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成瘾缓解:消除错误的神经回路还是构建新的神经回路?

Remission from addiction: erasing the wrong circuits or making new ones?

作者信息

Engeln Michel, Ahmed Serge H

机构信息

Univ. Bordeaux, CNRS, INCIA, UMR 5287, Bordeaux, France.

出版信息

Nat Rev Neurosci. 2025 Feb;26(2):115-130. doi: 10.1038/s41583-024-00886-y. Epub 2024 Dec 11.

Abstract

Chronic relapse is a hallmark of substance-use disorders (SUDs), but many people with SUDs do recover and eventually enter remission. Many preclinical studies in this field aim to identify interventions that can precipitate recovery by reversing or erasing the neuronal circuit changes caused by chronic drug use. A better understanding of remission from SUDs can also come from preclinical studies that model factors known to influence recovery in humans, such as the negative consequences of drug use and positive environmental influences. In this Perspective we discuss human neuroimaging studies that have provided information about recovery from SUDs and highlight mechanisms identified in preclinical studies - such as the reconfiguration of neuronal circuits - that could contribute to remission. We also analyse how studies of memory and forgetting can provide insights into the mechanisms of remission. Overall, we propose that remission can be driven by the introduction of new neuronal changes (which outcompete those induced by drugs) as well as by the erasure of drug-induced changes.

摘要

慢性复发是物质使用障碍(SUDs)的一个标志,但许多患有SUDs的人确实会康复并最终进入缓解期。该领域的许多临床前研究旨在确定能够通过逆转或消除慢性药物使用引起的神经回路变化来促进康复的干预措施。对SUDs缓解的更好理解也可以来自临床前研究,这些研究模拟已知影响人类康复的因素,如药物使用的负面后果和积极的环境影响。在这篇观点文章中,我们讨论了提供有关SUDs康复信息的人类神经影像学研究,并强调了临床前研究中确定的机制——如神经回路的重新配置——这可能有助于缓解。我们还分析了记忆和遗忘的研究如何能够深入了解缓解的机制。总体而言,我们提出缓解可以由新的神经元变化(其胜过药物诱导的变化)的引入以及药物诱导变化的消除来驱动。

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