冲动性对物质与非物质成瘾行为发展的调控及其神经机制

Drug addiction is a chronic brain disease for which early detection and prevention has been suggested to the best strategy of treatment. Mounting evidence demonstrated that impulsivity could be a potential biomarker that plays a crucial role in the development of addictive behaviors, and thus impulsivity is considered a possible treatment target for early prevention and intervention. Nevertheless, it remains unclear what the mechanisms underlying the trajectories of impulsivity are implicated in drug addiction and non-drug addiction. In the present project, we aim to identify the neural mechanisms of impulsivity in both nicotine dependence and internet gaming disorder by combining an across-spectrum comparison of drug and non-drug addictive behaviors with longitudinal studies and a cognitive-behavioral intervention study, using personality measurement, neurocognitive tasks and neuroimaging techniques. We will firstly compare nicotine-dependent individuals and internet gaming addicts on a series of behavioral tasks of impulsivity as well as the neural correlates in fronto-striatal brain systems using both structured and functional magnetic resonance imaging (MRI and fMRI) with a 3T Philips Trio MRI. Then we will investigate the predictive role of impulsivity for nicotine dependence and internet gaming disorder through a 2 to 3-year follow-up study of a large sample of non-addicted adolescents consist of two groups with either high- or low- levels of impulsivity. Lastly, a study of 6- to 12-month cognitive behavioral intervention on nicotine-dependent individuals and internet gaming addicts will be conducted, in order to explore the possible effects of reducing impulsivity level on restraining the exacerbation of addictive behaviors and also the promotion of continuous behavioral training on brain functions in fronto-striatal brain systems through functional magnetic resonance imaging (fMRI) tests. These studies will be much helpful for shedding light on the possible efficacy of impulsivity as a potential biomarker and treatment target for drug addiction as well as non-drug addiction.

成瘾是一种慢性复发性脑疾病，探索成瘾的生物标记对其防治具有重要意义。越来越多的研究证据提示，个体冲动性在成瘾障碍发生发展机制中具有关键作用，可能成为成瘾行为的潜在易感标记以及早期识别和干预的重要靶点，但冲动性对不同成瘾行为变化发展的调控机制尚不明确。本项目综合跨成瘾谱系比较、纵向追踪设计、冲动行为干预等研究途径，采用人格测量、神经认知、神经影像等技术，首先比较尼古丁依赖者与网络游戏成瘾者的冲动性结构及其在前额叶-纹状体环路的结构功能改变；然后采用混合分组设计筛选出具有高低冲动性的非成瘾青少年进行连续追踪研究，考察冲动性对尼古丁依赖与网络游戏成瘾的预测效力；并采用认知行为训练，对吸烟成瘾者与网络游戏成瘾者进行冲动干预，考察行为干预对冲动性水平及前额叶-纹状体环路功能的改变，以及对不同成瘾行为发展的抑制后效。旨在探索冲动性作为成瘾的潜在易感标记及干预靶点的效力。

越来越多的研究证据提示，个体冲动性在不同成瘾障碍发生发展中具有关键作用，可能成为成瘾行为的潜在易感标记以及早期识别和干预的重要靶点，但冲动性对不同成瘾行为变化发展的调控机制尚不明确。本项目综合跨成瘾谱系比较、纵向追踪设计、冲动行为干预等研究途径，采用人格测量、神经认知、神经影像等研究技术，旨在探索冲动性作为成瘾的潜在易感标记及干预靶点的效力。通过跨成瘾谱系比较设计，我们系统研究了物质成瘾行为（吸烟、饮酒、暴食）与非物质成瘾行为（网络游戏、赌博）在人格、认知及神经生理层面的异同冲动性特征；通过纵向追踪设计，我们分析了人格及认知层面的冲动性在物质成瘾行为（吸烟）与非物质成瘾行为（网络游戏）变化发展中的预测作用；通过团体认知行为干预实验，我们对物质成瘾人群（吸烟成瘾者）和非物质成瘾人群（网络游戏成瘾者）进行冲动性抑制训练，探索了行为干预在抑制不同成瘾行为发展中的作用。本项目发现，物质成瘾与非物质成瘾行为在冲动性特征上表现出共同性-特异性分离规律，包括与正负性情绪有关的积极紧迫感、消极紧迫感等，与认知控制功能有关的注意冲动性、动作冲动性、反应抑制等，以及与抑制控制功能密切相关的脑电成分P300波幅以及右侧额下回（IFG）功能激活程度。尤其是，注意冲动性可同时预测物质成瘾行为（吸烟）与非物质成瘾行为（网络使用）的变化发展，与奖赏相关的感觉寻求可预测物质成瘾行为（吸烟），动作冲动性等可预测非物质成瘾行为（网络使用）。3-6个月的认知行为/冲动抑制训练可有效降低物质成瘾者（吸烟）和非物质成瘾者（网络游戏）的消极情绪及冲动性水平，且在一定程度上逆转了不同成瘾者的神经生理功能及成瘾状况。这些结果提示，冲动性作为不同成瘾行为的潜在易感标记及干预靶点具有一定效用。