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酒精使用障碍患者治疗后长期戒断时区域皮质厚度的恢复情况。

Regional cortical thickness recovery with extended abstinence after treatment in those with alcohol use disorder.

作者信息

Durazzo Timothy C, Stephens Lauren H, Meyerhoff Dieter J

机构信息

Sierra-Pacific Mental Illness Research and Education Clinical Centers, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.

出版信息

Alcohol. 2024 Feb;114:51-60. doi: 10.1016/j.alcohol.2023.08.011. Epub 2023 Aug 30.

Abstract

Several cross-sectional investigations reported widespread cortical thinning in those with alcohol use disorder (AUD). The few longitudinal studies investigating cortical thickness changes during abstinence are limited to the first month of sobriety. Consequently, cortical thickness changes during extended abstinence in those with AUD is unclear. In this study, AUD participants were studied at approximately 1 week (n = 68), 1 month (n = 88), and 7.3 months (n = 40) of abstinence. Forty-five never-smoking controls (CON) completed a baseline study, and 15 were reassessed after approximately 9.6 months. Participants completed magnetic resonance imaging studies at 1.5T, and cortical thickness for 34 bilateral regions of interest (ROI) was quantitated with FreeSurfer. AUD participants demonstrated significant linear thickness increases in 25/34 ROI over 7.3 months of abstinence. The rate of change from 1 week to 1 month was greater than 1 month to 7.3 months in 19/34 ROIs. Proatherogenic conditions were associated with lower thickness recovery in anterior frontal, inferior parietal, and lateral/mesial temporal regions. After 7.3 months of abstinence, AUD participants were statistically equivalent to CON on cortical thickness in 24/34 ROIs; the cortical thickness differences between AUD and CON in the banks superior temporal gyrus, post central, posterior cingulate, superior parietal, supramarginal, and superior frontal cortices were driven by thinner cortices in AUD with proatherogenic conditions relative to CON. In actively smoking AUD, increasing pack-years was associated with decreasing thickness recovery primarily in the anterior frontal ROIs. Widespread bilateral cortical thickness recovery over 7.3 months of abstinence was the central finding for this AUD cohort. The longitudinal and cross-sectional findings for AUD with proatherogenic suggests alterations in perfusion or vascular integrity may relate to structural recovery in those with AUD. These results support the adaptive and beneficial effects of sustained sobriety on brain structural recovery in people with AUD.

摘要

多项横断面研究报告称,酒精使用障碍(AUD)患者存在广泛的皮质变薄现象。少数纵向研究调查了戒酒期间皮质厚度的变化,但仅限于戒酒的第一个月。因此,AUD患者长期戒酒期间皮质厚度的变化尚不清楚。在本研究中,对AUD参与者在戒酒约1周(n = 68)、1个月(n = 88)和7.3个月(n = 40)时进行了研究。45名从不吸烟的对照者(CON)完成了基线研究,其中15名在约9.6个月后重新进行了评估。参与者接受了1.5T的磁共振成像研究,并使用FreeSurfer对34个双侧感兴趣区域(ROI)的皮质厚度进行了定量分析。AUD参与者在戒酒7.3个月期间,34个ROI中有25个显示出显著的线性厚度增加。在34个ROI中的19个,从1周到1个月的变化率大于从1个月到7.3个月的变化率。促动脉粥样硬化状态与前额叶前部、顶叶下部以及外侧/内侧颞叶区域较低的厚度恢复相关。戒酒7.3个月后,AUD参与者在34个ROI中的24个的皮质厚度在统计学上与CON相当;颞上回、中央后回、后扣带回、顶上回、缘上回和额上回皮质中,AUD与CON之间的皮质厚度差异是由AUD中患有促动脉粥样硬化状态的参与者相对于CON的皮质较薄所驱动的。在积极吸烟的AUD患者中,吸烟包年数增加主要与前额叶前部ROI的厚度恢复降低有关。戒酒7.3个月期间广泛的双侧皮质厚度恢复是该AUD队列的核心发现。AUD伴促动脉粥样硬化状态的纵向和横断面研究结果表明,灌注或血管完整性的改变可能与AUD患者的结构恢复有关。这些结果支持了持续戒酒对AUD患者脑结构恢复的适应性和有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29ad/10902196/e6885bd3aab3/nihms-1955350-f0001.jpg

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