阿片药物依赖的神经机制---内侧前额叶与药物的心理依赖

Mental dependence, characterized by craving and impulsive seeking behavior, is the matter of intensive study in the field of drug addiction. The mesolimbic dopamine system has been suggested to play an important role in rewarding of drugs and relapse. Although chronic drug use can induce neuroadaptations of the mesolimbic system and changes of drug reinforcement, these mechanisms cannot fully account for the craving and the compulsive drug-using behavior of addicts. Acknowledging the reinforcement effects of drugs, most previous studies have studied the impact of environmental cues and conditioned learning on addiction behavior, often using established classical or operant conditioning model. These studies, however, paid little attention to the role of cognitive control and emotion in addiction. These mental factors that are believed to have an important influence on conditioned learning. The medial prefrontal cortex (mPFC) has close anatomic and functional connections with the mesolimbic dopamine system. A number of the cognitive neurological studies demonstrate that mPFC is involved in motivation, emotional regulation, monitoring of responses and other executive functions. Thus we speculated that the function of abnormality in mPFC following chronic drug use would cause related to the abnormal behavior in addicts including impulse and emotional changes. In the present study of a series of experiments, we used functional magnetic resonance imaging to examine the hemodynamic response of the mPFC and related circuits to various cognitive and emotional stimuli in heroin addicts and to explore the underlying dopamine neuromechnism by microinjection of tool drugs into the mPFC in laboratory animals. In the first experiment, we found that heroin patients, relative to the normal controls, took a much shorter time and committed more errors in completing the more demanding of cognitive regulation in the reverse condition of the task, while the neural activity in anterior cingulate cortex (ACC) was attenuated. In the second experiment, the scores of the heroin patients in self-rating depression scale (SDS) and Self-rating anxiety scale (SAS) were significantly higher than the normal controls and they rated the negative pictures more aversive than the normal controls. Being congruent with the behavioral results, hemodynamic response to negative pictures showed significant difference between the two groups in bilateral ventral mPFC (VMPFC), amygdala, and right thalamus. The VMPFC of patients showed increased activation than normal controls, whereas activation in the amygdala of patients was weaker than that in normal subjects. Our third experiment showed that microinjection of D1 receptor agonist SKF38393 into the mPFC of rats decreased hyperactivity, which was induced by morphine injection, in contrast, D1 receptor antagonist SCH23390 increased the hyperactivity, These findings suggest: (1) The behavior and neural activity in ACC of addicts changed in chronic drug users. Their impulsive behavior might result from the abnormal neural activity in the mPFC especially the ACC. (2) Heroine patients were more depress and anxiety than normal controls. The dysfunction of the mPFC---amygdala circuit of heroine addicts might be related to the abnormal emotion response. (3) Dopamine in the mPFC has an inhibitory effect on morphine induced behavior. The hyperactivity induced by chronic morphine was reduced by dopamine increase with D1 receptor agonist, confirm the first experiment that the neuroadaption of mPFC system induced by chronic morphine administration appears to be the substrate the impulse behavior of drug users.

吗啡相关情境线索的形成及效应表达的神经基础——海马与基底外侧杏仁核在其中的作用

Drug-associated cue-induced relapse to drug seeking causes most difficulties of therapy for drug addiction. Addicts are exposed to two forms of environmental stimuli during drug-taking: contextual stimuli (e.g. a house in which the drug is consumed) and discrete stimuli (DS, e.g. a crack pipe or a syringe for drug). These stimuli become contextual cues and discrete cues, respectively. The incentive value of contextual cues plays a great role in opiates relapse. Compared with drug self-administration model, conditioned place preference (CPP) reflects the approach behavior for drug cues, not concerned with acquisition of operant behaviors. The present study aimed to investigate the role of basolateral amygdala (BLA) and hippocampus in the effect of opiates-related contextual cues using CPP model. Establishing DS-dependent or contextual cues-dependent CPP, the effect of BLA or hippocampus inactivation prior to training phase on acquisition of contextual cues-opiates association was evaluated. Inactivation prior to test phase was used to evaluate roles of BLA and hippocampus in expression of contextual cues-dependent morphine CPP. The main results were as follows: Inactivation of BLA or dorsal hippocampus selectively impaired acquisition of contextual cue-dependent CPP, but inactivation of ventral hippocampus had no impact on acquisition of either DS-dependent or contextual cue-dependent morphine CPP. Inactivation of BLA selectively inhibited expression of contextual cue-depended CPP. Inactivation of ventral hippocampus inhibited expression of both DS-dependent and contextual cue-dependent morphine CPP. These results suggest that BLA and dorsal hippocampus contribute to contextual cue association with opiates but not DS-opiates association. BLA and ventral hippocampus play important roles in incentive value of contextual cues. The present study provides more information for the neurological substrates underlying contextual cues associated with opiates.