Barrios Nathalie, Nartey Nathania, Yue Johnny, Riordan Will, Kohler Robert, Verplaetse Terril L, Roberts Walter, Carretta Rachel F, Banini Bubu A, Zhou Hang, Garcia-Rivas Vernon, Blackford Jennifer Urbano, Zakiniaeiz Yasmin
Department of Psychiatry, School of Medicine, Yale University, 40 Temple Street, Suite 7C, New Haven, CT 06519, USA.
Department of Psychology, Yale College, Yale University, New Haven, CT, USA.
Curr Addict Rep. 2025;12(1). doi: 10.1007/s40429-025-00624-z. Epub 2025 Feb 4.
Women experience worse alcohol-related health consequences compared to men, including greater risk and susceptibility to the neurotoxic effects of alcohol. There is a critical need to identify underlying neurobiological mechanisms underlying sex differences in alcohol use disorder (AUD) phenotypes to better inform individualized treatment options. This report aimed to systematically review existing original literature that examined sex differences in white matter tract integrity in individuals with heavy drinking/AUD using diffusion magnetic resonance imaging (dMRI) and provide recommendations for future research. A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and PubMed and Google Scholar databases from inception until January 1, 2024.
Of 565 studies from the database search, 12 met study criteria. Nine (75%) showed evidence of sex-related differences in white matter tract integrity. Five studies showed greater vulnerability of white matter tract degradation in women with heavy drinking/AUD and four showed greater vulnerability in men with heavy drinking/AUD.
This is the first study to systematically assess the existing literature on sex differences in AUD-related white matter tract integrity. The findings from this systematic review were equivocal. Future research should address the mixed literature by systematically examining sex differences in white matter tract integrity in larger, well-characterized samples to account for confounding factors such as alcohol use history, age, other substance use, and psychiatric comorbidities.
与男性相比，女性饮酒相关的健康后果更严重，包括酒精神经毒性作用的风险和易感性更高。迫切需要确定酒精使用障碍（AUD）表型性别差异背后的潜在神经生物学机制，以便更好地为个体化治疗方案提供依据。本报告旨在系统回顾现有原始文献，这些文献使用扩散磁共振成像（dMRI）研究了重度饮酒/AUD个体白质束完整性的性别差异，并为未来研究提供建议。使用系统评价和Meta分析的首选报告项目（PRISMA）指南以及PubMed和谷歌学术数据库进行了一项系统评价，时间跨度从数据库创建到2024年1月1日。
在数据库检索的565项研究中，12项符合研究标准。9项（75%）显示白质束完整性存在性别相关差异的证据。5项研究表明，重度饮酒/AUD女性白质束退化的易感性更高，4项研究表明，重度饮酒/AUD男性白质束退化的易感性更高。
这是第一项系统评估AUD相关白质束完整性性别差异现有文献的研究。该系统评价的结果并不明确。未来的研究应通过在更大、特征明确的样本中系统检查白质束完整性的性别差异来解决文献不一致的问题，以考虑饮酒史、年龄、其他物质使用和精神共病等混杂因素。
