CAJ | 학술논문

目的探讨海洛因依赖者和戒断者背侧注意网络(DAN)的功能影像学变化及其对注意功能的影响.方法 17例海洛因依赖者和15例海洛因戒断者分别进行神经心理学测评了解依赖者和戒断者注意功能的差异;基于静息态功能磁共振成像(fMRI)扫描,利用独立成分分析(ICA)方法提取依赖组和戒断组的DAN,进行组内及组间分析,将组间差异有统计学意义的脑区与Stroop测验干扰效应进行相关分析.结果神经心理学测评表明,戒断组在数字广度测验(倒背)(P=0.0363)、数字符号测验(书写)(P=0.0195)、Stroop测验C(反应时)(P=0.0379)、Stroop测验C(错误数)(P=0.0014)以及Stroop测验干扰效应(P=0.0002)等一些相对复杂的注意功能测验中,其结果明显优于依赖组(均P＜0.05);神经影像学发现依赖组与戒断组具有相似的DAN分布,主要包括双侧顶内沟、中央后回及额眼区;相对于依赖组的DAN,海洛因戒断组左侧顶上小叶、右侧顶下小叶及左侧顶下小叶的功能连接明显增强(P＜0.05);海洛因依赖组左侧顶上小叶(MIN坐标:-24,-75,48)、右侧侧顶下小叶(39,-54,45)及左侧顶下小叶(-33,-51,57)的功能连接均与Stroop测验干扰效应呈负相关(r=-0.79、-0.69、-0.64,P＜0.01),而戒断组上述脑区与Stroop测验干扰效应无相关性.结论海洛因成瘾会导致注意功能损害,静息态下海洛因戒断者DAN的左侧顶上小叶及双侧顶下小叶的功能连接明显强于依赖者,这可能是戒断后注意功能改善的神经机制之一.
목적 탐토해락인의뢰자화계단자배측주의망락(DAN)적공능영상학변화급기대주의공능적영향.방법 17례해락인의뢰자화15례해락인계단자분별진행신경심이학측평료해의뢰자화계단자주의공능적차이;기우정식태공능자공진성상(fMRI)소묘,이용독립성분분석(ICA)방법제취의뢰조화계단조적DAN,진행조내급조간분석,장조간차이유통계학의의적뇌구여Stroop측험간우효응진행상관분석.결과 신경심이학측평표명,계단조재수자엄도측험(도배)(P=0.0363)、수자부호측험(서사)(P=0.0195)、Stroop측험C(반응시)(P=0.0379)、Stroop측험C(착오수)(P=0.0014)이급Stroop측험간우효응(P=0.0002)등일사상대복잡적주의공능측험중,기결과명현우우의뢰조(균P＜0.05);신경영상학발현의뢰조여계단조구유상사적DAN분포,주요포괄쌍측정내구、중앙후회급액안구;상대우의뢰조적DAN,해락인계단조좌측정상소협、우측정하소협급좌측정하소협적공능련접명현증강(P＜0.05);해락인의뢰조좌측정상소협(MIN좌표:-24,-75,48)、우측측정하소협(39,-54,45)급좌측정하소협(-33,-51,57)적공능련접균여Stroop측험간우효응정부상관(r=-0.79、-0.69、-0.64,P＜0.01),이계단조상술뇌구여Stroop측험간우효응무상관성.결론 해락인성은회도치주의공능손해,정식태하해락인계단자DAN적좌측정상소협급쌍측정하소협적공능련접명현강우의뢰자,저가능시계단후주의공능개선적신경궤제지일.
Objective To explore the functional imaging alteration of dorsal attention network (DAN) between heroin addicts and heroin abstainers and probe into its influence on attentional function.Methods Attention-related neuropsychological assessments were applied to evaluate the difference of attentional function between heroin addicts and heroin abstainers.With the functional magnetic resonance imaging (fMRI) data obtained from 17 heroin addicts and 15 heroin abstainers at resting state,we extracted the DANs of heroin withdrawal group and heroin dependence group respectively by using independent component analysis (ICA) and analysed the differences of intra-group and inter-group,then correlation analysis was performed among brain areas which have significant difference between groups and Stroop interference effect test.Results Compared with the heroin dependence group,there was a better result of attentional function in the heroin withdrawal group (P＜0.05),especially at the digit span test(backward) (P=0.0363),digit symbol test (writing) (P =0.0195),Stroop test C (reaction) (P =0.0379),Stroop test C (error) (P=0.0014) and Stroop interference effect test (P=0.0002).Neuroimaging findings demonstrated that there was a similar DAN in the heroin withdrawal group and heroin dependence group which mainly included the bilateral intraparietal suleus,postcentral gyrus and frontal eye field.Compared with the DAN of heroin addicts,significantly enhanced functional connectivity within the DAN of heroin abstainers was observed in the left superior parietal lobule (MIN:-24,-75,48),right inferior parietal lobule (MIN:39,-54,45) and left inferior parietal lobule (MIN:-33,-51,57).Significant negative correlations were observed between these brain areas and Stroop interference effect test in the heroin dependence group (r=-0.79,-0.69,-0.64,P＜0.01),but not in the heroin withdrawal group.Conclusions Heroin addiction can impair attentional function,compared with the DAN of heroin addicts,significantly enhanced functional connectivity in the left superior parietal lobule as well as bilateral inferior parietal lobule are observed in the heroin abstainers at resting state,which may be one of the neural mechanisms of attentional function improvement.