背景:建议女性可卡因使用障碍的发展与应激反应性的神经机制密切相关,而在男性中,建议与药物提示反应性的神经机制密切相关。现有证据,然而,是基于神经影像学研究,要么缺乏对照组和/或样本量非常小,不允许调查性别差异。
方法:本研究的主要目的是调查高风险鼻内可卡因使用者(CU:31名男性和26名女性)和非可卡因使用对照(非CU:28名男性和26名女性)中可卡因和负面情绪线索反应性的神经相关性的性别差异。应用感兴趣区域(ROI)分析来测试群体的主要效应和交互作用,性别,和刺激类型(可卡因提示与中性可卡因线索和负面情绪线索与中性情绪线索)对背侧纹状体的活动,腹侧纹状体(VS),杏仁核,和背侧前扣带回皮质(dACC)。
结果:在任何ROI中,可卡因提示反应性没有显著的性别或群体差异。结果确实揭示了杏仁核和VS的显着情感线索反应性,但这些影响不是由群体或性别来调节的。探索性分析表明,情感线索诱导的dACC和VS激活与女性CU中定期使用可卡因的年限呈负相关,而这种关系在男性CU中不存在。
结论:虽然推测,在dACC和VS中,经常使用的年份与情绪线索反应性之间的性别特异性关联表明,随着使用年限的延长,女性CU对厌恶刺激变得不那么敏感,包括使用可卡因的负面后果,这可以解释在女性CU中观察到的“伸缩效应”。
BACKGROUND: The development of cocaine use disorder in females is suggested to be more strongly related to neural mechanisms underlying stress-reactivity, whereas in males it is suggested to be more strongly related to neural mechanisms underlying drug cue-reactivity. Existing evidence, however, is based on neuroimaging studies that either lack a control group and/or have very small sample sizes that do not allow to investigate sex differences.
METHODS: The main objective of the current study was to investigate sex differences in the neural correlates of cocaine and negative emotional cue-reactivity within high-risk intranasal cocaine users (CUs: 31 males and 26 females) and non-cocaine-using controls (non-CUs: 28 males and 26 females). A region of interest (ROI) analysis was applied to test for the main and interaction effects of group, sex, and stimulus type (cocaine cues vs. neutral cocaine cues and negative emotional cues vs. neutral emotional cues) on activity in the dorsal striatum, ventral striatum (VS), amygdala, and dorsal anterior cingulate cortex (dACC).
RESULTS: There were no significant sex or group differences in cocaine cue-reactivity in any of the ROIs. Results did reveal significant emotional cue-reactivity in the amygdala and VS, but these effects were not moderated by group or sex. Exploratory analyses demonstrated that emotional cue-induced activation of the dACC and VS was negatively associated with years of regular cocaine use in female CUs, while this relationship was absent in male CUs.
CONCLUSIONS: While speculative, the sex-specific associations between years of regular use and emotional cue-reactivity in the dACC and VS suggest that, with longer years of use, female CUs become less sensitive to aversive stimuli, including the negative consequences of cocaine use, which could account for the observed \"telescoping effect\" in female CUs.