美国波士顿贝斯以色列女执事医学中心Michael D. Fox和芬兰图尔库大学Juho Joutsa课题组合作的研究表明，常见人脑回路映射调控了由脑损伤导致的成瘾缓解。该项研究成果发表在2022年6月13日出版的《自然-医学》上。

研究人员分析了两组吸烟成瘾患者（队列1n = 67；队列2n = 62）在局灶性脑损伤时的情况。将病变位置映射到大脑图谱，并使用人类连接组数据（n=1,000）计算与每个病变位置功能连接的大脑网络，确定了与成瘾缓解间的关联。研究通过局灶性脑损伤和酒精成瘾风险评分独立患者队列来评估普遍性（n=186）。通过与其他37个神经心理学变量进行比较来评估特异性。破坏吸烟成瘾的病变发生在许多不同的大脑位置，但具有特定的大脑连接模式。

这种模式包括与背侧扣带回、外侧前额叶皮层和岛叶的正连接以及与内侧前额叶和颞叶皮层的负连接。该回路在独立的病变组群中是可重复的，与降低酒精成瘾风险相关，并且特定于成瘾指标。与成瘾缓解连接特征最匹配的中枢是副扣带回、左额叶盖和内侧额极皮层。该研究得出结论，破坏成瘾的脑损伤映射到特定的大脑回路，并且该回路中的枢纽为治疗性神经调节提供了潜在靶点。

据悉，毒瘾是一种公共卫生危机，迫切需要新的治疗方法。在极少数情况下，局部脑损伤可缓解成瘾。这些病例可用于确定神经调节的治疗靶点。

附：英文原文

Title: Brain lesions disrupting addiction map to a common human brain circuit

Author: Joutsa, Juho, Moussawi, Khaled, Siddiqi, Shan H., Abdolahi, Amir, Drew, William, Cohen, Alexander L., Ross, Thomas J., Deshpande, Harshawardhan U., Wang, Henry Z., Bruss, Joel, Stein, Elliot A., Volkow, Nora D., Grafman, Jordan H., van Wijngaarden, Edwin, Boes, Aaron D., Fox, Michael D.

Issue&Volume: 2022-06-13

Abstract: Drug addiction is a public health crisis for which new treatments are urgently needed. In rare cases, regional brain damage can lead to addiction remission. These cases may be used to identify therapeutic targets for neuromodulation. We analyzed two cohorts of patients addicted to smoking at the time of focal brain damage (cohort 1 n=67; cohort 2 n=62). Lesion locations were mapped to a brain atlas and the brain network functionally connected to each lesion location was computed using human connectome data (n=1,000). Associations with addiction remission were identified. Generalizability was assessed using an independent cohort of patients with focal brain damage and alcohol addiction risk scores (n=186). Specificity was assessed through comparison to 37 other neuropsychological variables. Lesions disrupting smoking addiction occurred in many different brain locations but were characterized by a specific pattern of brain connectivity. This pattern involved positive connectivity to the dorsal cingulate, lateral prefrontal cortex, and insula and negative connectivity to the medial prefrontal and temporal cortex. This circuit was reproducible across independent lesion cohorts, associated with reduced alcohol addiction risk, and specific to addiction metrics. Hubs that best matched the connectivity profile for addiction remission were the paracingulate gyrus, left frontal operculum, and medial fronto-polar cortex. We conclude that brain lesions disrupting addiction map to a specific human brain circuit and that hubs in this circuit provide testable targets for therapeutic neuromodulation.

DOI: 10.1038/s41591-022-01834-y

Source: https://www.nature.com/articles/s41591-022-01834-y