背景随着当代医疗技术水平的大幅提高,静息态功能磁共振成像(rs-fMRI)技术已经广泛应用于双相障碍(BD)的临床研究。目的探讨BD患者血清多巴胺转运受体(DAT)基因40 bp VNTR位点多态性和rs-fMRI与脑奖赏环路的相关性。方法收集2014年7月-2...背景随着当代医疗技术水平的大幅提高,静息态功能磁共振成像(rs-fMRI)技术已经广泛应用于双相障碍(BD)的临床研究。目的探讨BD患者血清多巴胺转运受体(DAT)基因40 bp VNTR位点多态性和rs-fMRI与脑奖赏环路的相关性。方法收集2014年7月-2015年7月在浙江大学医学院附属邵逸夫医院住院,年龄在20~50岁之间、性别不限、右利手、符合纳入、排除标准并签署知情同意书的BD患者90例,根据患者疾病分期分为BD躁狂相组(A组)32例、BD抑郁相组(B组)31例、BD缓解期组(C组)27例,另选取同期本院体检健康者30例为健康对照组(D组)。3组患者行功能磁共振成像(fMRI),然后使用NIH开发的脑功能数据处理平台分析rs-fMRI,针对不同的神经特征探讨局部一致性(ReHo)增强和减弱的区域;应用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术测定4组外周血DAT基因40 bp VNTR位点的多态性,分析该位点的多态性和rs-fMRI与脑奖赏环路的相关性。结果 A组患者rs-fMRI的ReHo显著增强的区域主要在腹侧纹状体、右侧前扣带回等,ReHc显著减弱的区域包括双侧楔前叶等;B组患者的ReHo显著增强的区域在右侧岛叶皮质、左额中回、左楔前叶等,而ReHo显著减弱的区域在小脑右前叶、右中央前回等;C组患者ReHo显著增强的区域主要在腹侧纹状体、右侧前扣带回、双侧海马,ReHo明显减弱的区域是脑桥、左中央后回、左额下回和右扣带回。4组受试者DAT基因40 bp VNTR位点的基因型频率总体分布比较,差异无统计学意义(P>0.10);4组的杂合度分布比较,差异无统计学意义(P>0.10)。结论 BD与脑奖赏环路相关脑区的相关作用异常有关,但是二者的分子机制有待进一步的研究和探索。展开更多
Chronic pain is often accompanied by negative emotions,and the progression of negative emotions may further impede pain relief.Both chronic pain and negative emotions are closely associated with reward/motivation circ...Chronic pain is often accompanied by negative emotions,and the progression of negative emotions may further impede pain relief.Both chronic pain and negative emotions are closely associated with reward/motivation circuits.Treatment with acupuncture is effective for the relief of pain and emotional disorders,although the acupoint combinations vary.Thus,this study aimed to elucidate the relationship of chronic pain and emotional disorders with the reward/motivation circuits.In association with the theory on "seven emotional factors that cause pain" in traditional Chinese medicine,the potential effect mechanism of "spirit-regulation with acupuncture" for the relief of chronic pain and negative emotions was explored.The findings suggest that chronic pain and its related negative emotions may be effectively relieved with acupuncture after optimizing its acupoint combination based on "spirit-regulation".However,the role of reward/motivation circuits for negative emotions in the relief of chronic pain with acupuncture needs to be demonstrated.展开更多
The periaqueductal gray(PAG)is a complex mesencephalic structure involved in the integration and execution of active and passive self-protective behaviors against imminent threats,such as immobility or flight from a p...The periaqueductal gray(PAG)is a complex mesencephalic structure involved in the integration and execution of active and passive self-protective behaviors against imminent threats,such as immobility or flight from a predator.PAG activity is also associated with the integration of responses against physical discomfort(e.g.,anxiety,fear,pain,and disgust)which occurs prior an imminent attack,but also during withdrawal from drugs such as morphine and cocaine.The PAG sends and receives projections to and from other well-documented nuclei linked to the phenomenon of drug addiction including:(i)the ventral tegmental area;(ii)extended amygdala;(iii)medial prefrontal cortex;(iv)pontine nucleus;(v)bed nucleus of the stria terminalis;and(vi)hypothalamus.Preclinical models have suggested that the PAG contributes to the modulation of anxiety,fear,and nociception(all of which may produce physical discomfort)linked with chronic exposure to drugs of abuse.Withdrawal produced by the major pharmacological classes of drugs of abuse is mediated through actions that include participation of the PAG.In support of this,there is evidence of functional,pharmacological,molecular.And/or genetic alterations in the PAG during the impulsive/compulsive intake or withdrawal from a drug.Due to its small size,it is difficult to assess the anatomical participation of the PAG when using classical neuroimaging techniques,so its phys-iopathology in drug addiction has been underestimated and poorly documented.In this theoretical review,we discuss the involvement of the PAG in drug addiction mainly via its role as an integrator of responses to the physical discomfort associated with drug withdrawal.展开更多
文摘背景随着当代医疗技术水平的大幅提高,静息态功能磁共振成像(rs-fMRI)技术已经广泛应用于双相障碍(BD)的临床研究。目的探讨BD患者血清多巴胺转运受体(DAT)基因40 bp VNTR位点多态性和rs-fMRI与脑奖赏环路的相关性。方法收集2014年7月-2015年7月在浙江大学医学院附属邵逸夫医院住院,年龄在20~50岁之间、性别不限、右利手、符合纳入、排除标准并签署知情同意书的BD患者90例,根据患者疾病分期分为BD躁狂相组(A组)32例、BD抑郁相组(B组)31例、BD缓解期组(C组)27例,另选取同期本院体检健康者30例为健康对照组(D组)。3组患者行功能磁共振成像(fMRI),然后使用NIH开发的脑功能数据处理平台分析rs-fMRI,针对不同的神经特征探讨局部一致性(ReHo)增强和减弱的区域;应用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术测定4组外周血DAT基因40 bp VNTR位点的多态性,分析该位点的多态性和rs-fMRI与脑奖赏环路的相关性。结果 A组患者rs-fMRI的ReHo显著增强的区域主要在腹侧纹状体、右侧前扣带回等,ReHc显著减弱的区域包括双侧楔前叶等;B组患者的ReHo显著增强的区域在右侧岛叶皮质、左额中回、左楔前叶等,而ReHo显著减弱的区域在小脑右前叶、右中央前回等;C组患者ReHo显著增强的区域主要在腹侧纹状体、右侧前扣带回、双侧海马,ReHo明显减弱的区域是脑桥、左中央后回、左额下回和右扣带回。4组受试者DAT基因40 bp VNTR位点的基因型频率总体分布比较,差异无统计学意义(P>0.10);4组的杂合度分布比较,差异无统计学意义(P>0.10)。结论 BD与脑奖赏环路相关脑区的相关作用异常有关,但是二者的分子机制有待进一步的研究和探索。
基金Supported by Youth Science Fund of the National Natural Science Foundation of China (81804180)General Program for TCM Scientific Research of Health Commission of Hubei Province (ZY2021M031)。
文摘Chronic pain is often accompanied by negative emotions,and the progression of negative emotions may further impede pain relief.Both chronic pain and negative emotions are closely associated with reward/motivation circuits.Treatment with acupuncture is effective for the relief of pain and emotional disorders,although the acupoint combinations vary.Thus,this study aimed to elucidate the relationship of chronic pain and emotional disorders with the reward/motivation circuits.In association with the theory on "seven emotional factors that cause pain" in traditional Chinese medicine,the potential effect mechanism of "spirit-regulation with acupuncture" for the relief of chronic pain and negative emotions was explored.The findings suggest that chronic pain and its related negative emotions may be effectively relieved with acupuncture after optimizing its acupoint combination based on "spirit-regulation".However,the role of reward/motivation circuits for negative emotions in the relief of chronic pain with acupuncture needs to be demonstrated.
基金by the Direccion General de Investigacion y Posgrado from the Autonomous University of Aguascalientes.PB-I was supported by the PRODEP program and an early career research grant from the International Association for the Study of Pain.AM-P was supported by the“Instituto Polit6cnico Nacional”(SIP-IPN 20200241)PV-L was supported by a CONACyT Postdoctoral Fellowship(406562)Figure 1 was partially drawn using biorender.com.BAM-C,PB-I,PV-L and JC-R are current fellows of the**Sistema Nacional de Investi-gadores”from CONACYT.
文摘The periaqueductal gray(PAG)is a complex mesencephalic structure involved in the integration and execution of active and passive self-protective behaviors against imminent threats,such as immobility or flight from a predator.PAG activity is also associated with the integration of responses against physical discomfort(e.g.,anxiety,fear,pain,and disgust)which occurs prior an imminent attack,but also during withdrawal from drugs such as morphine and cocaine.The PAG sends and receives projections to and from other well-documented nuclei linked to the phenomenon of drug addiction including:(i)the ventral tegmental area;(ii)extended amygdala;(iii)medial prefrontal cortex;(iv)pontine nucleus;(v)bed nucleus of the stria terminalis;and(vi)hypothalamus.Preclinical models have suggested that the PAG contributes to the modulation of anxiety,fear,and nociception(all of which may produce physical discomfort)linked with chronic exposure to drugs of abuse.Withdrawal produced by the major pharmacological classes of drugs of abuse is mediated through actions that include participation of the PAG.In support of this,there is evidence of functional,pharmacological,molecular.And/or genetic alterations in the PAG during the impulsive/compulsive intake or withdrawal from a drug.Due to its small size,it is difficult to assess the anatomical participation of the PAG when using classical neuroimaging techniques,so its phys-iopathology in drug addiction has been underestimated and poorly documented.In this theoretical review,we discuss the involvement of the PAG in drug addiction mainly via its role as an integrator of responses to the physical discomfort associated with drug withdrawal.
