Cerebral reserve capacity: implications for alcohol and drug abuse
Cerebral reserve capacity: implications for alcohol and drug abuse
复制标题
DOI：
10.1016/j.alcohol.2003.10.003
复制
发表时间：
2004-01-01
期刊：
影响因子：
2.3
通讯作者：
Di Sclafani, V
中科院分区：
文献类型：
--
作者：
Fein, G;Di Sclafani, V
大脑储备能力（或功能储备）是指大脑在面临退化过程时维持功能的能力。功能储备可以通过多种相关指标来估计，包括病前大脑大小、病前智商和受教育程度。越来越多的证据表明，储备能力的大小对于确定神经退行性脑疾病临床表现的发作和进展很重要。正常的衰老也会削弱这种大脑储备，当这种代偿性储备充足时，可能会随之出现临床上不明显的病态影响。我们回顾了支持该模型的许多退行性大脑过程的证据，包括阿尔茨海默氏病、早老性痴呆、艾滋病毒痴呆、衰老和慢性（多年）药物滥用。脑功能储备的概念对酒精和药物滥用发病率具有重要意义。首先，鉴于遗传因素对药物滥用的影响很大，药物滥用者的父母本身就是药物滥用者的可能性增加。怀孕期间滥用药物会抑制大脑发育。导致大脑体积缩小和储备能力降低（因此补偿晚年功能丧失的能力降低）。其次，药物滥用常常与贫困联系在一起，而药物滥用和贫困都与一些抑制大脑发育的相同条件有关。最后，我们评论大脑储备能力模型（相对于成瘾）最重要的公共健康影响。 (C) 2004 Elsevier Inc. 保留所有权利。
Cerebral reserve capacity (or functional reserve) refers to the brain's ability to maintain function when confronted by degenerative processes. Functional reserve can be estimated by several associated measures, including premorbid brain size, premorbid IQ, and level of education attained. There is accumulating evidence that the magnitude of reserve capacity is important in determining the onset and progression of the clinical manifestations of neurodegenerative brain diseases. Normal aging also whittles away at this cerebral reserve, and there may be a consequent unmasking of morbid effects that was not clinically evident when this compensatory reserve was sufficient. We review the evidence supporting this model for a number of degenerative brain processes, including Alzheimer's disease, presenile dementia, HIV dementia, aging, and chronic (multiyear) substance abuse. The concept of cerebral functional reserve has important implications for alcohol and drug abuse morbidity. First, given the high genetic contribution to substance abuse, there is an increased likelihood that the parents of substance abusers were substance abusers themselves. Substance abuse during pregnancy can inhibit brain growth. resulting in reduced brain size and reduced reserve capacity (and therefore less ability to compensate for loss of function later in life). Second, substance abuse is often coupled with poverty, and both substance abuse and poverty are associated with some of the same conditions that reduce brain growth. Finally, we comment on the most important public health implication of the cerebral reserve capacity model (vis-a-vis addiction). (C) 2004 Elsevier Inc. All rights reserved.