Substance use disorders (SUDs) are characterized by a compulsion to seek and consume one or more substances of abuse, with a perceived loss of control and a negative emotional state. Prolonged substance use seems to be associated with morphological changes of multiple neural circuits, in particular the frontal–striatal and limbic pathways. Such neuroadaptations are evident across several substance disorders, but may vary depending on the type of substance, consumption severity and/or other unknown factors. We therefore identified studies investigating the effects of SUDs using volumetric whole-brain voxel-based morphometry (VBM) in gray (GM) and white matter (WM). We performed a systematic review and meta-analysis of VBM studies using the anatomic likelihood estimation (ALE) method implemented in GingerALE (PROSPERO pre-registration CRD42017071222). Sixty studies met inclusion criteria and were included in the final quantitative meta-analysis, with a total of 614 foci, 94 experiments and 4938 participants. We found convergence and divergence in brain regions and volume effects (higher vs. lower volume) in GM and WM depending on the severity of the consumption pattern and type of substance used. Convergent pathology was evident across substances in GM of the insula, anterior cingulate cortex, putamen, and thalamus, and in WM of the thalamic radiation and internal capsule bundle. Divergent pathology between occasional use (cortical pathology) and addiction (cortical-subcortical pathology) provides evidence of a possible top-down neuroadaptation. Our findings indicate particular brain morphometry alterations in SUDs, which may inform our understanding of disease progression and ultimately therapeutic approaches.

物质使用障碍 (SUD) 的特点是强迫性地寻求和消耗一种或多种滥用物质，并伴有明显的失控感和消极情绪状态。长期物质使用似乎与多个神经回路的形态变化有关，特别是额叶-纹状体和边缘通路。这种神经适应在多种物质障碍中都很明显，但可能会根据物质类型、消耗严重程度和/或其他未知因素而有所不同。因此，我们确定了使用体积全脑体素形态测量 (VBM) 对灰质 (GM) 和白质 (WM) 进行 SUD 影响的研究。我们使用 GingerALE 中实施的解剖似然估计 (ALE) 方法对 VBM 研究进行了系统回顾和荟萃分析（PROSPERO 预注册 CRD42017071222）。 60 项研究符合纳入标准并纳入最终定量荟萃分析，共有 614 个焦点、94 个实验和 4938 名参与者。我们发现 GM 和 WM 中大脑区域的趋同和发散以及容量效应（较高与较低的容量）取决于消费模式的严重程度和所用物质的类型。岛叶、前扣带皮层、壳核和丘脑的 GM 以及丘脑辐射和内囊束的 WM 中的物质之间的趋同病理学是明显的。偶尔使用（皮质病理学）和成瘾（皮质-皮质下病理学）之间不同的病理学提供了可能的自上而下的神经适应的证据。我们的研究结果表明 SUD 中存在特定的大脑形态测量变化，这可能有助于我们了解疾病进展和最终的治疗方法。