useful in differential diagnosis of neurological diseases associated with AUD. Structural MRI has revealed acute and chronic effects of alcohol on both white and gray matter volumes. MR Spectroscopy, able to quantify brain metabolites in vivo, has shed light on biochemical alterations associated with alcoholism. Diffusion tensor imaging permits microstructural characterization of white matter fiber tracts. Functional MRI has allowed for elucidation of hemodynamic responses at rest and during task engagement. Positron emission tomography, a non-MRI imaging tool, has led to a deeper understanding of alcohol-induced receptor and neurotransmitter changes during various stages of drinking and abstinence. Together, such in vivo imaging tools have expanded our understanding of the dynamic course of alcoholism including evidence for regional specificity of the effects of AUD, hints at mechanisms underlying the shift from casual to compulsive use of alcohol, and profound recovery with sustained abstinence.
本文从临床前模型和临床研究的磁共振成像(MRI)研究角度,概述了近年来人们对酒精使用障碍(AUD)对大脑影响的认识进展。MRI 作为一种非侵入性的研究工具,可以评估形态、代谢和血流动力学随时间的变化,为开始于最初接触、狂欢饮酒和升级、清醒和复发的酒精中毒的动态过程提供了深入了解,并且在与 AUD 相关的神经疾病的鉴别诊断中很有用。结构 MRI 揭示了酒精对白质和灰质体积的急性和慢性影响。能够在体内定量脑代谢物的磁共振波谱,揭示了与酒精中毒相关的生化变化。弥散张量成像允许对大脑白质纤维束进行微观结构特征描述。功能 MRI 允许阐明在静息和任务参与期间的血液动力学反应。正电子发射断层扫描(PET),一种非 MRI 成像工具,使我们更深入地了解了在饮酒和禁欲的各个阶段,酒精引起的受体和神经递质变化。这些体内成像工具共同扩展了我们对酒精中毒动态过程的理解,包括 AUD 影响的区域特异性的证据,提示了从随意使用酒精到强迫使用酒精的转变机制,以及持续禁欲带来的深刻恢复。