CAJ | 학술논문

目的：探讨单纯海洛因成瘾者(HA)大脑奖赏环路功能连接特点及其在成瘾中的作用。方法收集26例长期HA（HA组）和25名人口学特征相匹配但无海洛因吸食的健康志愿者（对照组）接受fMRI扫描，使用静息态fMRI数据处理助手（DPARSF）基于MATLAB2009a平台进行数据预处理，然后采用静息态fMRI数据分析工具包（REST），以双侧伏隔核为ROI，与全脑其他所有体素的时间序列做相关分析，使用单样本t检验和两样本t检验做组内和组间分析；将HA组功能连接强度值与海洛因使用总时间及总剂量做偏相关分析。结果 HA组与双侧伏隔核正相关的脑区包括前额叶、背侧纹状体、丘脑及桥脑，负相关的脑区包括颞叶,部分顶、枕叶,部分背外侧前额叶及小脑；对照组与双侧伏隔核正相关的脑区包括前额叶、背侧纹状体、丘脑、海马、桥脑，负相关脑区包括双侧枕叶、部分背外侧前额叶及小脑（单个体素P<0.005，体素值>26）。与对照组相比，HA组与右侧伏隔核功能连接增强的脑区包括双侧距状回、左枕中回（体素个数分别为31、28、47，t值分别为3.99、3.74、3.74，P值均<0.005），未发现减低的脑区；与左侧伏隔核功能连接增强的脑区包括左梭状回和右楔前叶（体素个数分别为40、26，t值分别为3.77、3.57，P值均<0.005），减弱的脑区包括左背内、外侧前额叶、双背侧前扣带（体素个数为98，t=-4.14，P<0.005）；HA组功能连接强度值与海洛因使用时间、剂量之间无相关性（P值均>0.05）。结论海洛因成瘾可能与奖赏环路关键脑区伏隔核和认知控制及视觉空间注意力相关脑区的相互作用异常有关。
목적：탐토단순해락인성은자(HA)대뇌장상배로공능련접특점급기재성은중적작용。방법수집26례장기HA（HA조）화25명인구학특정상필배단무해락인흡식적건강지원자（대조조）접수fMRI소묘，사용정식태fMRI수거처리조수（DPARSF）기우MATLAB2009a평태진행수거예처리，연후채용정식태fMRI수거분석공구포（REST），이쌍측복격핵위ROI，여전뇌기타소유체소적시간서렬주상관분석，사용단양본t검험화량양본t검험주조내화조간분석；장HA조공능련접강도치여해락인사용총시간급총제량주편상관분석。결과 HA조여쌍측복격핵정상관적뇌구포괄전액협、배측문상체、구뇌급교뇌，부상관적뇌구포괄섭협,부분정、침협,부분배외측전액협급소뇌；대조조여쌍측복격핵정상관적뇌구포괄전액협、배측문상체、구뇌、해마、교뇌，부상관뇌구포괄쌍측침협、부분배외측전액협급소뇌（단개체소P<0.005，체소치>26）。여대조조상비，HA조여우측복격핵공능련접증강적뇌구포괄쌍측거상회、좌침중회（체소개수분별위31、28、47，t치분별위3.99、3.74、3.74，P치균<0.005），미발현감저적뇌구；여좌측복격핵공능련접증강적뇌구포괄좌사상회화우설전협（체소개수분별위40、26，t치분별위3.77、3.57，P치균<0.005），감약적뇌구포괄좌배내、외측전액협、쌍배측전구대（체소개수위98，t=-4.14，P<0.005）；HA조공능련접강도치여해락인사용시간、제량지간무상관성（P치균>0.05）。결론해락인성은가능여장상배로관건뇌구복격핵화인지공제급시각공간주의력상관뇌구적상호작용이상유관。
Objective To explore the changes and effect of functional connectivity(FC) of reward network in chronic heroin addicts(HA) using resting-state fMRl(rs-fMRI). Methods rs-fMRI was performed on 26 chronic heroin addicts(HA group) and 25 matched normal volunteers(control group).The rs-fMRI data were proceeded by usingrs-fMRI(DPARSF) software on Matlab 2009a. Bilateral nucleus accumbens(Nacc) were set as ROIs. Then the mean time series of ROI were compared with other voxels within the brain by the rs-fMRI data analysis toolkit(REST). Intra-and inter-group analysis was performed with single sample and two sample t test respectively.The association of intensity of FC in brain regions and the duration/doses of heroin consumption was investigated. Results In HA group, positiveresting-state FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus and pons, while temporal lobe, negative found in part of parietal cortex and occipital cortex, part of dorsal lateral prefrontal cortex and cerebellum. Within control group, positive FC compared with the ROIs was found in frontal gyms, dorsal striatum, thalamus, hippocampal gyrus and pons, occipital cortex, negative FC with ROIs found in part of dorsal lateral prefrontal cortex and cerebellum(P<0.005, voxels>26). Compared with the control group,the FC between the right Nacc and the bilateral calcarinegyrus, left middle occipital gyrus(voxel numbe r=31,28,47;t=3.99, 3.74,3.74;and P<0.005,respectively)were significantly increased in the HA group.The FC between the left Nacc and left fusiform gyrus and right precuneus(voxel number=40,26;t=3.77,3.57;and P<0.005, respectively)were significantly increased, while between the left Nacc and left dorsal medial/lateral prefrontal cortex and bilateral dorsal anterior cingulate(voxel number=98;t=-4.14;and P<0.005)were significantly decreased in the HA group. There was no corrlation between the abnormal FC and the duration/doses of heroin consumption in HA group(P>0.05). Conclusion The abnormal interaction between Nacc and the regions involved in cognitive control and visual spatial attention may contribute to the heroin addiction.