CAJ | 학술논문

目的研究海洛因成瘾者在图片线索诱导产生渴求的神经机制,以及伏隔核(NAc)的激活与成瘾者渴求程度变化的关系.方法选取12例海洛因成瘾者和12名健康对照者,首先进行头部结构MR扫描,然后进行功能扫描,试验刺激采用组块(block)设计,功能扫描时被试者观看与药物线索相关的图片和中性图片.扫描数据经后处理软件校正分析,获得大脑激活图.MR扫描前后,对被试者进行药物渴求程度评分,并对NAc激活的情况与患者渴求程度间进行Pearson相关性分析,渴求程度评分的比较采用Wilcoxon符号秩和检验.结果暴露于视觉药物线索前后,海洛因成瘾者渴求评分范围分别为0～3.70和0～5.10,中位数为0.15和3.25,差异有统计学意义(Z=-2.666,P<0.05).功能扫描时共有16个脑区被药物图片线索激活,主要分为2部分,一是边缘系统结构(杏仁核、海马、壳核、前扣带回、尾状核),另外为大脑皮层,包括额叶(额中、下回和中央前回)、颞叶(颞中、下回和梭状回)、顶叶(楔前叶)、枕叶(枕中回);双侧NAc激活程度范围为0.19～3.50,与成瘾者渴求程度呈直线正相关(r=0.829,P<0.05).结论海洛因与其他成瘾物质共享部分相同渴求的神经机制,主要涉及大脑奖赏环路、视觉空间注意力区和工作记忆脑区;NAc的功能异常与海洛因线索诱导的渴求相关.
목적 연구해락인성은자재도편선색유도산생갈구적신경궤제,이급복격핵(NAc)적격활여성은자갈구정도변화적관계.방법 선취12례해락인성은자화12명건강대조자,수선진행두부결구MR소묘,연후진행공능소묘,시험자격채용조괴(block)설계,공능소묘시피시자관간여약물선색상관적도편화중성도편.소묘수거경후처리연건교정분석,획득대뇌격활도.MR소묘전후,대피시자진행약물갈구정도평분,병대NAc격활적정황여환자갈구정도간진행Pearson상관성분석,갈구정도평분적비교채용Wilcoxon부호질화검험.결과 폭로우시각약물선색전후,해락인성은자갈구평분범위분별위0～3.70화0～5.10,중위수위0.15화3.25,차이유통계학의의(Z=-2.666,P<0.05).공능소묘시공유16개뇌구피약물도편선색격활,주요분위2부분,일시변연계통결구(행인핵、해마、각핵、전구대회、미상핵),령외위대뇌피층,포괄액협(액중、하회화중앙전회)、섭협(섭중、하회화사상회)、정협(설전협)、침협(침중회);쌍측NAc격활정도범위위0.19～3.50,여성은자갈구정도정직선정상관(r=0.829,P<0.05).결론 해락인여기타성은물질공향부분상동갈구적신경궤제,주요섭급대뇌장상배로、시각공간주의력구화공작기억뇌구;NAc적공능이상여해락인선색유도적갈구상관.
Objective To explore the neural mechanism underlying the craving of heroin addicts induced by picture-cue and the correlation between the brain activation degree in nucleus accumbens (NAc)/the ventral striatum and the scores of patients' self-report craving. Methods Twelve active heroin addicts and 12 matched healthy controls underwent fMRI scan while viewing drug-related pictures and neutral pictures presented in a block design paradigm after anatomical scanning in GE 3.0 T scanner. The fMRI data were analyzed with SPM 5. The change of craving scores was tested by Wilcoxon signed rank test. The Pearson correlation between the activation of NAc/the ventral striatum and the heroin craving score was tested by SPSS 13.0. Results The craving scores of heroin addicts ranged from 0 to 3.70(median 0.15) before exposed to drug cue and 0 to 5.10(median 3.25) after viewing drug-related pictures and showed statistical significance(Z = -2.666, P < 0.05). There were 16 activated brain areas when heroin dependent patients exposed to visual drug-related cue vs. neutral visual stimuli. The activation brain regions belonged to two parts, one was limbic system (amygdale, hippocampus, putamen, anterior cingulate cortex and caudate), another was brain cortex (middle frontal cortex, inferior frontal cortex, precentral gyrus, middle temporal cortex, inferior temporal cortex, fusiform gyrus, precuneus and middle occipital gyrus). The MR signal activation magnitude of heroin addicts ranged from 0.19 to 3.50. The result displayed a significant positive correlation between the cue-induced fMRI activation in NAc/the ventral striatum and heroin craving severity (r=0.829, P < 0.05). Conclusion Heroin shared the same neural circuitry in part with other drugs of abuse for cue-induced craving, including brain reward circuitry, visualspatial attention circuit and working memory region. In addition, the dysfunction of NAc/the ventral striatum may attribute to heroin-related cue induced craving.