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Advances in Substance Abuse Prevention and Treatment Interventions Among Racial, Ethnic, and Sexual Minority Populations. 种族、民族和性少数群体药物滥用预防和治疗干预措施的进展。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2016-01-01
Arthur W Blume

Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind. In addition, previously established evidence-based and culturally relevant interventions are being combined with computer technology. Empirical data support using brief interventions with patients of color in medical settings, capitalizing on teachable and reachable moments during a physical trauma or other health crisis. Finally, use of empirically supported treatment may be helpful, with a caveat that these interventions must appropriately match cultural traditions and respect the values of the clients. More research clearly is needed, especially among certain minority populations in the United States. A greater emphasis should be placed on developing novel, culturally grounded interventions in partnership with communities, in addition to adapting existing mainstream interventions for use by other cultures.

在种族、民族和性少数群体中开展的药物滥用研究历来落后于对多数群体样本的研究。然而,在过去几年中,至少在一些少数群体中,如美国印第安青年,在预防、简单干预和治疗方面取得了令人感兴趣和潜在的重要进展。新的预防工作主要集中在对酒精的销售点干预,以及根据亚人群文化价值观设计的家庭单位干预。此外,以前建立的基于证据和文化相关的干预措施正在与计算机技术相结合。经验数据支持在医疗环境中对有色人种患者进行简短干预,利用身体创伤或其他健康危机中的可教和可及时刻。最后,使用经验支持的治疗方法可能会有所帮助,但需要注意的是,这些干预措施必须适当符合文化传统并尊重客户的价值观。显然还需要更多的研究,尤其是针对美国某些少数民族人群的研究。除了调整现有的主流干预措施供其他文化使用外,还应更加重视与社区合作开发新颖的、以文化为基础的干预措施。
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引用次数: 0
Advances in Medications and Tailoring Treatment for Alcohol Use Disorder. 酒精使用障碍的药物治疗和针对性治疗进展
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Chamindi Seneviratne, Bankole A Johnson

Alcohol use disorder (AUD) is a chronic heritable brain disorder with a variable clinical presentation. This variability, or heterogeneity, in clinical presentation suggests complex interactions between environmental and biological factors, resulting in several underlying pathophysiological mechanisms in the development and progression of AUD. Classifying AUD into subgroups of common clinical or pathological characteristics would ease the complexity of teasing apart underlying molecular mechanisms. Genetic association analyses have revealed several polymorphisms-small differences in DNA-that increase a person's vulnerability to develop AUD and other alcohol-related intermediate characteristics, such as severity of drinking, age of AUD onset, or measures of craving. They also have identified polymorphisms associated with reduced drinking. Researchers have begun utilizing these genetic polymorphisms to identify alcoholics who might respond best to various treatments, thereby enhancing the effectiveness of currently tested medications for treating AUD. This review compares the efficacy of medications tested for treatment of AUD with and without incorporating genetics. It then discusses advances in pre-clinical genetic and genomic studies that potentially could be adapted to clinical trials to improve treatment efficacy. Although a pharmacogenetic approach is promising, it is relatively new and will need to overcome many challenges, including inadequate scientific knowledge and social and logistic constraints, to be utilized in clinical practice.

酒精使用障碍(AUD)是一种具有多种临床表现的慢性遗传性脑部疾病。这种临床表现的变异性或异质性表明环境和生物因素之间存在复杂的相互作用,导致AUD的发生和发展存在多种潜在的病理生理机制。根据共同的临床或病理特征将AUD分类为亚组,可以简化梳理潜在分子机制的复杂性。遗传关联分析揭示了几种多态性——dna的微小差异——增加了一个人患AUD和其他与酒精相关的中间特征的脆弱性,如饮酒严重程度、AUD发病年龄或渴望程度。他们还发现了与减少饮酒有关的多态性。研究人员已经开始利用这些基因多态性来识别可能对各种治疗反应最好的酗酒者,从而提高目前测试的治疗AUD药物的有效性。本综述比较了合并和不合并遗传学的AUD治疗药物的疗效。然后讨论了临床前遗传学和基因组研究的进展,这些研究可能适用于临床试验,以提高治疗效果。虽然药物遗传学方法很有前途,但它相对较新,需要克服许多挑战,包括科学知识不足以及社会和后勤限制,才能用于临床实践。
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引用次数: 0
Advances in Human Neuroconnectivity Research: Applications for Understanding Familial History Risk for Alcoholism. 人类神经连通性研究进展:用于了解酗酒家族史风险的应用。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Anita Cservenka, Gabriela Alarcón, Scott A Jones, Bonnie J Nagel

Recent advances in brain imaging have allowed researchers to further study the networks connecting brain regions. Specifically, research examining the functioning of these networks in groups with a genetic predisposition for alcoholism has found atypical circuitry in the brains of such individuals. Further research with larger sample sizes and multimodal method integration are necessary to confirm these intriguing findings.

脑成像的最新进展使研究人员能够进一步研究连接大脑区域的网络。具体来说,研究酒精中毒遗传易感性群体中这些网络功能的研究发现,这些个体的大脑中存在非典型回路。进一步的研究需要更大的样本量和多模态方法集成来证实这些有趣的发现。
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引用次数: 0
Advances in Diagnosis and Treatment of Fetal Alcohol Spectrum Disorders: From Animal Models to Human Studies. 胎儿酒精谱系障碍的诊断和治疗进展:从动物模型到人类研究
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Nathen J Murawski, Eileen M Moore, Jennifer D Thomas, Edward P Riley

Prenatal alcohol exposure can cause a number of physical, behavioral, cognitive, and neural impairments, collectively known as fetal alcohol spectrum disorders (FASD). This article examines basic research that has been or could be translated into practical applications for the diagnosis or treatment of FASD. Diagnosing FASD continues to be a challenge, but advances are being made at both basic science and clinical levels. These include identification of biomarkers, recognition of subtle facial characteristics of exposure, and examination of the relation between face, brain, and behavior. Basic research also is pointing toward potential new interventions for FASD involving pharmacotherapies, nutritional therapies, and exercise interventions. Although researchers have assessed the majority of these treatments in animal models of FASD, a limited number of recent clinical studies exist. An assessment of this literature suggests that targeted interventions can improve some impairments resulting from developmental alcohol exposure. However, combining interventions may prove more efficacious. Ultimately, advances in basic and clinical sciences may translate to clinical care, improving both diagnosis and treatment.

产前酒精暴露会导致一系列身体、行为、认知和神经损伤,统称为胎儿酒精谱系障碍(FASD)。本文探讨了已经或可能转化为FASD诊断或治疗的实际应用的基础研究。诊断FASD仍然是一个挑战,但在基础科学和临床水平上都取得了进展。这些包括识别生物标记,识别暴露的细微面部特征,以及检查面部,大脑和行为之间的关系。基础研究也指出了FASD潜在的新干预措施,包括药物治疗、营养治疗和运动干预。尽管研究人员已经在FASD动物模型中评估了大多数这些治疗方法,但最近的临床研究数量有限。对这些文献的评估表明,有针对性的干预可以改善由于发育性酒精暴露造成的一些损害。然而,联合干预可能更有效。最终,基础和临床科学的进步可能转化为临床护理,改善诊断和治疗。
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引用次数: 0
Advances in Electrophysiological Research. 电生理研究进展。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Chella Kamarajan, Bernice Porjesz

Electrophysiological measures of brain function are effective tools to understand neurocognitive phenomena and sensitive indicators of pathophysiological processes associated with various clinical conditions, including alcoholism. Individuals with alcohol use disorder (AUD) and their high-risk offspring have consistently shown dysfunction in several electrophysiological measures in resting state (i.e., electroencephalogram) and during cognitive tasks (i.e., event-related potentials and event-related oscillations). Researchers have recently developed sophisticated signal-processing techniques to characterize different aspects of brain dynamics, which can aid in identifying the neural mechanisms underlying alcoholism and other related complex disorders.These quantitative measures of brain function also have been successfully used as endophenotypes to identify and help understand genes associated with AUD and related disorders. Translational research also is examining how brain electrophysiological measures potentially can be applied to diagnosis, prevention, and treatment.

脑功能电生理测量是了解神经认知现象的有效工具,也是与包括酗酒在内的各种临床疾病相关的病理生理过程的敏感指标。酒精使用障碍(AUD)患者及其高危后代在静息状态(即脑电图)和认知任务期间(即事件相关电位和事件相关振荡)的几种电生理测量中一直表现出功能障碍。研究人员最近开发了复杂的信号处理技术来描述大脑动态的不同方面,这有助于确定酗酒和其他相关复杂疾病的神经机制。这些大脑功能的定量测量方法还被成功地用作内表型,以确定和帮助理解与 AUD 和相关疾病有关的基因。转化研究也在探讨如何将脑电生理测量应用于诊断、预防和治疗。
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引用次数: 0
Translating Alcohol Research: Opportunities and Challenges. 翻译酒精研究:机遇与挑战。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Angela M Batman, Michael F Miles

Alcohol use disorder (AUD) and its sequelae impose a major burden on the public health of the United States, and adequate long-term control of this disorder has not been achieved. Molecular and behavioral basic science research findings are providing the groundwork for understanding the mechanisms underlying AUD and have identified multiple candidate targets for ongoing clinical trials. However, the translation of basic research or clinical findings into improved therapeutic approaches for AUD must become more efficient. Translational research is a multistage process of stream-lining the movement of basic biomedical research findings into clinical research and then to the clinical target populations. This process demands efficient bidirectional communication across basic, applied, and clinical science as well as with clinical practitioners. Ongoing work suggests rapid progress is being made with an evolving translational framework within the alcohol research field. This is helped by multiple interdisciplinary collaborative research structures that have been developed to advance translational work on AUD. Moreover, the integration of systems biology approaches with collaborative clinical studies may yield novel insights for future translational success. Finally, appreciation of genetic variation in pharmacological or behavioral treatment responses and optimal communication from bench to bedside and back may strengthen the success of translational research applications to AUD.

酒精使用障碍(AUD)及其后遗症对美国的公共卫生造成了重大负担,对这种疾病的适当长期控制尚未实现。分子和行为基础科学研究成果为理解AUD的机制提供了基础,并为正在进行的临床试验确定了多个候选靶点。然而,将基础研究或临床发现转化为AUD的改进治疗方法必须变得更加有效。转化研究是将生物医学基础研究成果转化为临床研究,再转化为临床目标人群的一个多阶段过程。这个过程需要在基础科学、应用科学和临床科学之间以及与临床从业人员之间进行有效的双向沟通。正在进行的工作表明,在酒精研究领域内,一个不断发展的转化框架正在取得迅速进展。这得益于多个跨学科的合作研究结构,这些研究结构已被开发出来,以推进AUD的翻译工作。此外,系统生物学方法与协作临床研究的整合可能会为未来的转化成功产生新的见解。最后,对药物或行为治疗反应的遗传变异的认识,以及从实验室到床边和背后的最佳沟通,可能会加强AUD转化研究应用的成功。
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引用次数: 0
Utilization of Magnetic Resonance Imaging in Research Involving Animal Models of Fetal Alcohol Spectrum Disorders. 磁共振成像在胎儿酒精谱系障碍动物模型研究中的应用。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Xiaojie Wang, Christopher D Kroenke

It is well recognized that fetal alcohol exposure can profoundly damage the developing brain. The term fetal alcohol spectrum disorder (FASD) describes the range of deficits that result from prenatal alcohol exposure. Over the past two decades, researchers have used magnetic resonance imaging (MRI) as a noninvasive technique to characterize anatomical, physiological, and metabolic changes in the human brain that are part of FASD. As using animal models can circumvent many of the complications inherent to human studies, researchers have established and explored a number of models involving a range of species. Using MRI-based modalities, the FASD animal models have demonstrated decreased brain volume and abnormal brain shape, disrupted cellular morphology differentiation, altered neurochemistry, and blood perfusion. These animal studies have facilitated characterization of the direct effects of ethanol; in many cases identifying specific sequelae related to the timing and dose of exposure. Further, as a result of the ability to perform traditional (such as histological) analyses on animal brains following neuroimaging experiments, this work leads to improvements in the accuracy of our interpretations of neuroimaging findings in human studies.

众所周知,胎儿接触酒精会严重损害发育中的大脑。胎儿酒精谱系障碍(FASD)一词描述了产前酒精暴露导致的一系列缺陷。在过去的二十年里,研究人员使用磁共振成像(MRI)作为一种非侵入性技术来表征FASD的一部分人脑的解剖、生理和代谢变化。由于使用动物模型可以避免人类研究固有的许多复杂性,研究人员已经建立和探索了一些涉及一系列物种的模型。使用基于mri的模式,FASD动物模型显示脑容量减少,脑形状异常,细胞形态分化中断,神经化学和血液灌注改变。这些动物研究有助于表征乙醇的直接影响;在许多情况下,确定与暴露时间和剂量有关的特定后遗症。此外,由于能够在神经成像实验后对动物大脑进行传统(如组织学)分析,这项工作导致我们对人类研究中神经成像结果解释的准确性得到提高。
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引用次数: 0
Neuroplasticity in Human Alcoholism: Studies of Extended Abstinence with Potential Treatment Implications. 人类酒精中毒的神经可塑性:长期戒酒与潜在治疗意义的研究。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
George Fein, Valerie A Cardenas

Alcoholism is characterized by a lack of control over excessive alcohol consumption despite significant negative consequences. This impulsive and compulsive behavior may be related to functional abnormalities within networks of brain regions responsible for how we make decisions. The abnormalities may result in strengthened networks related to appetitive drive-or the need to fulfill desires-and simultaneously weakened networks that exercise control over behaviors. Studies using functional magnetic resonance imaging (fMRI) in abstinent alcoholics suggest that abstinence is associated with changes in the tone of such networks, decreasing resting tone in appetitive drive networks, and increasing resting tone in inhibitory control networks to support continued abstinence. Identifying electroencephalographic (EEG) measures of resting tone in these networks initially identified using fMRI, and establishing in longitudinal studies that these abstinence-related changes in network tone are progressive would motivate treatment initiatives to facilitate these changes in network tone, thereby supporting successful ongoing abstinence.

酗酒的特点是缺乏对过量饮酒的控制,尽管有严重的负面后果。这种冲动和强迫行为可能与负责我们如何做出决定的大脑区域网络中的功能异常有关。这种异常可能会导致与食欲驱动(或满足欲望的需要)相关的网络增强,同时削弱控制行为的网络。使用功能性磁共振成像(fMRI)对戒酒者进行的研究表明,戒酒与这些网络的张力变化有关,食欲驱动网络的静息张力降低,抑制控制网络的静息张力增加,以支持持续戒酒。识别这些网络的静息张力的脑电图(EEG)测量,最初使用功能磁共振成像(fMRI)识别,并在纵向研究中建立这些戒断相关的网络张力变化是渐进的,这将激励治疗措施,促进这些网络张力的变化,从而支持成功的持续戒断。
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引用次数: 0
Neuroplasticity and Predictors of Alcohol Recovery. 神经可塑性和酒精恢复的预测因子。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Dongju Seo, Rajita Sinha

Chronic alcohol-related neuroadaptations in key neural circuits of emotional and cognitive control play a critical role in the development of, and recovery from, alcoholism. Converging evidence in the neurobiological literature indicates that neuroplastic changes in the prefrontal-striatal-limbic circuit, which governs emotion regulation and decisionmaking and controls physiological responses in the autonomic nervous system and hypothalamic-pituitary-adrenal axis system, contribute to chronic alcoholism and also are significant predictors of relapse and recovery. This paper reviews recent evidence on the neuroplasticity associated with alcoholism in humans, including acute and chronic effects, and how these neurobiological adaptations contribute to alcohol recovery, along with the discussion of relevant clinical implications and future research directions.

在情绪和认知控制的关键神经回路中,慢性酒精相关的神经适应在酒精中毒的发展和恢复中起着关键作用。神经生物学文献中越来越多的证据表明,控制情绪调节和决策,控制自主神经系统和下丘脑-垂体-肾上腺轴系统生理反应的前额叶-纹状体-边缘回路的神经可塑性变化有助于慢性酒精中毒,也是复发和恢复的重要预测因素。本文综述了最近关于人类酒精中毒相关的神经可塑性的证据,包括急性和慢性影响,以及这些神经生物学适应如何促进酒精恢复,并讨论了相关的临床意义和未来的研究方向。
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引用次数: 0
Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments. 认知神经科学方法理解酒精使用障碍治疗中的行为改变。
IF 9.4 1区 医学 Q1 SUBSTANCE ABUSE Pub Date : 2015-01-01
Nasir H Naqvi, Jon Morgenstern

Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.

研究者已经开始应用认知神经科学的概念和方法来研究酒精使用障碍(AUD)治疗中的行为改变机制。本综述首先检查了使用临床和社会心理学方法的治疗机制研究的现状。然后从认知神经科学的角度总结了目前对成瘾病理生理学的理解。最后,它回顾了最近使用认知神经科学方法来理解AUD行为改变的神经机制的努力,包括使用神经功能预测复发和戒断的研究;研究在当前AUD的循证行为干预中运作的神经机制;以及基于我们对AUD患者行为改变的神经和认知机制的新兴理解而产生的新型行为干预研究。这篇文章强调了参与认知控制的前额皮质区域对参与酒精激励动机的皮质下区域的调节可能是在AUD患者这些不同形式的行为改变中发挥作用的核心机制。我们还提出了一个多层次的框架,将认知神经科学方法与更传统的方法结合起来,用于检查AUD的治疗机制。
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引用次数: 0
期刊
Alcohol Research : Current Reviews
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