Chronic alcohol neuroadaptation and stress contribute to susceptibility for alcohol craving and relapse.
Chronic alcohol neuroadaptation and stress contribute to susceptibility for alcohol craving and relapse.
复制标题
DOI：
10.1016/j.pharmthera.2010.09.007
复制
发表时间：
2011-02
影响因子：
13.5
通讯作者：
Heilig, Markus
中科院分区：
文献类型：
--
作者：
Breese, George R.;Sinha, Rajita;Heilig, Markus
关键词：
酗酒是一种慢性复发性疾病。酗酒者在最初戒酒期间所观察到的主要特征是生理功能改变和消极情绪状态。有证据表明，在反复慢性饮酒过程中会发生一种涉及点燃/稳态失衡样过程的持续性、累积性适应，这对戒酒期间观察到的负面症状至关重要。基础研究已经提供证据表明，在特定脑区的特定神经递质对间歇性饮酒后持续性累积适应所诱发的消极情绪负有责任。经过长时间戒酒之后，累积的酒精适应会增加对压力和酒精线索诱发的负面症状以及寻求酒精的易感性，这两者都会促使过度饮酒。在酗酒者中，压力性意象和酒精线索会改变生理反应，增强消极情绪，并诱发渴望。在压力和酒精线索刺激后进行的脑部功能性磁共振成像已经记录了酗酒者特定脑区的神经变化，而这些变化在社交饮酒者中未被观察到。戒酒的酗酒者大脑对压力和酒精线索的这种活动改变与持续性的酒精适应有关。在酗酒者中，被发现能阻断对压力和酒精线索反应的疗法可能是潜在的治疗方法，通过这些方法可以降低持续酗酒的易感性。通过继续确定对酗酒者因压力和酒精线索而增加的易感性（这种易感性会促进渴望）至关重要的持续性酒精适应的神经生物学基础，有望开创一个将酗酒复发率降至最低的新时代。
Alcoholism is a chronic relapsing disorder. Major characteristics observed in alcoholics during an initial period of alcohol abstinence are altered physiological functions and a negative emotional state. Evidence suggests that a persistent, cumulative adaptation involving a kindling/allostasis-like process occurs during the course of repeated chronic alcohol exposures that is critical for the negative symptoms observed during alcohol withdrawal. Basic studies have provided evidence for specific neurotransmitters within identified brain sites being responsible for the negative emotion induced by the persistent cumulative adaptation following intermittent-alcohol exposures. After an extended period of abstinence, the cumulative alcohol adaptation increases susceptibility to stress- and alcohol cue-induced negative symptoms and alcohol seeking, both of which can facilitate excessive ingestion of alcohol. In the alcoholic, stressful imagery and alcohol cues alter physiological responses, enhance negative emotion, and induce craving. Brain fMRI imaging following stress and alcohol cues has documented neural changes in specific brain regions of alcoholics not observed in social drinkers. Such altered activity in brain of abstinent alcoholics to stress and alcohol cues is consistent with a continuing ethanol adaptation being responsible. Therapies in alcoholics found to block responses to stress and alcohol cues would presumably be potential treatments by which susceptibility for continued alcohol abuse can be reduced. By continuing to define the neurobiological basis of the sustained alcohol adaptation critical for the increased susceptibility of alcoholics to stress and alcohol cues that facilitate craving, a new era is expected to evolve in which the high rate of relapse in alcoholism is minimized. 250
登录
查看更多内容
影响因子：
5.3
作者：
Becker, Jill B.;Monteggia, Lisa M.;Bale, Tracy L.
通讯作者：
Bale, Tracy L.
影响因子：
10.6
作者：
Besheer, Joyce;Grondin, Julie J. M.;Cannady, Reginald;Sharko, Amanda C.;Faccidomo, Sara;Hodge, Clyde W.
通讯作者：
Hodge, Clyde W.
DOI：
10.1097/01.alc.0000158940.05529.0a
发表时间：
2005-04-01
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
--
作者：
Adinoff, B;Krebaum, SR;Williams, MJ
通讯作者：
Williams, MJ
影响因子：
3.4
作者：
BALDWIN, HA;RASSNICK, S;BRITTON, KT
通讯作者：
BRITTON, KT
影响因子：
6.2
作者：
Achur, Rajeshwara N.;Freeman, Willard M.;Vrana, Kent E.
通讯作者：
Vrana, Kent E.