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酒精中毒患者脑葡萄糖代谢减少与皮质厚度变薄的相关性:神经毒性的证据。

Association Between Reduced Brain Glucose Metabolism and Cortical Thickness in Alcoholics: Evidence of Neurotoxicity.

机构信息

National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD.

National Institute on Drug Abuse, Bethesda, MD.

出版信息

Int J Neuropsychopharmacol. 2019 Sep 1;22(9):548-559. doi: 10.1093/ijnp/pyz036.

Abstract

BACKGROUND

Excessive alcohol consumption is associated with reduced cortical thickness (CT) and lower cerebral metabolic rate of glucose (CMRGlu), but the correlation between these 2 measures has not been investigated.

METHODS

We tested the association between CT and cerebral CMRGlu in 19 participants with alcohol use disorder (AUD) and 20 healthy controls. Participants underwent 2-Deoxy-2-[18F]fluoroglucose positron emission tomography to map CMRGlu and magnetic resonance imaging to assess CT.

RESULTS

Although performance accuracy on a broad range of cognitive domains did not differ significantly between AUD and HC, AUD had widespread decreases in CT and CMRGlu. CMRGlu, normalized to cerebellum (rCMRGlu), showed significant correlation with CT across participants. Although there were large group differences in CMRGlu (>17%) and CT (>6%) in medial orbitofrontal and BA 47, the superior parietal cortex showed large reductions in CMRGlu (17%) and minimal CT differences (2.2%). Though total lifetime alcohol (TLA) was associated with CT and rCMRGlu, the causal mediation analysis revealed significant direct effects of TLA on rCMRGlu but not on CT, and there were no significant mediation effects of TLA, CT, and rCMRGlu.

CONCLUSIONS

The significant correlation between decrements in CT and CMRGlu across AUD participants is suggestive of alcohol-induced neurotoxicity, whereas the findings that the most metabolically affected regions in AUD had minimal atrophy and vice versa indicates that changes in CT and CMRGlu reflect distinct responses to alcohol across brain regions.

摘要

背景

过量饮酒与皮质厚度(CT)降低和脑葡萄糖代谢率(CMRGlu)降低有关,但这两种测量方法之间的相关性尚未得到研究。

方法

我们测试了 19 名酒精使用障碍(AUD)患者和 20 名健康对照者的 CT 与脑 CMRGlu 之间的相关性。参与者接受了 2-脱氧-2-[18F]氟葡萄糖正电子发射断层扫描以绘制 CMRGlu 图谱,并进行磁共振成像以评估 CT。

结果

尽管 AUD 和 HC 在广泛的认知领域的表现准确性没有显著差异,但 AUD 患者的 CT 和 CMRGlu 广泛降低。CMRGlu 与 CT 之间存在显著相关性。尽管在中眶额回和 BA47 中,CMRGlu(归一化为小脑)(rCMRGlu)和 CT 存在较大的组间差异(>17%和>6%),但顶叶上回的 CMRGlu 减少幅度较大(17%),CT 差异较小(2.2%)。虽然总 lifetime alcohol(TLA)与 CT 和 rCMRGlu 相关,但因果中介分析显示 TLA 对 rCMRGlu 有显著的直接影响,而对 CT 没有显著影响,且 TLA、CT 和 rCMRGlu 没有显著的中介作用。

结论

AUD 患者 CT 和 CMRGlu 下降之间的显著相关性表明酒精具有神经毒性,而在 AUD 中代谢最活跃的区域最小化萎缩而反之亦然的发现表明 CT 和 CMRGlu 的变化反映了不同的大脑区域对酒精的反应。

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