School of Economics and Business Administration, Chongqing University, Chongqing, 400044, China.
Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Hempstead, NY, USA; Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA.
Neurosci Biobehav Rev. 2021 Sep;128:294-310. doi: 10.1016/j.neubiorev.2021.06.031. Epub 2021 Jun 23.
Altered brain responses to alcohol-associated stimuli are a neural hallmark of alcohol-use disorder (AUD) and a promising target for pharmacotherapy. However, findings in cue-reactivity based functional MRI (fMRI) studies are inconclusive. To investigate the neural substrates of cue-reactivity and their relevance to treatment outcomes, alcohol craving and relapse in AUD patients, we performed five meta-analyses using signed differential mapping software. Our meta-analysis revealed that alcohol cues evoke greater cue-reactivity than neutral cues in the mesocorticolimbic circuit and lower reactivity in the parietal and temporal regions in AUD patients. Compared to controls, AUD individuals displayed hyperactivations in the medial prefrontal cortex and anterior/middle part of the cingulate cortex. After receiving AUD treatment, AUD patients exhibited greater activations in the precentral gyrus but reduced activations in the bilateral caudate nucleus, insula, right DLPFC, and left superior frontal gyrus. No significant results were found in cue-reactivity correlates of alcohol craving and relapse. Our results implicate cue-induced abnormalities in corticostriatal-limbic circuits may underline the pathophysiology of AUD, and have translational value for treatment development.
对与酒精相关刺激的大脑反应改变是酒精使用障碍(AUD)的神经标志,也是药物治疗的有前途的靶点。然而,基于线索反应的功能磁共振成像(fMRI)研究的结果尚无定论。为了研究线索反应的神经基础及其与 AUD 患者的治疗结果、酒精渴求和复发的相关性,我们使用符号差分映射软件进行了五项荟萃分析。我们的荟萃分析表明,与中性线索相比,酒精线索在边缘皮质回路中引起更大的线索反应,而在 AUD 患者的顶叶和颞叶区域反应较低。与对照组相比,AUD 个体在前扣带回皮质和扣带前回的内侧/中间部分显示出过度激活。接受 AUD 治疗后,AUD 患者的中央前回激活增加,但双侧尾状核、岛叶、右侧 DLPFC 和左侧额上回的激活减少。在酒精渴求和复发的线索反应相关性中未发现显著结果。我们的研究结果表明,皮质纹状体 - 边缘回路中的线索诱导异常可能是 AUD 病理生理学的基础,并为治疗开发具有转化价值。
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