物质成瘾人群金钱奖赏加工的异常机制及可恢复性

Dysfunction of Monetary Reward Processing and Recoverability in Drug Addicts

长期的成瘾物质使用造成奖赏系统的变化是成瘾过程发展和维持的关键,这种病理性变化反过来会对奖赏系统的调节功能产生不利的影响,引起认知表现和日常功能方面的障碍。近年来大量的功能性核磁共振成像研究表明物质成瘾人群的金钱奖赏加工相关的腹侧纹状体及其它奖赏脑区激活存在异常。而奖赏加工相关的纹状体激活可以作为治疗效果的预测器和临床恢复的指标;这种奖赏加工异常可以通过戒断有所恢复。今后的研究需要进一步补充奖赏加工的事件相关电位研究,研究物质成瘾人群奖赏加工的特异性,并增加对家庭物质依赖史个体的奖赏加工研究,以及奖赏与执行功能的交互作用机制的研究。

The changes of brain reward system caused by chronic substance use are considered central to the development and maintenance of addiction, and those pathological changes adversely affect regulation of reward system, inducing deficits in cognitive performance and daily function. In recent years, numerous fMRI studies have suggested that there are progressive changes in the ventral striatum and reward circuitry related to monetary reward processing in people with history of substance abuse, and the change of reward-related activation of the striatum can be used as a predictor of treatment outcome, indicating the degree of functional recovery. It has been shown that drug-induced dysfunction in the reward processing system can be recovered to some degree following abstinence. Further research in this area should address the specificity of reward processing associated with substance use, and investigate reward processing of individuals with family history of substance dependent and the effects of monetary reward on executive function, using event related potentials （ERPs）.