Department of Clinical Medicine, Center for Music in the Brain, University of Aarhus, Aarhus, Denmark.
Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM) campus Juriquilla, Queretaro, Mexico.
Transl Psychiatry. 2021 Jan 11;11(1):29. doi: 10.1038/s41398-020-01128-2.
Substance use disorders (SUDs) are characterized by a compulsion to seek and consume one or more substances of abuse, with a perceived loss of control and a negative emotional state. Prolonged substance use seems to be associated with morphological changes of multiple neural circuits, in particular the frontal-striatal and limbic pathways. Such neuroadaptations are evident across several substance disorders, but may vary depending on the type of substance, consumption severity and/or other unknown factors. We therefore identified studies investigating the effects of SUDs using volumetric whole-brain voxel-based morphometry (VBM) in gray (GM) and white matter (WM). We performed a systematic review and meta-analysis of VBM studies using the anatomic likelihood estimation (ALE) method implemented in GingerALE (PROSPERO pre-registration CRD42017071222 ). Sixty studies met inclusion criteria and were included in the final quantitative meta-analysis, with a total of 614 foci, 94 experiments and 4938 participants. We found convergence and divergence in brain regions and volume effects (higher vs. lower volume) in GM and WM depending on the severity of the consumption pattern and type of substance used. Convergent pathology was evident across substances in GM of the insula, anterior cingulate cortex, putamen, and thalamus, and in WM of the thalamic radiation and internal capsule bundle. Divergent pathology between occasional use (cortical pathology) and addiction (cortical-subcortical pathology) provides evidence of a possible top-down neuroadaptation. Our findings indicate particular brain morphometry alterations in SUDs, which may inform our understanding of disease progression and ultimately therapeutic approaches.
物质使用障碍（SUD）的特征是强迫寻求和消费一种或多种滥用物质，同时感知到控制能力丧失和负面情绪状态。长期物质使用似乎与多个神经回路的形态变化有关，特别是额纹状体和边缘通路。这种神经适应性在多种物质障碍中都很明显，但可能因物质类型、消费严重程度和/或其他未知因素而异。因此，我们确定了使用全脑基于体素的形态计量学（VBM）研究 SUD 的研究，以研究灰质（GM）和白质（WM）的影响。我们使用 GingerALE（PROSPERO 预注册 CRD42017071222）中的解剖似然估计（ALE）方法对 VBM 研究进行了系统评价和荟萃分析。符合纳入标准的 60 项研究被纳入最终的定量荟萃分析，共涉及 614 个焦点、94 个实验和 4938 名参与者。我们发现，根据消费模式的严重程度和使用的物质类型，GM 和 WM 中的脑区和体积效应（更高或更低的体积）存在趋同和发散。在 GM 中，岛叶、前扣带皮层、壳核和丘脑，以及 WM 中的丘脑辐射和内囊束中，各种物质都存在趋同的病理变化。偶尔使用（皮质病变）和成瘾（皮质-皮质下病变）之间的发散性病理变化提供了一种可能的自上而下的神经适应性的证据。我们的发现表明 SUD 中存在特定的脑形态计量学改变，这可能有助于我们了解疾病进展，并最终为治疗方法提供信息。
