Liu Chang, Tian Xuefei, Ling Yang, Xu Jiabin, Zhou Xuhui
Department of Psychiatrics, Brains Hospital of Hunan Province, Changsha, China.
Clinical Medical School, Hunan University of Chinese Medicine, Changsha, China.
Front Psychiatry. 2020 Sep 11;11:00694. doi: 10.3389/fpsyt.2020.00694. eCollection 2020.
Alcohol dependence (AD) patients have a high prevalence of aggressive behavior (AB). The frontal cortex and amygdala contains various neurotransmitter systems and plays an important role in AB, which is also associated with cognitive deficits. However, to date, no study has addressed the association of metabolites in the frontal cortex and amygdala with cognitive deficits in Chinese aggressive behavior-alcohol dependent patients(AB-ADs).
We recruited 80 male AD and 40 male healthy controls (HCs), who completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Modified Overt Aggression Scale (MOAS), and the proton magnetic resonance spectroscopy (¹H MRS) scan using 3.0T Siemens. The ¹H MRS data were automatically fitted with a linear combination model for quantification of metabolite levels of n-acetyl-aspartate (NAA), glutamate (Glu), Choline (Cho) and creatine (Cr). Metabolite levels were reported as ratios to Cr.
The AB-ADs group scored significantly lower than the non-aggression-alcohol dependent patients (NA-ADs) on these two RBANS subscales (immediate memory and attention function indices). The AB-ADs group showed a significant reduction in NAA/CR ratio in the left frontal cortex and Cho/Cr ratio in the left amygdala, and elevation in Glu/Cr ratio in the bilateral amygdala, compared with the NA-ADs group. The NAA/Cr ratio in the left frontal cortex was positively associated with immediate memory (r=0.60, P<0.05), and the Glu/Cr ratio in the right amygdala was negatively associated with delayed memory (r=-0.44,P<0.05) in AB-ADs group.
Metabolite alterations in the frontal cortex and amygdala may be involved in the pathophysiology of AB in AD and its associated cognitive impairment, especially immediate memory and delayed memory.
酒精依赖（AD）患者攻击性行为（AB）的发生率很高。额叶皮质和杏仁核包含多种神经递质系统，在攻击性行为中起重要作用，攻击性行为也与认知缺陷有关。然而，迄今为止，尚无研究探讨中国攻击性行为-酒精依赖患者（AB-ADs）额叶皮质和杏仁核中的代谢物与认知缺陷之间的关联。
我们招募了80名男性AD患者和40名男性健康对照者（HCs），他们完成了可重复神经心理状态评估量表（RBANS）、改良外显攻击量表（MOAS），并使用3.0T西门子进行了质子磁共振波谱（¹H MRS）扫描。¹H MRS数据自动采用线性组合模型拟合，以定量分析N-乙酰天门冬氨酸（NAA）、谷氨酸（Glu）、胆碱（Cho）和肌酸（Cr）的代谢物水平。代谢物水平以与Cr的比值表示。
在RBANS的这两个分量表（即时记忆和注意力功能指数）上，AB-ADs组的得分显著低于非攻击性行为酒精依赖患者（NA-ADs）。与NA-ADs组相比，AB-ADs组左侧额叶皮质的NAA/Cr比值显著降低，左侧杏仁核的Cho/Cr比值显著降低，双侧杏仁核的Glu/Cr比值升高。在AB-ADs组中，左侧额叶皮质的NAA/Cr比值与即时记忆呈正相关（r = 0.60，P < 0.05），右侧杏仁核的Glu/Cr比值与延迟记忆呈负相关（r = -0.44，P < 0.05）。
额叶皮质和杏仁核的代谢物改变可能参与了AD患者攻击性行为及其相关认知障碍的病理生理过程，尤其是即时记忆和延迟记忆。
