Laureate Institute for Brain Research, Tulsa, Oklahoma, USA.
Curr Opin Neurol. 2022 Aug 1;35(4):460-466. doi: 10.1097/WCO.0000000000001077. Epub 2022 Jul 5.
Substance use disorders account for a tremendous burden to society, yet despite substantial progress in basic studies, our understanding of the brain-basis of these disorders is still emerging. This review summarizes the recent findings of neuroimaging studies with substance use disorder individuals.
Resting-state functional connectivity studies support for some but not all substances of abuse and disruption in executive control. Structural neuroimaging findings point towards reduced subcortical volumes, which may emerge as an interaction between preexisting factors and recent substance use. Longitudinal studies implicate some of the same core brain structures and their functional role that have also been identified via case-control studies. Finally, meta-analyses support the idea of dysregulation of cortical control over subcortical salience processing.
Although progress has been made and there is both structural and functional imaging evidence of an imbalance between brain structures involved in executive control and salience processing, there is emerging evidence that brain-behaviour relationships, which are core to discovering the neural processes that lead to and maintain substance use, are small and require larger consortia that prospectively examine individuals with substance use disorder.
物质使用障碍给社会造成了巨大负担，尽管基础研究取得了重大进展，但我们对这些障碍的大脑基础的理解仍在不断发展。本综述总结了具有物质使用障碍个体的神经影像学研究的最新发现。
静息态功能连接研究支持一些但不是所有的滥用物质，并破坏执行控制。结构神经影像学研究表明，皮质下体积减少，这可能是由于先前存在的因素和最近的物质使用之间的相互作用而出现的。纵向研究提示了一些相同的核心脑结构及其功能作用，这些结构和功能作用也通过病例对照研究得到了确认。最后，荟萃分析支持皮质对皮质下突显处理的控制失调的观点。
尽管已经取得了进展，并且有结构和功能成像证据表明，参与执行控制和突显处理的大脑结构之间存在不平衡，但有新的证据表明，大脑-行为关系是发现导致和维持物质使用的神经过程的核心，这些关系很小，需要更大的联盟来前瞻性地检查具有物质使用障碍的个体。
