Voon Valerie, Grodin Erica, Mandali Alekhya, Morris Laurel, Doñamayor Nuria, Weidacker Kathrin, Kwako Laura, Goldman David, Koob George F, Momenan Reza
Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, Cambridge, UK; Cambridgeshire and Peterborough NHS Trust, Cambridge, UK.
Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, UK.
Neurosci Biobehav Rev. 2020 Jun;113:492-506. doi: 10.1016/j.neubiorev.2020.04.004. Epub 2020 Apr 13.
Alcohol misuse and addiction are major international public health issues. Addiction can be characterized as a disorder of aberrant neurocircuitry interacting with environmental, genetic and social factors. Neuroimaging in alcohol misuse can thus provide a critical window into underlying neural mechanisms, highlighting possible treatment targets and acting as clinical biomarkers for predicting risk and treatment outcomes. This neuroimaging review on alcohol misuse in humans follows the Addictions Neuroclinical Assessment (ANA) that proposes incorporating three functional neuroscience domains integral to the neurocircuitry of addiction: incentive salience and habits, negative emotional states, and executive function within the context of the addiction cycle. Here we review and integrate multiple imaging modalities focusing on underlying cognitive processes such as reward anticipation, negative emotionality, cue reactivity, impulsivity, compulsivity and executive function. We highlight limitations in the literature and propose a model forward in the use of neuroimaging as a tool to understanding underlying mechanisms and potential clinical applicability for phenotyping of heterogeneity and predicting risk and treatment outcomes.
酒精滥用和成瘾是重大的国际公共卫生问题。成瘾可被视为一种与环境、遗传和社会因素相互作用的异常神经回路紊乱。因此，酒精滥用的神经影像学研究能够为深入了解潜在神经机制提供关键视角，突出可能的治疗靶点，并作为预测风险和治疗结果的临床生物标志物。这篇关于人类酒精滥用的神经影像学综述遵循成瘾神经临床评估（ANA），该评估建议纳入成瘾神经回路中不可或缺的三个功能性神经科学领域：动机显著性与习惯、负面情绪状态以及成瘾周期背景下的执行功能。在此，我们回顾并整合多种成像方式，重点关注诸如奖励预期、负面情绪、线索反应性、冲动性、强迫性和执行功能等潜在认知过程。我们强调了文献中的局限性，并提出了一个利用神经影像学作为工具来理解潜在机制以及在异质性表型分析、预测风险和治疗结果方面潜在临床适用性的未来模型。
