Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Psychopharmacology (Berl). 2021 Sep;238(9):2365-2379. doi: 10.1007/s00213-021-05920-w. Epub 2021 Jul 27.
Numerous studies based on voxel-based morphometry (VBM) have revealed gray matter (GM) alterations in multiple brain regions for addiction. However, findings are poorly replicated, and it remains elusive whether distinct diagnoses of addiction are underpinned by shared abnormalities. Our aim was to conduct a quantitative meta-analysis of structural neuroimaging studies investigating GM abnormalities in two main categories of addiction: substance use disorders (SUD) and behavioral addictions (BA).
A systematic database search was conducted in several databases from Jan 1, 2010, to Oct 23, 2020, to identify eligible VBM studies. Meta-analysis was performed with the seed-based d mapping software package to compare alternations between individuals with addiction-related disorders and healthy controls (HC).
A total of 59 VBM studies including 2096 individuals with addiction-related disorders and 2637 HC met the inclusion criteria. Individuals with addiction-related disorders showed shared GM volume decrease in bilateral prefrontal cortex, bilateral insula, bilateral rolandic operculum, left superior temporal gyrus, and right Heschl gyrus and GM increase in right lingual gyrus and right fusiform gyrus comparing with HC (p < 0.005). Subgroup analysis found heterogeneity between SUD and BA mainly in left inferior occipital gyrus and right striatum (p < 0.005). Meta-regression revealed that GM atrophy in right anterior cingulate (r = 0.541, p = 0.03 (uncorrected)) and left inferior frontal gyrus (r = 0.595, p = 0.015) were positively correlated with higher impulsivity.
This meta-analysis identified a concordance across subtypes of addiction in terms of the brain structural changes in prefrontal and insula areas, which may relate to higher impulsivity observed across addiction diagnoses. This concordance provides an organizing model that emphasizes the importance of shared neural substrates in addiction.
基于体素形态计量学（VBM）的大量研究揭示了多种大脑区域的灰质（GM）改变与成瘾有关。然而，这些发现的重复性较差，并且仍然不清楚不同的成瘾诊断是否存在共同的异常。我们的目的是对两个主要成瘾类别（物质使用障碍（SUD）和行为成瘾（BA）的结构神经影像学研究进行定量荟萃分析。
从 2010 年 1 月 1 日至 2020 年 10 月 23 日，在几个数据库中进行了系统的数据库搜索，以确定符合条件的 VBM 研究。使用基于种子的 d 映射软件包进行荟萃分析，以比较与健康对照（HC）相比，有与成瘾相关障碍的个体的变化。
共有 59 项 VBM 研究，包括 2096 名有与成瘾相关障碍的个体和 2637 名 HC，符合纳入标准。与 HC 相比，有与成瘾相关障碍的个体显示双侧前额叶皮层、双侧岛叶、双侧 Rolandic 脑盖、左侧颞上回和右侧 Heschl 回的 GM 体积减少，以及右侧舌回和右侧梭状回的 GM 增加（p<0.005）。亚组分析发现 SUD 和 BA 之间的异质性主要在左侧枕下回和右侧纹状体（p<0.005）。元回归显示右侧前扣带回（r=0.541，p=0.03（未校正））和左侧额下回（r=0.595，p=0.015）的 GM 萎缩与更高的冲动性呈正相关。
这项荟萃分析确定了不同成瘾亚型在额叶和岛叶区域的大脑结构变化方面的一致性，这可能与不同成瘾诊断中观察到的更高冲动性有关。这种一致性提供了一个组织模型，强调了成瘾中共同神经基础的重要性。
