基于“相关线索-自动化用药行为”联结的成瘾记忆消退

Drug addiction memory extinction based on the association between related cues and automatic drug use behavior

成瘾记忆消退致力于消除成瘾者相关线索与药物奖赏效应的联结,以达到消除心理渴求、戒断成瘾行为的目的,但其效果还十分有限。最近,大量的动物和人类实验研究发现:在相关线索下,成瘾者的激活脑区不仅包括中脑边缘皮层-背内侧纹状体,还延伸到感觉运动脑区-背外侧纹状体。这意味着成瘾记忆中存在相关线索与自动化(习惯性)用药行为的联结。所以,与成瘾相关的记忆可能包含两种不同的成分:一是与药物奖赏效应相关的情绪记忆,另一种是与用药动作、技能有关的动作记忆(程序记忆)。由于在成瘾阶段,药物奖赏效应对药物使用和复发的作用已经相对减少,因此,针对成瘾记忆的消退训练,以相关线索与自动化用药行为的联结为标靶,可能可以取得更好的效果,值得做进一步的深入探索。

Memory extinction refers to the suppression of conditioned responses to drug cues. However, research on cue-exposure therapy related to memory extinction in clinical settings has found the extinguished responses significantly reemerge after exposure to the drug associated cues. This may indicate that current therapy methods using memory extinction do not prevent drug use or relapse when former drug addicts return to their previous drug environments. Extensive research employing a variety of animal and human learning paradigms indicates a neuroanatomical shift from the hippocampus/dorsomedial striatum towards the sensorimotor-dorsolateral striatum in the addiction period, which is characterized by habitual control drug use behavior. This proves that addiction memory also comprises the association between drug related cues and automatic drug using behavior, suggesting that drug addiction memory consists of at least two independent components： the emotion memory related to the drug reward effect and the action memory related to habitual drug use motion. Recent studies show that extinction training that builds an association between drug related cues and the physical action of pushing away has a significantly effect on addiction memory extinction. This serves as a reminder that eliminating or substituting the association between drug related cues and drug use motion could be the aim of memory extinction treatments. Therefore, the sensorimotor-dorsolateral striatum system is the relevant biological target. A better effect of intervention could be expected based on this specific form of memory extinction.