A debate on working memory and cognitive control: can we learn about the treatment of substance use disorders from the neural correlates of anorexia nervosa?
A debate on working memory and cognitive control: can we learn about the treatment of substance use disorders from the neural correlates of anorexia nervosa?
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DOI：
10.1186/s12888-016-0714-z
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发表时间：
2016-01-16
期刊：
影响因子：
4.4
通讯作者：
Brooks SJ
中科院分区：
文献类型：
--
作者：
Brooks SJ
神经性厌食症（AN）是一种使人衰弱的、有时是致命的进食障碍（艾德），其中食欲和情绪的抑制伴随着不灵活的、注重细节的完美主义认知风格和强迫行为。有趣的是，患有AN的人不太可能使用物质，而那些患有具有暴食成分的艾德的人更容易患上物质使用障碍（SUD）。这种对AN患者食欲控制的有益结果的洞察，被许多其他不健康，过度和不足的症状所掩盖，可能会提供一些线索，说明如何训练大脑对食欲和冲动过程施加更好，持续的控制。结构和功能脑成像研究表明执行控制网络（ECN）和显着网络（SN）与AN和SUD的神经病理学有关。此外，过度使用工作记忆（WM），以及更突出的认知缺陷可能被用来科普负面情绪的体验，并可能导致异常的大脑功能。工作记忆使认知策略的心理排练，同时调节，限制或避免与SN相关的神经反应。因此，高与低WM容量可能是分别患有AN和SUD的患者中共同认知和行为症状的因素之一。此外，新出现的证据表明，通过WM训练唤起ECN和SN中的神经可塑性，可以实现神经认知功能和认知控制的改善。因此，考虑到过度食欲控制的神经认知过程以及它如何与AN中的WM联系，可能有助于SUD的连续治疗。本文的在线版本（doi：10.1186/s12888-016-0714-z）包含补充材料，可供授权用户使用。
Anorexia Nervosa (AN) is a debilitating, sometimes fatal eating disorder (ED) whereby restraint of appetite and emotion is concomitant with an inflexible, attention-to-detail perfectionist cognitive style and obsessive-compulsive behaviour. Intriguingly, people with AN are less likely to engage in substance use, whereas those who suffer from an ED with a bingeing component are more vulnerable to substance use disorder (SUD). This insight into a beneficial consequence of appetite control in those with AN, which is shrouded by the many other unhealthy, excessive and deficit symptoms, may provide some clues as to how the brain could be trained to exert better, sustained control over appetitive and impulsive processes. Structural and functional brain imaging studies implicate the executive control network (ECN) and the salience network (SN) in the neuropathology of AN and SUD. Additionally, excessive employment of working memory (WM), alongside more prominent cognitive deficits may be utilised to cope with the experience of negative emotions and may account for aberrant brain function. WM enables mental rehearsal of cognitive strategies while regulating, restricting or avoiding neural responses associated with the SN. Therefore, high versus low WM capacity may be one of the factors that unites common cognitive and behavioural symptoms in those suffering from AN and SUD respectively. Furthermore, emerging evidence suggests that by evoking neural plasticity in the ECN and SN with WM training, improvements in neurocognitive function and cognitive control can be achieved. Thus, considering the neurocognitive processes of excessive appetite control and how it links to WM in AN may aid the application of adjunctive treatment for SUD. The online version of this article (doi:10.1186/s12888-016-0714-z) contains supplementary material, which is available to authorized users.