American Journal of Psychiatry ( IF 15.1 ) Pub Date : 2018-10-19 , DOI: 10.1176/appi.ajp.2018.17040415 Scott Mackey 1 , Nicholas Allgaier 1 , Bader Chaarani 1 , Philip Spechler 1 , Catherine Orr 1 , Janice Bunn 1 , Nicholas B Allen 1 , Nelly Alia-Klein 1 , Albert Batalla 1 , Sara Blaine 1 , Samantha Brooks 1 , Elisabeth Caparelli 1 , Yann Ying Chye 1 , Janna Cousijn 1 , Alain Dagher 1 , Sylvane Desrivieres 1 , Sarah Feldstein-Ewing 1 , John J Foxe 1 , Rita Z Goldstein 1 , Anna E Goudriaan 1 , Mary M Heitzeg 1 , Robert Hester 1 , Kent Hutchison 1 , Ozlem Korucuoglu 1 , Chiang-Shan R Li 1 , Edythe London 1 , Valentina Lorenzetti 1 , Maartje Luijten 1 , Rocio Martin-Santos 1 , April May 1 , Reza Momenan 1 , Angelica Morales 1 , Martin P Paulus 1 , Godfrey Pearlson 1 , Marc-Etienne Rousseau 1 , Betty Jo Salmeron 1 , Renée Schluter 1 , Lianne Schmaal 1 , Gunter Schumann 1 , Zsuzsika Sjoerds 1 , Dan J Stein 1 , Elliot A Stein 1 , Rajita Sinha 1 , Nadia Solowij 1 , Susan Tapert 1 , Anne Uhlmann 1 , Dick Veltman 1 , Ruth van Holst 1 , Sarah Whittle 1 , Margaret J Wright 1 , Murat Yücel 1 , Sheng Zhang 1 , Deborah Yurgelun-Todd 1 , Derrek P Hibar 1 , Neda Jahanshad 1 , Alan Evans 1 , Paul M Thompson 1 , David C Glahn 1 , Patricia Conrod 1 , Hugh Garavan 1 , 1
Objective:
Although lower brain volume has been routinely observed in individuals with substance dependence compared with nondependent control subjects, the brain regions exhibiting lower volume have not been consistent across studies. In addition, it is not clear whether a common set of regions are involved in substance dependence regardless of the substance used or whether some brain volume effects are substance specific. Resolution of these issues may contribute to the identification of clinically relevant imaging biomarkers. Using pooled data from 14 countries, the authors sought to identify general and substance-specific associations between dependence and regional brain volumes.
Method:
Brain structure was examined in a mega-analysis of previously published data pooled from 23 laboratories, including 3,240 individuals, 2,140 of whom had substance dependence on one of five substances: alcohol, nicotine, cocaine, methamphetamine, or cannabis. Subcortical volume and cortical thickness in regions defined by FreeSurfer were compared with nondependent control subjects when all sampled substance categories were combined, as well as separately, while controlling for age, sex, imaging site, and total intracranial volume. Because of extensive associations with alcohol dependence, a secondary contrast was also performed for dependence on all substances except alcohol. An optimized split-half strategy was used to assess the reliability of the findings.
Results:
Lower volume or thickness was observed in many brain regions in individuals with substance dependence. The greatest effects were associated with alcohol use disorder. A set of affected regions related to dependence in general, regardless of the substance, included the insula and the medial orbitofrontal cortex. Furthermore, a support vector machine multivariate classification of regional brain volumes successfully classified individuals with substance dependence on alcohol or nicotine relative to nondependent control subjects.
Conclusions:
The results indicate that dependence on a range of different substances shares a common neural substrate and that differential patterns of regional volume could serve as useful biomarkers of dependence on alcohol and nicotine.
中文翻译:
物质依赖性中灰质体积的大型分析:一般和特定物质的区域效应。
客观的:
尽管与非依赖性对照受试者相比,在具有物质依赖性的个体中经常观察到较低的脑容量,但在不同研究中表现出较低体积的大脑区域并不一致。此外,尚不清楚是否有一组共同的区域与物质依赖有关,而不管所使用的物质如何,或者某些脑容量效应是否是物质特异性的。这些问题的解决可能有助于临床相关成像生物标志物的鉴定。作者使用来自 14 个国家/地区的汇总数据,试图确定依赖性和区域脑容量之间的一般关联和特定物质关联。
方法:
对先前公布的 23 个实验室收集的数据进行了大型分析,其中包括 3,240 人,其中 2,140 人对以下五种物质中的一种产生物质依赖:酒精、尼古丁、可卡因、甲基苯丙胺或大麻。在控制年龄、性别、成像部位和颅内总体积的同时,将 FreeSurfer 定义的区域的皮层下体积和皮层厚度与所有样本物质类别组合时的非依赖性对照受试者进行比较,以及单独进行比较。由于与酒精依赖的广泛关联,还对除酒精以外的所有物质的依赖进行了二次对比。使用优化的对半策略来评估研究结果的可靠性。
结果:
在具有物质依赖性的个体的许多大脑区域中观察到较低的体积或厚度。最大的影响与酒精使用障碍有关。无论物质如何,一组与一般依赖相关的受影响区域包括岛叶和内侧眶额皮质。此外,区域脑容量的支持向量机多元分类成功地将对酒精或尼古丁的物质依赖与非依赖性对照受试者进行了分类。
结论:
结果表明,对一系列不同物质的依赖具有共同的神经基质,并且区域体积的差异模式可以作为对酒精和尼古丁依赖的有用生物标志物。