Michaels Timothy I, Stone Emily, Singal Sonali, Novakovic Vladan, Barkin Robert L, Barkin Stacy
Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY 11004, United States.
Department of Psychiatry, The Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Glen Oaks, NY 11004, United States.
World J Psychiatry. 2021 Jun 19;11(6):222-231. doi: 10.5498/wjp.v11.i6.222.
Mental health symptoms secondary to trauma exposure and substance use disorders (SUDs) co-occur frequently in both clinical and community samples. The possibility of a shared aetiology remains an important question in translational neuroscience. Advancements in genetics, basic science, and neuroimaging have led to an improved understanding of the neural basis of these disorders, their frequent comorbidity and high rates of relapse remain a clinical challenge. This project aimed to conduct a review of the field's current understanding regarding the neural circuitry underlying posttraumatic stress disorder and SUD. A comprehensive review was conducted of available published literature regarding the shared neurobiology of these disorders, and is summarized in detail, including evidence from both animal and clinical studies. Upon summarizing the relevant literature, this review puts forth a hypothesis related to their shared neurobiology within the context of fear processing and reward cues. It provides an overview of brain reward circuitry and its relation to the neurobiology, symptomology, and phenomenology of trauma and substance use. This review provides clinical insights and implications of the proposed theory, including the potential development of novel pharmacological and therapeutic treatments to address this shared neurobiology. Limitations and extensions of this theory are discussed to provide future directions and insights for this shared phenomena.
创伤暴露和物质使用障碍（SUDs）继发的心理健康症状在临床和社区样本中经常同时出现。共同病因的可能性仍然是转化神经科学中的一个重要问题。遗传学、基础科学和神经影像学的进展使人们对这些疾病的神经基础有了更好的理解，但它们频繁的共病和高复发率仍然是一个临床挑战。本项目旨在对该领域目前对创伤后应激障碍和物质使用障碍潜在神经回路的理解进行综述。对有关这些疾病共同神经生物学的现有已发表文献进行了全面综述，并进行了详细总结，包括来自动物和临床研究的证据。在总结相关文献后，本综述提出了一个在恐惧处理和奖励线索背景下与它们共同神经生物学相关的假设。它概述了大脑奖励回路及其与创伤和物质使用的神经生物学、症状学和现象学的关系。本综述提供了所提出理论的临床见解和启示，包括开发新的药物和治疗方法以应对这种共同神经生物学的潜力。讨论了该理论的局限性和扩展，为这一共同现象提供未来的方向和见解。
