Arioli Maria, Bossert Irene, D'Ambrosio Daniela, Manera Marina, Andreolli Elena Maria, Canessa Nicola, Trifirò Giuseppe
Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
Istituti Clinici Scientifici Maugeri IRCCS, Nuclear Medicine Unit of Pavia Institute, Pavia, Italy.
Front Psychol. 2025 May 12;16:1568085. doi: 10.3389/fpsyg.2025.1568085. eCollection 2025.
Neuroimaging studies have shown that cognitive impairments in Alcohol Use Disorder (AUD), particularly involving executive functions, reflect widespread structural and functional brain alterations. However, these findings mostly result from magnetic resonance imaging (MRI). To complement previous MRI findings with a more direct measure of brain metabolism, we therefore explored the neural bases of executive impairments in AUD using FDG-PET. Twenty-three AUD patients and 18 healthy controls underwent a neurocognitive assessment, and patients also an F-FDG-PET scan. Using as reference for brain metabolism a FDG-PET dataset of age-matched healthy controls, we assessed a relationship between executive impairment and regional hypometabolism in AUD patients, while also considering a possible moderating age effect. Compared with controls, AUD patients exhibited widespread hypometabolism in the anterior/midcingulate cortex, fronto-insular cortex, and medial precuneus, supporting the hypothesis that their impaired executive performance might reflect an altered transition from automatic to controlled processing. Patients' worse executive performance reflected in higher metabolism in the midcingulate cortex and medial precuneus, suggesting a possible compensatory neural mechanism. This relationship was moderated by age in the right anterior insula, where the decrease of metabolism is steeper, in older patients, at the lowest level of cognitive performance. This finding suggests that an age-related decrease in the compensatory capacity of the insular node of the salience network might contribute to cognitive decline in older patients. While supporting the use of FDG-PET to improve the understanding of AUD-related cognitive decline, and differential diagnosis in older patients, these findings might help design personalized innovative treatment protocols.
神经影像学研究表明，酒精使用障碍（AUD）中的认知障碍，尤其是涉及执行功能的障碍，反映了广泛的大脑结构和功能改变。然而，这些发现大多来自磁共振成像（MRI）。为了用更直接的脑代谢测量方法补充先前的MRI研究结果，我们因此使用氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）探索了AUD中执行功能障碍的神经基础。23名AUD患者和18名健康对照者接受了神经认知评估，患者还进行了F-FDG-PET扫描。以年龄匹配的健康对照者的FDG-PET数据集作为脑代谢的参考，我们评估了AUD患者执行功能障碍与局部代谢减低之间的关系，同时也考虑了可能的年龄调节效应。与对照组相比，AUD患者在前扣带回中部/前部、额岛叶皮质和楔前叶内侧表现出广泛的代谢减低，支持了这样的假设，即他们受损的执行功能可能反映了从自动加工到控制加工的转变改变。患者较差的执行功能在扣带回中部和楔前叶内侧较高的代谢中得到体现，提示可能存在一种代偿性神经机制。这种关系在右侧前岛叶受年龄调节，在认知表现最低水平的老年患者中，该区域代谢下降更为陡峭。这一发现表明，突显网络岛叶节点的代偿能力随年龄下降可能导致老年患者认知能力下降。这些发现支持使用FDG-PET来增进对AUD相关认知衰退的理解以及老年患者的鉴别诊断，同时可能有助于设计个性化的创新治疗方案。
