Brain activation elicited by affectively positive stimuli is associated with a lower risk of relapse in detoxified alcoholic subjects
Brain activation elicited by affectively positive stimuli is associated with a lower risk of relapse in detoxified alcoholic subjects
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DOI：
10.1111/j.1530-0277.2007.00406.x
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发表时间：
2007-07-01
影响因子：
3.2
通讯作者：
Mann, Karl
中科院分区：
文献类型：
--
作者：
Heinz, Andreas;Wrase, Jana;Mann, Karl
背景：经常与酒精摄入(AI)相关的刺激可能会获得激励性突显，而其他增强剂可能会贬值。我们评估了(1)酒精相关刺激，(2)情感积极刺激，(3)消极与中性刺激引起的脑激活是否与随后的复发风险有关。方法：使用标准化的情感和酒精相关图片，对12名戒酒受试者(6名女性和6名男性)和12名年龄匹配和性别匹配的健康对照组进行功能磁共振成像(FMRI)和快速单事件范式的评估。结果：与健康对照组相比，(1)酒精相关视觉刺激引起前额叶(PFC；BA6和10)、扣带回(BA23和24)、楔前叶和邻近顶叶的激活增加；(2)正性刺激和中性刺激引起前扣带回(ACC；BA24)、PFC(BA10)、腹侧纹状体和丘脑的激活增加；(3)负性刺激引起PFC(BA10)的激活增加。七名酗酒的受试者复发。在6个月的随访期内，连续饮酒天数(DD)和AI量与正性刺激和中性刺激在丘脑(DD：r=-0.63，p=0.03；AI：r=-0.63，p=0.03)和腹侧纹状体(DD：r=-0.60，p=0.04；AI：r=-0.48，p=0.11)的脑激活呈负相关。结论：在本研究中，短暂呈现酒精相关刺激引起的脑激活与预期复发风险无关。出人意料的是，酒精中毒受试者在呈现积极的情感刺激而不是消极刺激时，边缘脑激活增加，这可能反映了戒酒受试者的一种保护因素。
Background: Stimuli that are regularly associated with alcohol intake (AI) may acquire incentive salience, while other reinforcers can be devalued. We assessed whether brain activation elicited by (1) alcohol associated, (2) affectively positive, and (3) negative versus neutral stimuli is associated with the subsequent risk of relapse.Methods: Twelve detoxified alcoholic subjects (6 women and 6 men) and 12 age-matched and gender-matched healthy control subjects were assessed with functional magnetic resonance imaging (fMRI) and a fast single-event paradigm using standardized affective and alcohol-associated pictures. Patients were followed for 6 months and AI was recorded.Results: In alcoholic subjects, compared with healthy control subjects, (1) alcohol-related versus neutral visual stimuli elicited increased activation in the prefrontal (PFC; BA 6 and 10) and cingulate cortex (BA 23 and 24), precuneus and adjacent parietal cortex; (2) positive versus neutral stimuli elicited increased activation in the anterior cingulate cortex (ACC; BA 24), PFC (BA 10), ventral striatum and thalamus; and (3) negative versus neutral stimuli elicited increased activation in the PFC (BA 10). Seven alcoholic subjects relapsed. Within the follow-up period of 6 months, the number of subsequent drinking days (DD) and the amount of AI were inversely correlated with brain activation elicited by positive versus neutral stimuli in the thalamus (DD: r=-0.63, p=0.03; AI: r=-0.63, p=0.03) and in the ventral striatum (DD: r=-0.60, p=0.04; AI: r=-0.48, p=0.11).Conclusions: In this study, brain activation elicited by briefly presented alcohol-associated stimuli was not associated with the prospective risk of relapse. Unexpectedly, alcoholic subjects displayed increased limbic brain activation during the presentation of affectively positive but not negative stimuli, which may reflect a protective factor in detoxified alcoholic subjects.