Vathy I
Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
NIDA Res Monogr. 1995;158:88-114.
There are several possible mechanisms that may explain how psychoactive drugs affect brain and behavioral development. During early development of the CNS, neurotransmitters are thought to act as signals for growth and synaptogenesis (Lauder 1990; Lauder and Krebs 1978; Whitaker-Azmitia et al. 1987). Fetal or early neonatal exposure to opiates or cocaine may cause an overall inhibition of brain growth and development due to inappropriate neural response to hormones and neurotrophic signals during this critical period of CNS development. Because exposure to opiates and cocaine prenatally can alter opioid and catecholamine receptor density and distribution, this in turn could affect the development of neural connections by delaying or accelerating neural outgrowth during fetal and/or postnatal periods (Bardo et al. 1982; Hammer et al. 1989; Spear et al. 1989a, 1989b; Tempel et al. 1988; Tsang and Ng 1980). Another possibility may be alterations in monoamine neurotransmitter levels during gestation. Alterations in levels or distribution of these neurotransmitters may interfere with the mechanisms involved in the establishment of neural connections and behavior patterns. From this and other studies examining the impact of prenatal drug exposure on adult behaviors and brain catecholamine systems, three themes emerge: (1) Exposure of the developing fetus to psychoactive drugs produces long-term alterations in adult behaviors and brain catecholamines, (2) these neurobehavioral and neurochemical alterations are sexually dimorphic, and (3) the hypothalamic catecholamine systems seem particularly vulnerable to prenatal drug exposure. Thus, it is clear that to gain understanding of the impact of prenatal drug exposure on adult brain and behaviors, lifespan studies are essential. These lifespan studies should consider gender as an important variable, because the occurrence of long-term neurobehavioral changes in this author's and other studies strongly suggests that prenatal drug exposure modifies adult male and female brain and behavioral development differently. Additionally, researchers should be aware of the particular sensitivity of the hypothalamus to perturbation by developmental drug exposure. Obviously, understanding the consequences of prenatal drug exposure for the development of the human CNS and behavior is an extremely complicated and difficult task. However, animal models have already proved useful and will be essential to correlate neurochemical and behavioral consequences of prenatal drug exposure with clinical evidence.
有几种可能的机制可以解释精神活性药物如何影响大脑和行为发育。在中枢神经系统的早期发育过程中,神经递质被认为是生长和突触形成的信号(劳德,1990年;劳德和克雷布斯,1978年;惠特克-阿兹米蒂亚等人,1987年)。胎儿或新生儿早期接触阿片类药物或可卡因可能会导致大脑生长和发育的整体抑制,因为在中枢神经系统发育的这个关键时期,对激素和神经营养信号的神经反应不适当。由于产前接触阿片类药物和可卡因会改变阿片类和儿茶酚胺受体的密度和分布,这反过来可能会通过在胎儿期和/或出生后延迟或加速神经生长来影响神经连接的发育(巴尔多等人,1982年;哈默等人,1989年;斯皮尔等人,1989a,1989b;坦佩尔等人,1988年;曾和吴,1980年)。另一种可能性可能是孕期单胺神经递质水平的改变。这些神经递质水平或分布的改变可能会干扰神经连接和行为模式建立所涉及的机制。从这项研究以及其他研究产前药物暴露对成年行为和脑儿茶酚胺系统影响的研究中,出现了三个主题:(1)发育中的胎儿接触精神活性药物会导致成年行为和脑儿茶酚胺的长期改变,(2)这些神经行为和神经化学改变具有性别差异,(3)下丘脑儿茶酚胺系统似乎特别容易受到产前药物暴露的影响。因此,很明显,要了解产前药物暴露对成年大脑和行为的影响,寿命研究至关重要。这些寿命研究应将性别视为一个重要变量,因为在本作者以及其他研究中,长期神经行为变化的出现强烈表明,产前药物暴露对成年男性和女性大脑及行为发育的影响不同。此外,研究人员应意识到下丘脑对发育性药物暴露干扰的特殊敏感性。显然,了解产前药物暴露对人类中枢神经系统和行为发育的后果是一项极其复杂和困难的任务。然而,动物模型已经证明是有用的,并且对于将产前药物暴露的神经化学和行为后果与临床证据联系起来至关重要。