Correlation between dopamine D2 receptors in the ventral striatum and central processing of alcohol cues and craving
Correlation between dopamine D2 receptors in the ventral striatum and central processing of alcohol cues and craving
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DOI：
10.1176/appi.ajp.161.10.1783
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发表时间：
2004-10-01
影响因子：
17.7
通讯作者：
Bartenstein, P
中科院分区：
文献类型：
--
作者：
Heinz, A;Siessmeier, T;Bartenstein, P
目的：酒精和其他滥用药物刺激腹侧纹状体释放多巴胺，包括伏隔核，这是大脑奖赏系统的核心区域，并增加物质摄入。长期饮酒与中枢多巴胺D-2受体下调有关，戒毒后D-2受体敏感性恢复延迟与复发的高风险呈正相关。腹侧纹状体持续的D-2受体功能障碍可能会干扰多巴胺依赖的错误检测信号，并使大脑奖励系统倾向于过度归因于与酒精相关的刺激。方法：采用放射性配基[F-18]脱甲氧基苯丙氨酸和正电子发射断层扫描以及功能磁共振成像(FMRI)的多模式成像技术，对11名戒毒男性酗酒者和13名健康男性进行了比较。作者测量了腹侧纹状体D-2样多巴胺受体与酒精渴求和酒精线索中央加工的关系。结果：酒精相关刺激对内侧前额叶皮质和纹状体的激活，相对于中性视觉刺激的激活，戒酒组比健康男性更强。酗酒者腹侧纹状体D-2样受体的可获得性较低，这与酒精渴求的严重程度有关，并与提示诱导的内侧前额叶皮质和前扣带回的激活有关。讨论：在酗酒者中，腹侧纹状体的多巴胺能功能障碍可能将激励性突起归因于与酒精相关的刺激，因此酒精提示引发了与注意和行为控制相关的神经网络的渴望和过度激活。
Objective: Alcohol and other drugs of abuse stimulate dopamine release in the ventral striatum, which includes the nucleus accumbens, a core region of the brain reward system, and reinforce substance intake. Chronic alcohol intake is associated with down-regulation of central dopamine D-2 receptors, and delayed recovery of D-2 receptor sensitivity after detoxification is positively correlated with high risk for relapse. Prolonged D-2 receptor dysfunction in the ventral striatum may interfere with a dopamine-dependent error detection signal and bias the brain reward system toward excessive attribution of incentive salience to alcohol-associated stimuli.Method: Multimodal imaging, with the radioligand [F-18]desmethoxyfallypride and positron emission tomography as well as functional magnetic resonance imaging (fMRI), was used to compare 11 detoxified, male alcoholics with 13 healthy men. The authors measured the association of D-2-like dopamine receptors in the ventral striatum with alcohol craving and central processing of alcohol cues.Results: Activation of the medial prefrontal cortex and striatum by alcohol-associated stimuli, relative to activation by neutral visual stimuli, was greater in the detoxified alcoholics than in the healthy men. The alcoholics displayed less availability of D-2-like receptors in the ventral striatum, which was associated with alcohol craving severity and with greater cue-induced activation of the medial prefrontal cortex and anterior cingulate as assessed with fMRI.Discussion: In alcoholics, dopaminergic dysfunction in the ventral striatum may attribute incentive salience to alcohol-associated stimuli, so that alcohol cues elicit craving and excessive activation of neural networks associated with attention and behavior control.