Department of Psychiatry, Yale University, New Haven, CT, USA.
Department of Psychological & Brain Sciences, Dartmouth College, Hanover, NH, USA.
J Neural Transm (Vienna). 2024 May;131(5):509-523. doi: 10.1007/s00702-024-02766-2. Epub 2024 Apr 17.
Substance use disorders (SUDs) are the most costly and prevalent psychiatric conditions. Recent calls emphasize a need for biomarkers-measurable, stable indicators of normal and abnormal processes and response to treatment or environmental agents-and, in particular, brain-based neuromarkers that will advance understanding of the neurobiological basis of SUDs and clinical practice. To develop neuromarkers, researchers must be grounded in evidence that a putative marker (i) is sensitive and specific to the psychological phenomenon of interest, (ii) constitutes a predictive model, and (iii) generalizes to novel observations (e.g., through internal cross-validation and external application to novel data). These neuromarkers may be used to index risk of developing SUDs (susceptibility), classify individuals with SUDs (diagnostic), assess risk for progression to more severe pathology (prognostic) or index current severity of pathology (monitoring), detect response to treatment (response), and predict individualized treatment outcomes (predictive). Here, we outline guidelines for developing and assessing neuromarkers, we then review recent advances toward neuromarkers in addiction neuroscience centering our discussion around neuromarkers of craving-a core feature of SUDs. In doing so, we specifically focus on the Neurobiological Craving Signature (NCS), which show great promise for meeting the demand of neuromarkers.
物质使用障碍（SUDs）是最昂贵和最普遍的精神疾病。最近的呼吁强调了需要生物标志物——可衡量的、稳定的正常和异常过程以及对治疗或环境因素的反应的指标，特别是基于大脑的神经生物标志物，这将有助于理解 SUDs 的神经生物学基础和临床实践。为了开发神经生物标志物，研究人员必须基于证据，即假定的标志物（i）对感兴趣的心理现象敏感且具有特异性，（ii）构成预测模型，以及（iii）推广到新的观察结果（例如，通过内部交叉验证和对新数据的外部应用）。这些神经生物标志物可用于评估 SUDs 的发病风险（易感性）、分类 SUDs 患者（诊断）、评估向更严重病理进展的风险（预后）或评估当前病理严重程度（监测）、检测对治疗的反应（反应），并预测个体化治疗结果（预测）。在这里，我们概述了开发和评估神经生物标志物的指南，然后回顾了成瘾神经科学中神经生物标志物的最新进展，我们的讨论集中在 SUDs 的核心特征——渴望的神经生物标志物上。在这样做的过程中，我们特别关注神经生物学渴望特征（NCS），它在满足神经生物标志物的需求方面显示出巨大的潜力。
