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  • 文章类型: Journal Article
    过度使用酒精会促进酒精成瘾的发展,但是对酒精诱导的大脑改变如何导致成瘾的理解仍然有限。为了进一步理解,我们采用了基于系统医学原理的无偏见发现策略。我们使用了酒精成瘾样行为的患者和动物模型的功能磁共振成像数据,并开发了“易复发”网络状态的数学模型,以确定可以通过治疗干预选择性靶向的大脑部位和功能网络。我们的系统级别,非本地,大部分无偏见的分析集中在一些明确定义的大脑区域,脑岛是研究中最一致的发现之一。在概念验证实验中,我们能够证明有可能指导网络动力学提高动物的弹性,但是最初转化为针对脑岛的临床试验失败了。这里,在叙事审查中,我们总结了关键的实验,从这一轮完整的发现周期中获得的方法学发展和知识,从识别人类和动物的“易复发”网络状态到目标验证和干预试验。未来的共同努力是必要的,以更深入地了解状态依赖的脑岛功能,电路特异性和细胞群体的观点,并开发针对脑岛的干预手段,在这种结构的治疗靶向可能成为可能之前。
    Excessive use of alcohol promotes the development of alcohol addiction, but the understanding of how alcohol-induced brain alterations lead to addiction remains limited. To further this understanding, we adopted an unbiased discovery strategy based on the principles of systems medicine. We used functional magnetic resonance imaging data from patients and animal models of alcohol addiction-like behaviors, and developed mathematical models of the \'relapse-prone\' network states to identify brain sites and functional networks that can be selectively targeted by therapeutic interventions. Our systems level, non-local, and largely unbiased analyses converged on a few well-defined brain regions, with the insula emerging as one of the most consistent findings across studies. In proof-of-concept experiments we were able to demonstrate that it is possible to guide network dynamics towards increased resilience in animals but an initial translation into a clinical trial targeting the insula failed. Here, in a narrative review, we summarize the key experiments, methodological developments and knowledge gained from this complete round of a discovery cycle moving from identification of \'relapse-prone\' network states in humans and animals to target validation and intervention trial. Future concerted efforts are necessary to gain a deeper understanding of insula function a in a state-dependent, circuit-specific and cell population perspective, and to develop the means for insula-directed interventions, before therapeutic targeting of this structure may become possible.
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