Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
Normandie Université, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.
Eur Psychiatry. 2024 Nov 15;67(1):e75. doi: 10.1192/j.eurpsy.2024.1784.
Theoretical and empirical contributions have identified insula as key in addiction. However, anatomical modifications of the insula in addictive states, and their variations across substance use disorders (SUDs), remain to be specifically explored. We therefore explored the specificities and commonalities of insula gray matter (GM) alterations in severe alcohol use disorder (sAUD) and severe cocaine use disorder (sCUD).
We explored insula GM volume through a refined parcellation in 12 subregions (six bilateral): anterior inferior cortex (AIC), anterior short gyrus, middle short gyrus, posterior short gyrus, anterior long gyrus (ALG), and posterior long gyrus (PLG). Using a linear mixed model analysis, we explored the insula volume profiles of 50 patients with sAUD, 61 patients with sCUD, and 36 healthy controls (HCs).
In both sAUD and sCUD, we showed overall insular lower volume with a right-sided lateralization effect, and a major volume deficit in bilateral ALG. Moreover, differences emerged across groups, with higher left AIC and PLG volume deficits in sCUD compared to sAUD and HC.
We offered the first joint exploration of GM insular volumes in two SUD through refined parcellation, thus unveiling the similarities and dissimilarities in volume deficit profiles. Our results bring evidence complementing prior ones suggesting the core role of the right and posterior insula in craving and interoception, two crucial processes in addiction. Left AIC and PLG group differences also show that, while insula is a region of interest in SUD, sCUD and sAUD generate distinct insular profiles, which might parallel clinical differences across SUD.
理论和实证研究都将脑岛确定为成瘾的关键部位。然而，在成瘾状态下脑岛的解剖结构变化及其在各种物质使用障碍（SUD）中的变化仍需进一步探索。因此，我们探讨了严重酒精使用障碍（sAUD）和严重可卡因使用障碍（sCUD）患者脑岛灰质（GM）改变的特异性和共性。
我们通过精细的 12 个亚区（左右各 6 个）划分来探索脑岛 GM 体积，包括前下皮质（AIC）、前短回、中短回、后短回、前长回（ALG）和后长回（PLG）。我们使用线性混合模型分析，探讨了 50 例 sAUD 患者、61 例 sCUD 患者和 36 例健康对照者（HCs）的脑岛体积特征。
在 sAUD 和 sCUD 中，我们都发现了脑岛整体体积较小，且右侧偏侧化效应，双侧 ALG 体积明显不足。此外，各组之间也存在差异，与 sAUD 和 HCs 相比，sCUD 患者的左侧 AIC 和 PLG 体积缺陷更大。
我们首次通过精细的分区共同探讨了两种 SUD 患者的 GM 脑岛体积，从而揭示了体积缺陷模式的相似性和差异性。我们的研究结果为先前的研究提供了补充证据，表明右侧和后部脑岛在成瘾过程中的关键作用，即渴望和内感受。左侧 AIC 和 PLG 的组间差异也表明，虽然脑岛是 SUD 的一个研究区域，但 sCUD 和 sAUD 产生了不同的脑岛特征，这可能与 SUD 之间的临床差异相平行。
