Gardner E L, Vorel S R
Department of Psychiatry, Albert Einstein College of Medicine, New York, New York 10461-1602, USA.
Neurobiol Dis. 1998 Dec;5(6 Pt B):502-33. doi: 10.1006/nbdi.1998.0219.
The reward/reinforcement circuitry of the mammalian brain consists of synaptically interconnected neurons associated with the medial forebrain bundle, linking the ventral tegmental area, nucleus accumbens, and ventral pallidum. Electrical stimulation of this circuit supports intense self-stimulation in animals and, in humans, produces intense pleasure or euphoria. This circuit is strongly implicated in the neural substrates of drug addiction and in such addiction-related phenomena as withdrawal dysphoria and craving. This circuit is also implicated in the pleasures produced by natural rewards (e.g., food, sex). Cannabinoids are euphorigenic in humans and have addictive liability in vulnerable persons, but were long considered "anomalous" drugs of abuse, lacking pharmacological interaction with these brain reward substrates. It is now clear, however, that cannabinoids activate these brain substrates and influence reward-related behaviors. From these actions, presumably, derive both the abuse potential of cannabinoids and the possible clinical efficacy in dysphoric states.
哺乳动物大脑的奖赏/强化神经回路由与内侧前脑束相连的突触神经元组成，该神经束连接腹侧被盖区、伏隔核和腹侧苍白球。对这一神经回路进行电刺激能促使动物强烈地自我刺激，而在人类身上则会产生强烈的愉悦感或欣快感。这一神经回路与药物成瘾的神经基础以及诸如戒断烦躁和渴望等与成瘾相关的现象密切相关。该神经回路还与自然奖赏（如食物、性）产生的愉悦感有关。大麻素在人类身上具有致欣快作用，且在易成瘾人群中具有成瘾倾向，但长期以来被视为“特殊”的滥用药物，与这些大脑奖赏神经基础缺乏药理相互作用。然而，现在已经明确，大麻素会激活这些大脑神经基础并影响与奖赏相关的行为。据此推测，大麻素的滥用潜力以及在烦躁状态下可能的临床疗效都源于这些作用。
