急性酒精戒断后神经生物学和症状学：混合研究系统评价。
Neurobiology and Symptomatology of Post-Acute Alcohol Withdrawal: A Mixed-Studies Systematic Review.
机构信息
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
出版信息
J Stud Alcohol Drugs. 2022 Jul;83(4):461-469. doi: 10.15288/jsad.2022.83.461.
OBJECTIVE
This study aims to review the neurobiology and symptomatology of post-acute alcohol withdrawal syndrome (PAWS).
METHOD
We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-guided systematic review of articles from two databases for English-language randomized and nonrandomized studies involving PAWS published between database inception and December 2020.
RESULTS
Twenty-seven studies met inclusion criteria. PAWS involves predominantly negative affect, which develops in early abstinence and can persist for 4-6 months or longer. Symptoms include anxiety, dysphoria, anhedonia, sleep disturbance, cognitive impairment, cravings, and irritability. PAWS symptoms appear to be risk factors for recurrent alcohol consumption. They have been associated with reported neurobiological differences in evoked potentials; measures of orexins, cortisol, serotonin, and pancreatic polypeptides; and neuroadaptation changes in the nucleus accumbens and the prefrontal cortex.
CONCLUSIONS
There is credible evidence to support the concept of PAWS based on this review's findings. There remains a need to develop and test specific criteria for PAWS. High-quality treatment studies involving agents addressing its neurobiological underpinnings are also recommended.
目的
本研究旨在综述急性酒精戒断后综合征（PAWS）的神经生物学和症状学。
方法
我们进行了一项 PRISMA（系统评价和荟萃分析的首选报告项目）指导的系统综述，从两个数据库中检索了自数据库建立至 2020 年 12 月发表的关于 PAWS 的英文随机和非随机研究的文章。
结果
27 项研究符合纳入标准。PAWS 主要涉及负性情绪，在戒断早期出现，并可持续 4-6 个月或更长时间。症状包括焦虑、烦躁不安、快感缺失、睡眠障碍、认知障碍、渴望和易怒。PAWS 症状似乎是复饮的风险因素。它们与诱发电位的神经生物学差异、orexins、皮质醇、血清素和胰多肽的测量值、伏隔核和前额叶皮层的神经适应变化有关。
结论
根据本综述的发现，有可信的证据支持 PAWS 的概念。仍需要制定和测试 PAWS 的具体标准。还建议进行涉及针对其神经生物学基础的药物治疗的高质量研究。
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