Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas.
The Menninger Clinic, Houston, Texas.
Am J Addict. 2021 Jan;30(1):72-79. doi: 10.1111/ajad.13093. Epub 2020 Nov 24.
Substance use disorder (SUD) includes maladaptive patterns of substance use despite negative consequences. Previous structural neuroimaging studies showed some structural alterations in SUD, but it remains unknown whether these alterations are specifically associated with SUD or common comorbidities. This study attempts to validate the findings of structural differences between SUD, healthy controls (HC), and psychiatric controls (PC).
We used HC (N = 86) matched for demographics, and PC (N = 86) matched for demographics and psychiatric diagnoses to a group of SUD patients (N = 86). We assessed the group differences of subcortical volumes, cortical volumes, thickness, and surface areas between SUD and HC. We then analyzed the group differences between SUD and PC within regions showing differences between SUD and HC.
SUD had smaller left nucleus accumbens, right thalamus, right hippocampus, left caudal anterior cingulate cortex (ACC) volume, and larger right caudal ACC volume, and right caudal ACC, right caudal middle frontal gyrus (MFG), and right posterior cingulate cortex (PCC) surface than HC. Increased right caudal ACC volume and right PCC surface in SUD were the only findings when compared with PC. Several areas showed thickness alterations between SUD and HC, but none survived multiple comparisons vs PC.
Our findings suggest that cingulate structures may be altered in SUD compared with both HC and PC.
These results are among the first to indicate that some structural alterations may be SUD-specific, and highlight a cautionary note about using HC in psychiatric biomarker research. (Am J Addict 2021;30:72-79).
物质使用障碍（SUD）包括尽管有负面后果但仍存在的物质使用失调模式。先前的结构神经影像学研究表明 SUD 存在一些结构改变，但尚不清楚这些改变是否与 SUD 或常见共病有关。本研究试图验证 SUD、健康对照（HC）和精神科对照（PC）之间结构差异的研究结果。
我们使用了与 SUD 患者（N=86）相匹配的 HC（N=86）和与人口统计学和精神科诊断相匹配的 PC（N=86）。我们评估了 SUD 与 HC 之间的皮质下体积、皮质体积、厚度和表面积的组间差异。然后，我们分析了在 SUD 与 HC 之间存在差异的区域内 SUD 与 PC 之间的组间差异。
SUD 患者的左侧伏隔核、右侧丘脑、右侧海马、左侧扣带回后下部皮质（ACC）体积较小，右侧 ACC 体积较大，右侧 ACC、右侧 ACC 下部、右侧中部额下回（MFG）和右侧后扣带回皮质（PCC）表面积较大。与 PC 相比，SUD 患者的右侧 ACC 体积增加和右侧 PCC 表面增加是唯一的发现。SUD 与 HC 之间的几个区域存在厚度改变，但与 PC 相比，没有一个区域的改变通过了多重比较。
我们的研究结果表明，与 HC 和 PC 相比，ACC 结构可能在 SUD 中发生改变。
这些结果是首次表明，一些结构改变可能是 SUD 特异性的，并提醒人们在精神疾病生物标志物研究中使用 HC 时要谨慎。（美国药物滥用杂志 2021；30：72-79）。
