网络成瘾者奖赏系统和认知控制系统的神经机制

网络成瘾作为一种行为成瘾,已成为严重影响人们心理健康的全球性问题.根据大脑发育的神经生物模型,揭示网络成瘾者奖赏和认知控制系统的神经机制是解决网络成瘾问题的关键,也是心理学研究的重大问题.行为研究探讨了网络成瘾具有高奖赏寻求和低认知控制特征;神经机制研究揭示了奖赏和认知控制系统的缺陷是网络成瘾行为的高风险因素;与药物成瘾的比较研究发现,网络成瘾有着独特的奖赏机制.这些研究深化了对网络成瘾心理和神经机制的理解,但仍存在网络成瘾筛查和入组标准不科学、分型笼统、因果研究匮乏、干预和治疗效果具有争议、研究范式存在漏洞等一些急需解决的问题.     

基于ALFF和动态功能连接的槟榔成瘾的研究

槟榔(Betel Quid)是世界上使用最广泛的精神活性物质之一,长期嚼食会使人上瘾,给人体健康带来危害.敏感且高分辨率的神经成像技术的出现,使研究者对嚼食槟榔成瘾的神经病理学有了新的见解.本文基于静息态功能磁共振成像(rs-fMRI)数据,首次提出通过对槟榔成瘾者(BQD)和正常对照(HC)的7大脑功能网络上的低频振幅(ALFF)的幅值进行了Logistic回归以及回归系数的显著性检验来发现槟榔成瘾者存在异常的脑功能网络,该方法准确度较高且易于实现;其次,通过成组独立成分分析(Group ICA)和K-means聚类分析比较两组被试的动态功能连接的差异,由此探讨槟榔成瘾对脑功能网络和脑功能连接的影响.研究发现,槟榔成瘾者的小脑网络与正常人相比存在较为显著的差异.我们推断这可能与小脑调节躯体运动和涉及成瘾行为等生理机能有关.这一发现打破了以往人们对于小脑功能的认知,引导人们将成瘾机制与小脑网络的非运动功能结合起来进行研究,对研究槟榔成瘾这一公共健康问题以及发展针对槟榔成瘾的特异性治疗方法具有重要意义.     

网络成瘾类型特点及成瘾原因述评

不同类型的网络成瘾在其需要、特点和成瘾机制上存在着差异,因此,本文对国内外关于网络成瘾的类型特点及不同成瘾类型的成瘾原因进行了述评并对后续研究进行展望,旨在为网络成瘾实施个体化的预防和干预方案提供借鉴,使成瘾者和网络使用者以健康、科学的态度合理使用网络,适应现实生活.     

药物成瘾记忆的神经生物机制及临床干预方法

药物成瘾者戒断后的持久复吸是治疗药物成瘾的难点.成瘾者出现持续复吸的重要原因是由于成瘾记忆的长期存在.成瘾物质的长期反复使用导致前额叶-边缘多巴胺系统结构和功能的适应性改变,这种改变是成瘾记忆形成的神经基础.本文从学习记忆的角度来理解成瘾形成,介绍了成瘾记忆的初始形成阶段、习惯化阶段和成瘾行为维持阶段及其相应的神经基础.回顾了近年来成瘾记忆的临床干预方法,包括消退干预方法、增强消退干预的多情境干预方法,以及直接干预消除成瘾记忆的记忆再巩固干预方法,并总结了虚拟现实、神经调控技术在成瘾记忆干预中的应用.对记忆再巩固干预方法与虚拟现实、神经调控技术相结合干预成瘾记忆进行展望,为药物成瘾的临床干预和治疗提供了新方法、新思路.     

毒品成瘾与脑组织基因表达谱的研究进展

毒品成瘾是由滥用毒品外在因素与遗传易感性等内在因素共同作用而导致的一种慢性脑疾病; 毒品成瘾的机制目前还不十分清楚。毒品成瘾研究的一个主要目标是鉴别和分离毒品导致脑功能障碍的分子机制; 采用高通量的基因表达谱技术研究毒品成瘾者在不同状态下脑基因表达全貌, 对深入认识毒品成瘾的机制具有重要的意义。文章综述了毒品成瘾的遗传机制及高通量脑组织基因组表达技术——SAGE和微阵列(Microarry)在毒品成瘾研究中的进展。     

《脑》：研究发现氯胺酮所致脑结构损害

长沙中南大学湘雅二医院称。该院在国际上首次发现了慢性氯胺酮（俗称K粉）成瘾者的脑结构损害。此研究为揭示K粉成瘾病理机制提供了宝贵线索,将为K粉成瘾的治疗开辟新的途径。     

脑内的铁,转铁蛋白及转铁蛋白受体

脑铁异常增高可能参与脑神经变性疾病的发生发展。这一发现使得脑铁代谢成为近年广为关注和研究较为广泛的领域。本文综述了这一领域某些方面的目前认识。包括：（１）脑铁分布及功能;（２）铁转铁蛋白及转铁蛋白受体在脑内的合成与分布;（３）脑铁摄取和运输。此外,对铁与某些金属离子,转的蛋白和转铁蛋白受体与脑神经变性疾病的关系,以及转铁蛋白受体内吞在生物大分子跨血脑屏障运输中的作用也作了简要讨论。     

原发性痛经的脑神经机制：来自神经影像与动物模型研究的证据

原发性痛经(primary dysmenorrhea, PDM)是指育龄女性在无明显器质性病变的情况下出现的痉挛性月经期疼痛，具有急性、慢性疼痛双重特点。PDM严重影响患者的生活质量并导致社会经济的损失，PDM普遍没有得到根治，患者日后常罹患其它慢性疼痛。PDM的临床治疗现状、流行病学上PDM与慢性疼痛的共病，以及PDM患者表现出的异常生理和心理特征都表明PDM不仅与子宫周围的炎症有关，也可能与患者中枢系统疼痛加工调节功能异常相关。因此，探究PDM的脑神经机制是理解疾病病理学过程不可或缺的重要内容，也是近年来脑科学研究的热点。相关研究为探寻干预PDM的靶点带来新的启发。本文立足于PDM脑神经机制研究进展，系统归纳了来自神经影像与动物模型研究的证据。     

抑郁症相关的静息态脑功能网络异常

近年来,静息态脑功能磁共振成像(resting-state functional magnetic resonance imaging, rf MRI)被大量用于揭示抑郁个体脑功能网络的异常,主要体现在默认网络、认知控制网络和情绪网络各自内部及三大网络之间交互作用方面.与正常人相比,抑郁个体默认网络内部的异常主要表现为前部功能连接增强而后部功能连接减弱,前后两部分的异常可能有着分离的模式;认知控制网络内部的异常表现为功能连接减弱;而在情绪网络内部,抑郁个体的异常主要表现为边缘系统功能连接增强以及奖赏回路功能连接减弱.抑郁症对不同网络之间交互作用的影响主要体现在各个网络代表节点之间的功能连接异常.这些功能网络之间的交互异常可能反映了抑郁个体大脑在资源分配以及信息整合两方面存在缺陷.基于当前研究存在的不足,未来研究可关注抑郁症的多维度大数据整合和个体化研究,并将抑郁症与其他精神疾病脑网络异常的共性与特异性进行比较,在更深入揭示抑郁症神经机制的基础上为临床诊断和干预提供有效的生物学标记.     

涡虫生殖生物学研究进展

涡虫由于具有极强的再生能力而成为发育生物学及再生生物学研究的模式生物。此外,其在有性生殖方面所表现出来的独特性也备受人们关注。目前,涡虫生殖生物学研究领域主要围绕两个热点问题开展工作：1.无性生殖向有性生殖转化的诱因及机制的探讨;2.生殖相关基因的克隆、表达及功能分析。有关生殖转化机制方面的研究主要集中在涡虫的性化相关事件以及性化物质的本质探索;截至目前已克隆并对其表达和功能进行探讨的涡虫生殖相关基因主要有DjPTK1、vasa-like 基因、DeY1、Dryg、nanos相关基因以及Drpiwi-1等。此外,本文也对有关涡虫生殖生物学方面存在的问题及未来该领域的发展趋势进行了总结和展望。     

Abnormal white matter integrity in adolescents with internet addiction disorder: a tract-based spatial statistics study

Background

Internet addiction disorder (IAD) is currently becoming a serious mental health issue around the globe. Previous studies regarding IAD were mainly focused on associated psychological examinations. However, there are few studies on brain structure and function about IAD. In this study, we used diffusion tensor imaging (DTI) to investigate white matter integrity in adolescents with IAD.

Methodology/Principal Findings

Seventeen IAD subjects and sixteen healthy controls without IAD participated in this study. Whole brain voxel-wise analysis of fractional anisotropy (FA) was performed by tract-based spatial statistics (TBSS) to localize abnormal white matter regions between groups. TBSS demonstrated that IAD had significantly lower FA than controls throughout the brain, including the orbito-frontal white matter, corpus callosum, cingulum, inferior fronto-occipital fasciculus, and corona radiation, internal and external capsules, while exhibiting no areas of higher FA. Volume-of-interest (VOI) analysis was used to detect changes of diffusivity indices in the regions showing FA abnormalities. In most VOIs, FA reductions were caused by an increase in radial diffusivity while no changes in axial diffusivity. Correlation analysis was performed to assess the relationship between FA and behavioral measures within the IAD group. Significantly negative correlations were found between FA values in the left genu of the corpus callosum and the Screen for Child Anxiety Related Emotional Disorders, and between FA values in the left external capsule and the Young''s Internet addiction scale.

Conclusions

Our findings suggest that IAD demonstrated widespread reductions of FA in major white matter pathways and such abnormal white matter structure may be linked to some behavioral impairments. In addition, white matter integrity may serve as a potential new treatment target and FA may be as a qualified biomarker to understand the underlying neural mechanisms of injury or to assess the effectiveness of specific early interventions in IAD.     

Microstructure abnormalities in adolescents with internet addiction disorder

Background

Recent studies suggest that internet addiction disorder (IAD) is associated with structural abnormalities in brain gray matter. However, few studies have investigated the effects of internet addiction on the microstructural integrity of major neuronal fiber pathways, and almost no studies have assessed the microstructural changes with the duration of internet addiction.

Methodology/Principal Findings

We investigated the morphology of the brain in adolescents with IAD (N = 18) using an optimized voxel-based morphometry (VBM) technique, and studied the white matter fractional anisotropy (FA) changes using the diffusion tensor imaging (DTI) method, linking these brain structural measures to the duration of IAD. We provided evidences demonstrating the multiple structural changes of the brain in IAD subjects. VBM results indicated the decreased gray matter volume in the bilateral dorsolateral prefrontal cortex (DLPFC), the supplementary motor area (SMA), the orbitofrontal cortex (OFC), the cerebellum and the left rostral ACC (rACC). DTI analysis revealed the enhanced FA value of the left posterior limb of the internal capsule (PLIC) and reduced FA value in the white matter within the right parahippocampal gyrus (PHG). Gray matter volumes of the DLPFC, rACC, SMA, and white matter FA changes of the PLIC were significantly correlated with the duration of internet addiction in the adolescents with IAD.

Conclusions

Our results suggested that long-term internet addiction would result in brain structural alterations, which probably contributed to chronic dysfunction in subjects with IAD. The current study may shed further light on the potential brain effects of IAD.     

Decreased Functional Brain Connectivity in Adolescents with Internet Addiction

Background

Internet addiction has become increasingly recognized as a mental disorder, though its neurobiological basis is unknown. This study used functional neuroimaging to investigate whole-brain functional connectivity in adolescents diagnosed with internet addiction. Based on neurobiological changes seen in other addiction related disorders, it was predicted that connectivity disruptions in adolescents with internet addiction would be most prominent in cortico-striatal circuitry.

Methods

Participants were 12 adolescents diagnosed with internet addiction and 11 healthy comparison subjects. Resting-state functional magnetic resonance images were acquired, and group differences in brain functional connectivity were analyzed using the network-based statistic. We also analyzed network topology, testing for between-group differences in key graph-based network measures.

Results

Adolescents with internet addiction showed reduced functional connectivity spanning a distributed network. The majority of impaired connections involved cortico-subcortical circuits (∼24% with prefrontal and ∼27% with parietal cortex). Bilateral putamen was the most extensively involved subcortical brain region. No between-group difference was observed in network topological measures, including the clustering coefficient, characteristic path length, or the small-worldness ratio.

Conclusions

Internet addiction is associated with a widespread and significant decrease of functional connectivity in cortico-striatal circuits, in the absence of global changes in brain functional network topology.     

Rethinking Informed Consent in Research on Heroin‐Assisted Treatment

Can heroin addicts give consent to research on trials in which heroin is prescribed to them? Analyses of addicts and informed consent have been objects of debate in several articles. Informed consent requires the agent not only to be competent but also to give consent voluntarily. This has been questioned because of alleged features of heroin addiction. Until recently the discussion has focused on heroin addicts' desires for heroin, whether these are irresistible and thus pose a problem for giving consent. Still, in light of empirical evidence, there seems to be a consensus more or less that the problem is not whether the addicts can resist their desire for heroin. A recent article concentrates specifically on heroin addicts' false assumptions of options and voluntariness. We argue that the prevailing framing of the options in this discussion in terms of heroin and access to it is problematic. The way in which the options are typically laid out suggests an assumption that participation in the research is allegedly based on the addicts' views on using the drug. We argue that this way of presenting the options is, first, a mismatch to the studies carried out and, second, symptomatic of potential misconceptions about heroin addiction and addicts. Furthermore, we also suggest that the account of voluntariness needs to be realistic in order for subjects to be able to give consent voluntarily in actual situations, and for medical research to carry out studies on improving outcomes in addiction treatment in an ethical way.     

Precursor or sequela: pathological disorders in people with Internet addiction disorder

Background

This study aimed to evaluate the roles of pathological disorders in Internet addiction disorder and identify the pathological problems in IAD, as well as explore the mental status of Internet addicts prior to addiction, including the pathological traits that may trigger Internet addiction disorder.

Methods and Findings

59 students were measured by Symptom CheckList-90 before and after they became addicted to the Internet. A comparison of collected data from Symptom Checklist-90 before Internet addiction and the data collected after Internet addiction illustrated the roles of pathological disorders among people with Internet addiction disorder. The obsessive-compulsive dimension was found abnormal before they became addicted to the Internet. After their addiction, significantly higher scores were observed for dimensions on depression, anxiety, hostility, interpersonal sensitivity, and psychoticism, suggesting that these were outcomes of Internet addiction disorder. Dimensions on somatisation, paranoid ideation, and phobic anxiety did not change during the study period, signifying that these dimensions are not related to Internet addiction disorder.

Conclusions

We can not find a solid pathological predictor for Internet addiction disorder. Internet addiction disorder may bring some pathological problems to the addicts in some ways.     

Cognitive Biases toward Internet Game-Related Pictures and Executive Deficits in Individuals with an Internet Game Addiction

Background

The cue-related go/no-go switching task provides an experimental approach to study individual’s flexibility in changing situations. Because Internet addiction disorder (IAD) belongs to the compulsive-impulsive spectrum of disorders, it should present cognitive bias and executive functioning deficit characteristics of some of these types of disorders. Until now, no studies have been reported on cognitive bias and executive function involving mental flexibility and response inhibition in IAD.

Methodology/Principal Findings

A total of 46 subjects who met the criteria of the modified Young’s Diagnostic Questionnaire for Internet addiction (YDQ) were recruited as an Internet game addiction (IGA) group, along with 46 healthy control individuals. All participants performed the Internet game-shifting task. Using hit rate, RT, d′ and C as the dependent measures, a three-way ANOVA (group × target × condition) was performed. For hit rate, a significant effect of group, type of target and condition were found. The group–target interaction effect was significant. For RT, significant effects were revealed for group and type of target. The group–target interaction effect was significant. Comparisons of the means revealed that the slowing down of IGA relative to NIA was more pronounced when the target stimuli were neutral as opposed to Internet game-related pictures. In addition, the group–condition interaction effect was significant. For d′, significant effects of group, type of target and condition were found. The group–target interaction effect was significant. For C, the type of target produced a significant effect. There was a positive correlation between the length of the addiction (number of years) and the severity of the cognitive bias.

Conclusions

IGA present cognitive biases towards information related to Internet gaming. These biases, as well as poor executive functioning skills (lower mental flexibility and response inhibition), might be responsible for Internet game addiction. The assessment of cognitive biases in IGA might provide a methodology for evaluation of therapeutic effects.     

基于潜意识理论的青少年网络成瘾研究

本文综述了青少年网络成瘾的预防和戒除方法,坚持了"习惯说",保留了对"疾病说"的看法。基于潜意识理论,将网络成瘾视为心理亚健康状态,分析了青少年网络成瘾的发生机理、提出了其预防和戒除原则。青少年网络成瘾的成因是心理上的缺失感,与青少年自我防护意识差、自我控制能力小、心理弹性弱,以及潜意识具有反复影响才可改变的特点有关。戒除网络成瘾的原则是淡化评判试测的标准、分散注意力、培养成就感、增强自信心、坚持以心治心等。     

甲基苯丙胺成瘾的表观遗传学机制

苯丙胺类兴奋剂是全世界第二大滥用程度的药物,甲基苯丙胺作为苯胺类兴奋剂中的主要药物,是中国滥用的“头号毒品”。而现有的研究对甲基苯丙胺成瘾机制尚不清晰,且临床上对药物成瘾的治疗依然存在无药可医的局面。因此,发现新的成瘾机制和治疗策略尤为迫切。甲基苯丙胺成瘾与额前叶皮质（mPFC）、中脑腹侧被盖区（VTA）和伏隔核（NAc）中的多巴胺（DA）、谷氨酸（Glu）、去甲肾上腺素（NE）和血清素（SNRIS）等神经递质的异常释放有关。研究表明,这些神经递质受到表观遗传机制中组蛋白乙酰化、甲基化、泛素化和非编码RNA等调节,某些基因的表达在甲基苯丙胺的诱导过程中增强或被抑制,导致甲基苯丙胺依赖性产生。本文将针对表观遗传学对甲基苯丙胺成瘾机制的影响进行着重论述,以期推进临床开发甲基苯丙胺戒断药物的研究。