Subcortical volumes in long-term abstinent alcoholics: associations with psychiatric comorbidity.
Subcortical volumes in long-term abstinent alcoholics: associations with psychiatric comorbidity.
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长期戒酒者的皮质下体积：与精神共病的关联。
DOI：
10.1111/j.1530-0277.2011.01440.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Fein,George
中科院分区：
文献类型：
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作者：
Sameti,Mohammad;Smith,Stan;Patenaude,Brian;Fein,George
背景：对慢性酗酒者记忆、决策、学习、压力和奖励回路的研究越来越强调皮层下大脑结构的重要性。此外，流行病学研究已经确定了酗酒患者同时出现精神病诊断的普遍性。皮质下结构与外化病理学（包括酒精依赖）以及焦虑、情绪障碍和酒精依赖中失调的压力和奖励回路有关。大多数研究都集中在活跃或最近戒毒的酗酒者，而长期戒酒酗酒者（LTAA）的皮质下结构仍然相对uninvestigated.Methods：结构MRI被用来比较24名女性和28名男性LTAA（平均戒酒 = 6.3 年，平均年龄 = 46.6 岁）和23名女性和25名男性非酒精对照（NAC）（平均年龄 = 45.6 岁）的8个皮质下结构（侧脑室，丘脑，尾状核，壳核，苍白球，海马，杏仁核和丘脑核）的体积。探讨LTAA中皮质下脑容量与酒精使用测量之间的关系以及皮质下脑容量与精神病诊断之间的关系结果：我们发现LTAA和NAC在皮质下体积方面的差异很小。然而，在LTAA，但不是NAC，体积的目标皮质下结构较小的个人与无共病的生活或目前的精神病diagnosis，独立的终身alcohol consumption.Conclusions：我们发现LTAA和NAC之间的皮质下体积的最小差异是一致的LTAA从来没有在这些地区的体积赤字。然而，鉴于影像学研究经常报告较小的皮质下体积在活跃的和最近脱毒的酗酒者相比，控制，我们的研究结果也是一致的皮质下体积的恢复与持续戒酒。在LTAA中发现持续较小的皮质下体积，而在伴发精神病诊断的NAC中则不然，这表明较小的体积是慢性酒精依赖和精神病发病率综合影响的结果，并表明伴发精神疾病（即使不是当前的）干扰皮质下体积的恢复。
Background:Research in chronic alcoholics on memory, decision‐making, learning, stress, and reward circuitry has increasingly highlighted the importance of subcortical brain structures. In addition, epidemiological studies have established the pervasiveness of co‐occurring psychiatric diagnoses in alcoholism. Subcortical structures have been implicated in externalizing pathology, including alcohol dependence, and in dysregulated stress and reward circuitry in anxiety and mood disorders and alcohol dependence. Most studies have focused on active or recently detoxified alcoholics, while subcortical structures in long‐term abstinent alcoholics (LTAA) have remained relatively uninvestigated.Methods:Structural MRI was used to compare volumes of 8 subcortical structures (lateral ventricles, thalamus, caudate, putamen, pallidum, hippocampus, amygdala, and nucleus accumbens) in 24 female and 28 male LTAA (mean abstinence = 6.3 years, mean age = 46.6 years) and 23 female and 25 male nonalcoholic controls (NAC) (mean age = 45.6 years) to explore relations between subcortical brain volumes and alcohol use measures in LTAA and relations between subcortical volumes and psychiatric diagnoses and symptom counts in LTAA and NAC.Results:We found minimal differences between LTAA and NAC in subcortical volumes. However, in LTAA, but not NAC, volumes of targeted subcortical structures were smaller in individuals with versus without comorbid lifetime or current psychiatric diagnoses, independent of lifetime alcohol consumption.Conclusions:Our finding of minimal differences in subcortical volumes between LTAA and NAC is consistent with LTAA never having had volume deficits in these regions. However, given that imaging studies have frequently reported smaller subcortical volumes in active and recently detoxified alcoholics compared to controls, our results are also consistent with the recovery of subcortical volumes with sustained abstinence. The finding of persistent smaller subcortical volumes in LTAA, but not NAC, with comorbid psychiatric diagnoses, suggests that the smaller volumes are a result of the combined effects of chronic alcohol dependence and psychiatric morbidity and suggests that a comorbid psychiatric disorder (even if not current) interferes with the recovery of subcortical volumes.