甲基苯丙胺成瘾者情绪加工障碍的机制及其临床干预方法的整合研究进展

近年来,在中国以甲基苯丙胺为代表的合成毒品使用人数已经超过海洛因等传统毒品,而且滥用问题日益严重.情绪问题是诱发甲基苯丙胺成瘾者复吸的重要因素.慢性使用甲基苯丙胺导致前额叶-边缘单胺类神经递质系统及相应神经环路结构和功能损害,是成瘾者出现情绪加工障碍的原因.本文从情绪体验、情绪识别与表达和线索诱发的情绪反应性三个方面总结甲基苯丙胺成瘾者情绪加工障碍的表现形式,及相应神经递质系统神经环路基础.指出易激惹和愤怒攻击行为是甲基苯丙胺成瘾过程需要重点关注的情绪问题,并进一步总结了甲基苯丙胺成瘾者情绪障碍的临床治疗和干预的潜在方法,包括药物手段、神经调控技术、认知与行为治疗等,特别是信息科学和脑科学的新技术,如虚拟现实整合多感觉通道的情绪信息,并结合神经调控技术可为甲基苯丙胺成瘾者情绪加工障碍的临床干预提供新的视角.

The Progress in Identifying of The Behavioral and Neurobiological Characteristics of Emotional Dysfunction and Its Integrated Clinic Intervention Strategies in Methamphetamine Addicts

Methamphetamine is the most widely abused drug in China recent years with more registered people in methamphetamine than that in heroin, and the situation is getting more and more worse. The emotional dysfunction is one of the most important factors to induce relapse in methamphetamine addiction, which caused by the deficit on the structure and function of prefrontal-mesolimbic circuits innervated by monoamine and amino acid neurotransmitters. The present review summarizes the advances in identifying the characteristics of emotional dysfunction manifested in three dimensions: decreased emotional awareness and positive emotion experience, increased negative emotional experience and impaired emotion regulation, and the neural mechanism focused on the prefrontal-limbic circuits underlying the emotional dysfunction. It is found that the irritability and intense anger are the most prominent features of abnormal emotion in methamphetamine addicts even in protracted abstinence periods, which will cause aggressive behaviors and induce relapse. The future studies should pay more attention to identifying the unique features of emotional dysfunction in methamphetamine addiction. Intervention and treatment targeted to emotional dysfunction are also summarized in the present review, which includes pharmaceutical drugs, neuromodulation technology and cognitive and behavioral therapy, etc. With the advances in brain science and computer sciences, future clinical researches will employ neuromodulation methods interfaced on the virtual reality technology integrated multiple sensory emotional information to treat the emotional dysfunction in methamphetamine addiction.