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Bed nucleus of the stria terminalis network responses to unpredictable threat in early alcohol abstinence 戒酒早期纹状体末端床核网络对不可预测威胁的反应
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-24 DOI: 10.1111/acer.15407
Nicole L. Zabik, Elizabeth A. Flook, Brandee Feola, Margaret M. Benningfield, Marisa M. Silveri, Danny G. Winder, Jennifer Urbano Blackford

Background

Anxiety during early alcohol abstinence, likely resulting from neural changes caused by chronic alcohol use, contributes to high relapse rates. Studies in rodents show heightened activation during early abstinence in the bed nucleus of the stria terminalis (BNST)—a neural hub for anxiety—and its extended anxiety-related corticolimbic network. Despite the clinical importance of early abstinence, few studies investigate the underlying neural mechanisms.

Methods

To address this gap, we investigated brain function in early alcohol abstinence (EA = 20, 9 women) relative to controls (HC = 20, 11 women) using an unpredictable threat task shown to engage the BNST and corticolimbic brain regions involved in anxiety and alcohol use disorder (AUD). Group, anxiety, and sex were predictors used to determine whole-brain activation and BNST functional connectivity.

Results

We found widespread interactions of group × anxiety and group × anxiety × sex for both activation and BNST connectivity during unpredictable threat. In the EA group, higher anxiety was correlated with activation in the BNST, rostral anterior cingulate cortex (ACC), insula (men only), and dorsal ACC (men only). In the HC group, higher anxiety was negatively correlated with activation in the BNST, nucleus accumbens, thalamus, and insula (men only). For connectivity, anxiety was positively correlated in EA and negatively correlated in HC, between the BNST and the amygdala, ventromedial prefrontal cortex (PFC), and dorsomedial PFC; EA men showed stronger BNST-vmPFC connectivity than HC men.

Conclusions

These novel findings provide preliminary evidence for alterations in the BNST and anxiety-related corticolimbic brain regions in early alcohol abstinence, adding to growing literature in humans supporting the BNST's role in anxiety and sex-dependent effects of chronic alcohol use.

背景:早期戒酒期间的焦虑可能是由长期饮酒引起的神经变化造成的,这也是导致高复发率的原因之一。对啮齿类动物的研究表明,在早期戒酒期间,作为焦虑神经中枢的纹状体末端床核(BNST)及其扩展的焦虑相关皮质边缘网络的激活增强。尽管早期戒断具有重要的临床意义,但很少有研究调查其潜在的神经机制:为了填补这一空白,我们利用一项不可预测的威胁任务,研究了早期戒酒者(EA = 20 人,9 名女性)相对于对照组(HC = 20 人,11 名女性)的大脑功能,该任务显示了 BNST 和皮质边缘脑区参与焦虑和酒精使用障碍(AUD)。组别、焦虑和性别是用于确定全脑激活和 BNST 功能连接的预测因子:结果:我们发现,在不可预测的威胁下,组别×焦虑和组别×焦虑×性别对激活和 BNST 连接具有广泛的交互作用。在 EA 组,较高的焦虑与 BNST、喙状前扣带回皮层 (ACC)、脑岛(仅男性)和背侧 ACC(仅男性)的激活相关。在高危人群组中,较高的焦虑与 BNST、伏隔核、丘脑和脑岛(仅男性)的激活呈负相关。在连通性方面,EA 组的焦虑与 BNST 和杏仁核、腹外侧前额叶皮层 (PFC) 以及背内侧前额叶皮层之间呈正相关,而 HC 组则呈负相关;EA 组男性比 HC 组男性表现出更强的 BNST-vmPFC 连通性:这些新发现提供了初步证据,证明在早期戒酒过程中,BNST和焦虑相关的皮质边缘脑区发生了改变,为越来越多的人类文献支持BNST在焦虑和长期饮酒的性别依赖效应中的作用增添了新的内容。
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引用次数: 0
BNST GluN2D-containing NMDARs contribute to ethanol intake but not negative affective behaviors in female mice BNST 含 GluN2D 的 NMDARs 会导致雌性小鼠摄入乙醇,但不会导致其产生负面情绪行为。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-23 DOI: 10.1111/acer.15432
Marie A. Doyle, Gregory J. Salimando, Megan E. Altemus, Justin K. Badt, Michelle N. Bedenbaugh, Alexander S. Vardy, Danielle N. Adank, Anika S. Park, Danny G. Winder

Background

Alcohol use disorder (AUD) is a chronic, relapsing disease, highly comorbid with anxiety and depression. The bed nucleus of the stria terminalis (BNST) and Crh+ neurons in this region play a key role in chronic ethanol-induced increases in volitional intake, hypothesized to be driven by emergent negative affective behaviors. Excitatory N-methyl-d-aspartate receptors (NMDARs) are a major target of ethanol, and chronic ethanol exposure has been shown to regulate NMDAR function and expression. Specifically, GluN2D subunit-containing NMDARs have emerged as a target of interest due to their limited distribution and potential roles in affective behavior.

Methods

Male and female mice underwent a home cage chronic drinking forced abstinence model (CDFA) to assess the impact of 1 day or 2 weeks of ethanol abstinence on BNST synaptic transmission and BNST Grin gene expression. Constitutive and conditional BNST GluN2D knockout mice were used to assess the impact of GluN2D deletion on continuous access ethanol intake as well as negative affect behaviors, using the open field, elevated zero maze, and forced swim tasks.

Results

We report here that excitatory transmission undergoes time-dependent upregulation in BNST Crh+ cells. Further, knockdown of dorsal BNST (dBNST) GluN2D expression significantly decreases ethanol intake in female, but not male, mice. While BNST Grin2b expression was significantly increased in protracted abstinence following CDFA, no differences in Grin2d expression were observed in the dBNST or dBNST Crh+ neurons. Finally, we find that deletion of GluN2D fails to alter negative affect in ethanol-naïve female mice.

Conclusions

These data suggest a role for BNST GluN2D-containing NMDARs in ethanol drinking but not ethanol abstinence, highlighting sex differences and behavioral specificity. Overall, these data further suggest roles for BNST synaptic signaling in volitional ethanol intake that are partially independent of actions on affective behavior.

背景:酒精使用障碍(AUD)是一种慢性、复发性疾病,与焦虑和抑郁高度共存。纹状体末端床核(BNST)和该区域的Crh+神经元在慢性乙醇诱导的意志摄入量增加中起着关键作用,据推测,乙醇诱导的意志摄入量增加是由新出现的负性情感行为驱动的。兴奋性 N-甲基-d-天冬氨酸受体(NMDARs)是乙醇的一个主要靶点,慢性乙醇暴露已被证明能调节 NMDAR 的功能和表达。特别是含 GluN2D 亚基的 NMDARs,由于其有限的分布和在情感行为中的潜在作用,已成为一个受关注的靶点:方法:对雌雄小鼠进行家笼慢性饮酒强迫戒断模型(CDFA),以评估1天或2周的乙醇戒断对BNST突触传递和BNST Grin基因表达的影响。我们利用连续性和条件性BNST GluN2D基因敲除小鼠来评估GluN2D基因缺失对连续摄入乙醇以及负性情绪行为的影响,包括开放场地、高架零迷宫和强迫游泳任务:结果:我们在此报告了兴奋性传递在 BNST Crh+ 细胞中发生的时间依赖性上调。此外,敲除背侧 BNST(dBNST)GluN2D 的表达会显著降低雌性小鼠的乙醇摄入量,而雄性小鼠则不会。虽然 BNST Grin2b 的表达在 CDFA 后的长期戒断中显著增加,但在 dBNST 或 dBNST Crh+ 神经元中并未观察到 Grin2d 表达的差异。最后,我们发现删除 GluN2D 无法改变乙醇成瘾雌性小鼠的负性情绪:这些数据表明,含 BNST GluN2D 的 NMDARs 在乙醇饮酒中发挥作用,但在乙醇戒断中不发挥作用,凸显了性别差异和行为特异性。总之,这些数据进一步表明,BNST 突触信号在乙醇自愿摄入中的作用部分独立于对情感行为的作用。
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引用次数: 0
The impact of COVID-19-related national lockdowns on alcohol-related traffic collisions, injuries, and fatalities in Lithuania 立陶宛与 COVID-19 有关的全国封锁对与酒精有关的交通碰撞、伤亡事故的影响。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-23 DOI: 10.1111/acer.15429
Shannon Lange, Huan Jiang, Laura Miščikienė, Alexander Tran, Mindaugas Štelemėkas, Jürgen Rehm

Background

The national lockdowns that occurred all over the world in response to the Coronavirus Disease 2019 (COVID-19) pandemic have been found to have impacted alcohol use. The aim was to evaluate the impact of COVID-19-related national lockdowns on alcohol-related traffic collisions, injuries, and fatalities in Lithuania.

Methods

Using monthly data from the Lithuanian Road Police Service for January 2004 to December 2022, we performed interrupted time-series analyses using a generalized additive model to evaluate the impact of COVID-19-related national lockdowns on alcohol-related traffic collisions, injuries, and fatalities. In Lithuania, the COVID-19-related lockdowns occurred from March 2020 to June 2020 and from November 2020 to June 2021.

Results

Although overall rates for traffic collisions and injuries decreased during the COVID-19-related lockdowns in Lithuania, these lockdowns were associated with a 3.21% (95% CI: 1.19%, 5.23%) increase in the relative proportion of alcohol-related traffic collisions and a 2.46% (95% CI: 0.12%, 4.80%) increase in the relative proportion of alcohol-related traffic injuries. The association between the lockdowns and alcohol-related traffic fatalities was not statistically significant.

Conclusion

The COVID-19-related national lockdowns in Lithuania were associated with a decrease in the overall rate of traffic collisions and injuries, but an increase in the relative proportion of alcohol-related traffic collisions and injuries.

背景:世界各地为应对 2019 年冠状病毒病(COVID-19)大流行而采取的全国封锁措施已被发现对酒精的使用产生了影响。本研究旨在评估与 COVID-19 相关的国家禁酒令对立陶宛与酒精相关的交通碰撞、伤亡事故的影响:利用立陶宛道路警察局提供的 2004 年 1 月至 2022 年 12 月的月度数据,我们使用广义加法模型进行了间断时间序列分析,以评估与 COVID-19 相关的国家禁酒令对与酒精相关的交通碰撞、受伤和死亡事故的影响。立陶宛于 2020 年 3 月至 2020 年 6 月和 2020 年 11 月至 2021 年 6 月实施了与 COVID-19 相关的禁酒令:尽管在立陶宛与 COVID-19 相关的封锁期间,交通碰撞和受伤的总体比率有所下降,但这些封锁与酒精相关的交通碰撞相对比例增加了 3.21%(95% CI:1.19%,5.23%),与酒精相关的交通受伤相对比例增加了 2.46%(95% CI:0.12%,4.80%)。封锁与酒精相关交通死亡事故之间的联系在统计学上并不显著:立陶宛与 COVID-19 相关的全国禁酒令降低了交通碰撞和伤害的总体发生率,但增加了与酒精相关的交通碰撞和伤害的相对比例。
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引用次数: 0
Self-reported alcohol consumption during participation in a text messaging-based online drinking moderation platform 参与基于短信的在线饮酒节制平台期间的自我报告饮酒量。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-23 DOI: 10.1111/acer.15414
Nehal P. Vadhan, Hayley Treloar Padovano, Frederick J. Muench, Svetlana Levak, Nicholas Allen

Background

Many individuals with excessive alcohol consumption desire moderation but do not seek formalized treatment. Commercially available, technology-assisted options are flexible and highly accessible, yet often not empirically validated.

Methods

Individuals desiring alcohol moderation (age 21+) self-selected to use Sunnyside®, a web application with tailored and adaptive text messaging. The evaluable dataset included 46,411 members who completed a baseline assessment, enrolled in the program, and tracked their drinking at least once. An adaptive and customizable weekly plan was generated from typical drinking patterns, goals, and weekly reported progress. Personalized daily messages included reminders for real-time drink tracking, plans, and available interactive messaging with peer coaches. Generalized mixed-effect growth models characterized change in drinks per week and daily drinking for 12 weeks after enrollment. Models allowed for nonlinear change and individual variability across members and weeks.

Results

A majority (64.3%) of members reported typically drinking 7 of 7 days per week at baseline. During tracking, drinks per week decreased most in the initial weeks and slowed thereafter, with an overall 33% reduction in weekly drink counts. More severe alcohol-use patterns and concern over drinking at baseline were associated with greater relative benefit.

Conclusions

Drinking patterns appeared amenable to change during 12 weeks of daily drink tracking with Sunnyside®, a tailored web program to reduce drinking and improve overall wellness. Overall, the findings of this naturalistic study, one of the first of its kind, supplement data from randomized clinical trials and support the use of adaptive, technology-assisted tools for alcohol moderation.

背景:许多过度饮酒者希望节制饮酒,但并不寻求正规治疗。商业上可获得的技术辅助方案非常灵活且易于使用,但往往未经经验验证:方法:希望节制饮酒的个人(21 岁以上)自主选择使用 Sunnyside®,这是一款具有定制和自适应短信功能的网络应用程序。可评估的数据集包括 46,411 名完成基线评估、注册该计划并至少跟踪一次其饮酒情况的成员。根据典型的饮酒模式、目标和每周报告的进展情况,生成了自适应和可定制的每周计划。个性化的每日信息包括实时饮酒跟踪提醒、计划以及与同伴教练的互动信息。广义混合效应增长模型描述了入组后 12 周内每周饮酒量和每日饮酒量的变化。模型考虑了非线性变化以及成员和周之间的个体差异:大多数成员(64.3%)表示,在基线时,他们通常每周 7 天中有 7 天喝酒。在跟踪过程中,每周饮酒量在最初几周下降最多,之后有所减缓,每周饮酒量总体下降了 33%。基线时较严重的饮酒模式和对饮酒的担忧与更大的相对受益相关:结论:在使用阳光®进行为期12周的每日饮酒跟踪期间,饮酒模式似乎可以改变,阳光®是一项量身定制的网络计划,旨在减少饮酒并提高整体健康水平。总之,这项自然研究是同类研究中的首例,其结果补充了随机临床试验的数据,并支持使用适应性技术辅助工具来节制饮酒。
{"title":"Self-reported alcohol consumption during participation in a text messaging-based online drinking moderation platform","authors":"Nehal P. Vadhan,&nbsp;Hayley Treloar Padovano,&nbsp;Frederick J. Muench,&nbsp;Svetlana Levak,&nbsp;Nicholas Allen","doi":"10.1111/acer.15414","DOIUrl":"10.1111/acer.15414","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many individuals with excessive alcohol consumption desire moderation but do not seek formalized treatment. Commercially available, technology-assisted options are flexible and highly accessible, yet often not empirically validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals desiring alcohol moderation (age 21+) self-selected to use Sunnyside®, a web application with tailored and adaptive text messaging. The evaluable dataset included 46,411 members who completed a baseline assessment, enrolled in the program, and tracked their drinking at least once. An adaptive and customizable weekly plan was generated from typical drinking patterns, goals, and weekly reported progress. Personalized daily messages included reminders for real-time drink tracking, plans, and available interactive messaging with peer coaches. Generalized mixed-effect growth models characterized change in drinks per week and daily drinking for 12 weeks after enrollment. Models allowed for nonlinear change and individual variability across members and weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A majority (64.3%) of members reported typically drinking 7 of 7 days per week at baseline. During tracking, drinks per week decreased most in the initial weeks and slowed thereafter, with an overall 33% reduction in weekly drink counts. More severe alcohol-use patterns and concern over drinking at baseline were associated with greater relative benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Drinking patterns appeared amenable to change during 12 weeks of daily drink tracking with Sunnyside®, a tailored web program to reduce drinking and improve overall wellness. Overall, the findings of this naturalistic study, one of the first of its kind, supplement data from randomized clinical trials and support the use of adaptive, technology-assisted tools for alcohol moderation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"48 9","pages":"1784-1794"},"PeriodicalIF":3.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.15414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alcohol and arterial stiffness in middle-aged and older adults: Cross-sectional evidence from the UK Biobank study 酒精与中老年人动脉僵化:来自英国生物库研究的横断面证据。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-20 DOI: 10.1111/acer.15426
Rudolph Schutte, Jufen Zhang, Mahreen Kiran, Graham Ball

Background

The association between arterial stiffness and alcohol consumption is still controversial. We investigated this relationship by performing continuous analysis in men drinking only beer/cider, and women drinking only red wine.

Methods

This cross-sectional study involved participants aged 40–69 years consisting of 9029 men who drank only beer/cider, and 6989 women drinking only red wine. Alcohol consumption was captured by self-reported questionnaire and reported as units per week, where one unit is equal 10 mL pure ethanol. Arterial stiffness index (ASI) was estimated using photoplethysmography.

Results

In men consuming a mean 17.8 (5th and 95th percentiles, 2.6–76.7) units/week, ASI increased by heptiles (sevenths) of alcohol captured from beer/cider consumption and after adjusting for age (9.14, 9.40, 9.51, 9.53, 9.80, 9.80, 10.00 m/s; p-trend < 0.001) and after full adjustment (9.29, 9.46. 9.55, 9.55, 9.73, 9.73, 9.75 m/s; p-trend = 0.013). Similarly, in women consuming a mean 8.1 (1.6–29.3) units/week, ASI increased by heptiles of alcohol captured from red wine consumption and after adjusting for age (8.05, 8.05, 8.05, 8.11, 8.17, 8.30, 8.45 m/s; p-trend = 0.012) and borderline significant after full adjustment (8.05, 8.07, 8.05, 8.07, 8.11, 8.22, 8.43 m/s; p-trend = 0.055). These associations were confirmed in multivariable-adjusted regression analysis in all men, men younger and older than 50 years, and when consuming more than 14 units per week. Similarly, these associations were confirmed in all women, women older than 50 years, and in those consuming more than 14 units per week.

Conclusions

Positive linear relationships exist between arterial stiffness and alcohol, irrespective of whether captured from beer/cider consumption in men or red wine consumption in women. No evidence existed to support the notion that our arteries benefit from any level of alcohol consumption.

背景:动脉僵化与饮酒之间的关系仍存在争议。我们通过对只喝啤酒/苹果酒的男性和只喝红酒的女性进行连续分析来研究这种关系:这项横断面研究的参与者年龄在 40-69 岁之间,包括 9029 名只喝啤酒/苹果酒的男性和 6989 名只喝红酒的女性。酒精消耗量通过自我报告问卷调查获得,以每周为单位进行报告,其中一个单位等于 10 毫升纯乙醇。动脉僵化指数(ASI)通过光电血压计进行估算:结果:在平均每周摄入 17.8 单位(第 5 和第 95 百分位数,2.6-76.7)酒精的男性中,ASI 按啤酒/苹果酒酒精摄入量的七分位数(七分位数)和年龄调整后增加(9.14、9.40、9.51、9.53、9.80、9.80、10.00 m/s;p-趋势):动脉僵化与酒精之间存在正线性关系,不管是男性饮用啤酒/苹果酒还是女性饮用红酒。没有证据支持我们的动脉从任何程度的饮酒中获益的观点。
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引用次数: 0
Recovery from alcohol use disorder: Reinforcer pathology theory, measurement, and methods 酒精使用障碍的康复:强化剂病理学理论、测量和方法。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-18 DOI: 10.1111/acer.15406
Warren K. Bickel, Katie Witkiewitz, Liqa N. Athamneh, Alena Kuhlemeier

Recovery from alcohol use disorder (AUD) is a dynamic process that often entails periods of drinking but has been defined primarily by abstinence. Recently, a broader interpretation of recovery was developed, including meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) remission criteria and improved psychosocial functioning. This new understanding of recovery has facilitated the development of novel theories and methodologies. This paper reviews a new theoretical perspective of recovery, Reinforcer Pathology, and two novel methodological approaches in light of this broader view of recovery. Using this theoretical framework as a foundation, we propose an alternative perspective to explain the recovery process as it relates to environmental factors and valuation of the future; we suggest that changing the environment in which substances are available (e.g., increasing non-alcohol-related activities) and extending one's temporal window are associated with improved recovery outcomes (e.g., remission and quality of life). In this review, we discuss two novel methodological approaches. The first uses latent profile analysis to show that using a measure of Relative Reinforcement Value of Alcohol-Free Activities is associated with a greater likelihood of belonging to a high functioning/infrequent heavy drinking recovery profile. The second developed an online national sample and used an accelerated longitudinal design to study longer-term recovery of up to 12 years over a 5-year study period. Reinforcer Pathology theory, novel methods, and measures may further our understanding of recovery and begin to address critical questions for future studies. Subsequent randomized clinical trials should examine whether the suggested targets and interventions based on the theoretical model improve recovery outcomes prospectively. Measuring and promoting alcohol-free activity engagement may facilitate improved recovery outcomes, while novel methodologies permit an understanding of returning to use or remission across different recovery durations.

酒精使用障碍(AUD)的康复是一个动态的过程,通常需要一段时间的饮酒,但主要以戒酒来定义。最近,人们对康复有了更广泛的解释,包括达到《精神障碍诊断与统计手册》(DSM)的缓解标准和改善社会心理功能。这种对康复的新理解促进了新理论和新方法的发展。本文回顾了康复的一个新理论视角--强化者病理学,以及根据这一更广泛的康复视角提出的两种新方法。以这一理论框架为基础,我们提出了另一种视角来解释与环境因素和对未来的评价有关的康复过程;我们认为,改变可获得物质的环境(如增加与酒精无关的活动)和延长一个人的时间窗口与改善康复结果(如病情缓解和生活质量)有关。在本综述中,我们将讨论两种新颖的方法。第一种方法使用潜在特征分析表明,使用 "无酒精活动的相对强化价值 "衡量标准与更有可能属于 "高功能/不经常大量饮酒康复特征 "相关。第二项研究开发了一个在线全国样本,并采用加速纵向设计来研究在 5 年研究期内长达 12 年的长期恢复情况。强化者病理学理论、新方法和测量方法可以进一步加深我们对康复的理解,并开始解决未来研究的关键问题。随后的随机临床试验应检查基于该理论模型的建议目标和干预措施是否能改善康复效果。衡量和促进无酒精活动的参与可能有助于改善康复结果,而新的方法则有助于了解在不同的康复持续时间内恢复饮酒或病情缓解的情况。
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引用次数: 0
Phosphatidylethanol is a promising tool for screening alcohol consumption during pregnancy 磷脂酰乙醇是筛查孕期饮酒的一种很有前景的工具。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-15 DOI: 10.1111/acer.15418
Margareeta Häkkinen, Anne Arponen, Antti Jylhä, Kati Sulin, Teemu Gunnar

Background

Prenatal alcohol exposure (PAE) is one of the leading causes of preventable developmental disabilities. A lack of objective screening methods results in an under-recognition of the phenomenon. Phosphatidylethanol (PEth) is a specific ethanol biomarker that reveals alcohol intake up to several weeks after alcohol use. So far, PEth has mostly been a tool for detecting moderate and heavy drinking. With lower PEth cut-offs, revealing even minor prenatal alcohol consumption is possible. We aimed to find out if a sensitive method for PEth analysis would give additional information about PAE and to assess the cut-off value for a positive alcohol result in prenatal screening.

Methods

The study was an observational study of 3000 anonymous blood samples collected from the Helsinki University Hospital Diagnostic Center between June and September 2023. The Finnish Red Cross Blood Service received the samples originally for blood group typing and antibody screening as part of the prenatal blood screening program. We developed a sensitive PEth 16:0/18:1 analysis method using ultra-high-performance liquid chromatography tandem mass spectrometry (UHPLC–MS/MS) equipment after liquid–liquid extraction of PEth from whole blood. The lower limit of quantification was 1 ng/mL.

Results

PEth was ≥2 ng/mL in 5.2% of the cases, ≥8 ng/mL in 2.0%, and ≥20 ng/mL in 1.0%. The detection time of PEth can be several weeks, especially with low PEth concentrations and after heavy alcohol consumption. It remained unknown whether the positive PEth tests resulted from drinking deliberately during pregnancy or before pregnancy recognition.

Conclusions

We suggest adding PEth 16:0/18:1 to a routine prenatal blood screening program with a cut-off of 2 ng/mL—and in positive cases, clinical evaluation and retesting in 2–4 weeks. In clinical settings, information on gestational week and alcohol consumption before pregnancy is relevant and needs to be considered when interpreting low PEth concentrations.

背景:产前酒精暴露(PAE)是导致可预防的发育障碍的主要原因之一。由于缺乏客观的筛查方法,人们对这一现象的认识不足。磷脂酰乙醇(PEth)是一种特异性乙醇生物标志物,可在饮酒后数周内显示酒精摄入量。迄今为止,PEth 主要用于检测中度和重度饮酒。如果 PEth 的临界值较低,那么即使是轻微的产前饮酒也有可能被发现。我们的目的是找出一种敏感的 PEth 分析方法是否能提供 PAE 的额外信息,并评估产前筛查中酒精检测结果呈阳性的临界值:本研究是一项观察性研究,研究对象是 2023 年 6 月至 9 月期间从赫尔辛基大学医院诊断中心采集的 3000 份匿名血液样本。作为产前血液筛查项目的一部分,芬兰红十字会血液服务机构接收这些样本的初衷是进行血型配型和抗体筛查。我们使用超高效液相色谱-串联质谱(UHPLC-MS/MS)设备从全血中提取 PEth 后,开发了一种灵敏的 PEth 16:0/18:1 分析方法。定量下限为 1 ng/mL:结果:5.2%的病例 PEth ≥2 ng/mL,2.0%的病例 PEth ≥8 ng/mL,1.0%的病例 PEth ≥20 ng/mL。PEth 的检测时间可能长达数周,尤其是 PEth 浓度较低和大量饮酒后。目前仍不清楚 PEth 检测呈阳性的原因是怀孕期间故意饮酒还是在妊娠确认前饮酒:我们建议在常规产前血液筛查项目中加入 PEth 16:0/18:1,以 2 纳克/毫升为临界值。在临床环境中,妊娠周数和孕前饮酒量是相关信息,在解释低浓度 PEth 时需要加以考虑。
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引用次数: 0
George Robert Siggins: Researcher, musician, surfer, mentor, and friend 乔治-罗伯特-西金斯研究员、音乐家、冲浪者、良师益友。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-15 DOI: 10.1111/acer.15423
Marisa Roberto, Michal Bajo, Paul Schweitzer, Scott D. Moore, Christopher S. Oleata, Samuel Madamba, Martin A. Javors, Barbara J. Mason, George F. Koob
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引用次数: 0
Thromboxane A2 blockade attenuates ethanol-induced myocardial inflammation: Sipping from the same bottle 血栓素 A2 阻断剂可减轻乙醇诱发的心肌炎症:从同一个瓶子里啜饮
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-13 DOI: 10.1111/acer.15421
Thomas E. Sharp III, Thanh Trung Van
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引用次数: 0
Assessing and supporting children and young people with probable or diagnosed fetal alcohol spectrum disorder: The experience of clinicians working within child and adolescent mental health services 评估和支持可能或确诊患有胎儿酒精谱系障碍的儿童和青少年:在儿童和青少年心理健康服务机构工作的临床医生的经验。
IF 3 Q2 SUBSTANCE ABUSE Pub Date : 2024-08-13 DOI: 10.1111/acer.15376
Yasmin Tanfield, Kathy Burrows, Megan Middlemiss

Background

Fetal alcohol spectrum disorders (FASD) are a group of conditions that occur due to prenatal alcohol exposure (PAE), which impacts physical, behavioral, and cognitive ability. The literature demonstrates that healthcare professionals lack knowledge and understanding of FASD, resulting in children and young people (CYP) often getting misdiagnosed with neurodevelopmental disorders or the diagnosis of FASD missed, increasing their risk of experiencing secondary mental health difficulties. Child and Adolescent Mental Health Services (CAMHS) are the commissioned service to diagnose neurodevelopmental conditions and support CYP with mental health difficulties, therefore, it is likely that CYP with probable or diagnosed FASD will present in CAMHS. There is currently no research exploring the awareness and understanding of FASD within these services.

Methods

Constructivist grounded theory was utilized to explore the barriers and facilitators clinicians experience when assessing and supporting CYP with probable or diagnosed FASD within CAMHS. A sample of 12 CAMHS clinicians from an NHS Mental Health Trust situated in the Northeast of England were interviewed. Interviews were transcribed and analyzed and grounded theory techniques were utilized to generate an end model.

Results

The end model was developed on a box analogy with four categories. ‘Unable to Open the Box’ captures barriers CAMHS clinicians experience when exploring FASD, ‘Things that Help Open the Box’ captures facilitators CAMHS clinicians experience when exploring FASD, ‘Asking Others About the Box’ captures systemic influences CAMHS clinicians may experience when exploring FASD, and ‘Making the Box Easier to Open in Future’ captures how we can support CAMHS clinicians moving forward to explore FASD.

Conclusions

This model provides new insights into the barriers and facilitators CAMHS clinicians experience when assessing and supporting CYP with probable or diagnosed FASD, highlighting key clinical implications. Recommendations for future research are outlined to expand the knowledge base for this area.

背景:胎儿酒精谱系障碍(FASD)是一组因产前酒精暴露(PAE)而导致的疾病,会影响身体、行为和认知能力。文献表明,医护人员缺乏对 FASD 的认识和了解,导致儿童和青少年(CYP)经常被误诊为神经发育障碍或漏诊 FASD,从而增加了他们遭遇继发性心理健康问题的风险。儿童和青少年心理健康服务(CAMHS)是负责诊断神经发育疾病和为有心理健康问题的儿童和青少年提供支持的委托服务机构,因此,可能患有或被诊断患有 FASD 的儿童和青少年很可能会在儿童和青少年心理健康服务机构就诊。目前还没有研究探讨这些服务机构对 FASD 的认识和理解:方法:采用建构主义基础理论,探讨临床医生在评估和支持儿童青少年保健服务机构中可能或确诊患有 FASD 的儿童青少年时遇到的障碍和促进因素。研究人员对英格兰东北部一家 NHS 精神健康信托机构的 12 名 CAMHS 临床医生进行了抽样访谈。对访谈内容进行了转录和分析,并利用基础理论技术建立了最终模型:最终模型是在一个盒子类比的基础上建立的,共有四个类别。无法打开盒子 "反映了儿童及青少年保健服务机构的临床医生在探索 FASD 时遇到的障碍,"有助于打开盒子的事物 "反映了儿童及青少年保健服务机构的临床医生在探索 FASD 时遇到的促进因素,"向他人询问盒子 "反映了儿童及青少年保健服务机构的临床医生在探索 FASD 时可能遇到的系统性影响,"使盒子在未来更容易打开 "反映了我们如何支持儿童及青少年保健服务机构的临床医生探索 FASD:该模型为儿童及青少年保健服务机构的临床医生在评估和支持可能患有或已确诊患有 FASD 的儿童时所遇到的障碍和促进因素提供了新的视角,并强调了关键的临床影响。本文还概述了未来研究的建议,以扩大该领域的知识基础。
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引用次数: 0
期刊
Alcohol (Hanover, York County, Pa.)
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