Zabik Nicole L, Blackford Jennifer Urbano
Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Alcohol. 2024 Dec;121:33-44. doi: 10.1016/j.alcohol.2024.07.003. Epub 2024 Jul 26.
Women are drinking alcohol as much as men for the first time in history. Women experience more health-related consequences from alcohol use disorder (AUD), like increased prevalence of alcohol-related cancers, faster progression of alcohol-related liver disease, and greater risk for relapse compared to men. Thus, sex differences in chronic alcohol use pose a substantial public health problem. Despite these evident sex differences, our understanding of how these differences present during alcohol abstinence is limited. Investigations of brain structure and function are therefore critical for disentangling factors that lead to sex differences in AUD abstinence. This review will discuss current human neuroimaging data on sex differences in alcohol abstinence, focusing on structural and functional brain measures. Current structural imaging literature reveals that abstinent men have smaller gray and white matter volume and weaker structural connectivity compared to control men. Interestingly, abstinent women do not show differences in brain structure when compared to controls; instead, abstinent women show a relation between alcohol use and decreased measures of brain structure. Current functional brain studies reveal that abstinent men exhibit greater brain activation and stronger task-based functional connectivity to aversive stimuli than control men, while abstinent women exhibit lesser brain activation and weaker task-based functional connectivity than control women. Together, the current literature suggests that sex differences persist well into alcohol abstinence and impact brain structure and function differently. Understanding how men and women differ during alcohol abstinence can improve our understanding of sex-specific effects of alcohol, which will be critical to augment treatment methods to better serve women.
历史上女性饮酒量首次与男性相当。与男性相比，女性因酒精使用障碍（AUD）面临更多与健康相关的后果，如与酒精相关癌症的患病率增加、酒精性肝病进展更快以及复发风险更高。因此，慢性酒精使用中的性别差异构成了一个重大的公共卫生问题。尽管存在这些明显的性别差异，但我们对戒酒期间这些差异如何表现的了解仍然有限。因此，对大脑结构和功能的研究对于厘清导致戒酒中性别差异的因素至关重要。本综述将讨论目前关于戒酒中性别差异的人类神经影像学数据，重点关注大脑的结构和功能测量。当前的结构成像文献表明，与对照男性相比，戒酒男性的灰质和白质体积更小，结构连接性更弱。有趣的是，与对照组相比，戒酒女性的大脑结构没有差异；相反，戒酒女性表现出酒精使用与大脑结构测量值降低之间的关系。当前的大脑功能研究表明，与对照男性相比，戒酒男性对厌恶刺激表现出更大的大脑激活和更强的基于任务的功能连接性，而与对照女性相比，戒酒女性表现出较小的大脑激活和较弱的基于任务的功能连接性。总之，当前的文献表明，性别差异在戒酒过程中持续存在，并且对大脑结构和功能的影响有所不同。了解男性和女性在戒酒期间的差异可以增进我们对酒精性别特异性影响的理解，这对于改进治疗方法以更好地服务女性至关重要。
