Neurobiological mechanisms and related clinical treatment of addiction: a review  

作　　者：Yehong Fang Yunkai Sun Yi Liu Tieqiao Liu Wei Hao Yanhui Liao 

机构地区：[1]Department of Psychiatry,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,3 East Qingchun Road,Hangzhou,Zhejiang 310016,China [2]Department of Psychiatry&Mental Health Institute of the Second Xiangya Hospital,Central South University.National Clinical Research Center on Mental Disorders&National Technology Institute on Mental Disorders.Hunan Key Laboratory of Psychiatry and Mental Health,139 Renmin(M)Rd,Changsha,Hunan 410011,P.R.China

出　　处：《Psychoradiology》2022年第4期180-189,共10页精神影像学（英文）

基　　金：This study was supported by grants from the Hunan Provincial Natural Science Foundation of China(2020JJ4794);the Science Innovation 2030–Brain Science and Brain-Inspired Intelligence Technology Major Project(2022ZD0211200).

摘　　要：Drug addiction or substance use disorder(SUD),has been conceptualized as a three-stage(i.e.binge/intoxication,withdrawal/negative affect,and preoccupation/anticipation/craving)recurring cycle that involves complex changes in neuroplasticity,reward,motivation,desire,stress,memory,and cognitive control,and other related brain regions and brain circuits.Neuroimaging approaches,including magnetic resonance imaging,have been key to mapping neurobiological changes correlated to complex brain regions of SUD.In this review,we highlight the neurobiological mechanisms of these three stages of addiction.The abnormal activity of the ventral tegmental,nucleus accumbens,and caudate nucleus in the binge/intoxication stage involve the reward circuit of the midbrain limbic system.The changes in the orbitofrontal cortex,dorsolateral prefrontal cortex,amygdala,and hypothalamus emotional system in the withdrawal/negative affect stage involve increases in negative emotional states,dysphoric-like effects,and stress-like responses.The dysregulation of the insula and prefrontal lobes is associated with craving in the anticipation stage.Then,we review the present treatments of SUD based on these neuroimaging findings.Finally,we conclude that SUD is a chronically relapsing disorder with complex neurobiological mechanisms and multimodal stages,of which the craving stage with high relapse rate may be the key element in treatment efficacy of SUD.Precise interventions targeting different stages of SUD and characteristics of individuals might serve as a potential therapeutic strategy for SUD.

关 键 词：ADDICTION substance use disorder magnetic resonance imaging neurobiological mechanisms CRAVING treatment 

分 类 号：R749[医药卫生—神经病学与精神病学]