线索诱发海洛因依赖者戒断期心理渴求的功能磁共振成像研究  

A functional magnetic resonance imaging study of cue-elicited heroin craving

作　　者：邵春红[1] 江开达[2] 李一峰[3] 赵敏[2] 孙华平[4] 徐一峰[2] 汤伟军[4] 冯晓源[4] 周伟航 夏根发 徐定 宋冰 

机构地区：[1]复旦大学附属华山医院精神科,上海200040 [2]上海市精神卫生中心 [3]复旦大学生命科学院遗传所,上海200040 [4]复旦大学附属华山医院影像科,上海200040 [5]上海市禁毒委员会办公室 [6]上海市劳教戒毒所 [7]上海市女子劳教所

出　　处：《中华精神科杂志》2005年第2期65-68,共4页Chinese Journal of Psychiatry

基　　金：上海市卫生局科技发展基金项目(01417)

摘　　要：目的　探讨线索诱发海洛因依赖者戒断期心理渴求的特异神经结构,为寻找干预复吸的有效策略提供理论依据。方法　采用3 0T磁共振成像系统,对30例戒断期海洛因依赖者和17名健康对照者在观看自然风光和吸毒图片时行全脑扫描,识别线索诱发海洛因渴求的特异脑区。结果(1)与观看自然风光相比,观看吸毒图片可以诱导戒断期海洛因依赖者产生明显心理渴求(t=-6 535,P<0 001),且渴求程度与吸毒量呈正相关(r=0 464,P=0 01)。(2)共发现17个参与线索诱发海洛因渴求的特异脑区,主要集中在前额叶皮质和边缘系统,以左侧为主。自我报告渴求与激活脑区数目及左侧额下回、额中回、扣带回前部、额内测回,右侧眶额皮质、杏仁核和岛叶等7个脑区的激活体积呈正相关(P<0 05)。结论　多个脑区参与线索诱发海洛因渴求,既包括认知过程又涉及情感加工,不同渴求程度激活脑区数目与某些脑区的激活体积不同。Objective To identify the specific neuroanatomy structures of cue-elicited heroin craving in heroin addicts who were in abstinent period so as to contribute to finding effective strategy against relapse.Methods Thirty heroin addicts and 17 healthy subjects were scanned with 3.0 T fMRI when they watched pictures of natural scenes and heroin-taking.Results (1) Compared with natural scenes, abstinent heroin addicts were induced significant craving when watching the pictures of heroin-taking (t=-6.535, P<0.001). Cue-elicited heroin craving was positively correlated with using dosages of heroin (r= 0.464, P =0.01), but correlation between self-reported heroin craving and years of heroin using was not found (P=0.324). (2) Seventeen specific activation brain areas involving in cue-elicited heroin craving were found. They were mostly located in prefrontal lobe (medial and dorsal lateral) and limbic lobe, predominantly left localized. The numbers of activation brain areas were positively correlated with self-report craving. Among these activated brain areas, volumes of seven specific activated areas also were positively correlated with self-report craving (P<0.05).Conclusion The specific activating areas of cue-elicited heroin craving may be involved in multiple and different brain areas, including not only cognitive but also emotion psychological processing. The numbers and volumes of certain brain areas are positively correlated with the self-report craving.

关 键 词：海洛因依赖者 心理渴求 戒断期 功能磁共振 诱发 线索 成像研究 海洛因渴求 磁共振成像系统 前额叶皮质 扣带回前部 神经结构 边缘系统 自我报告 眶额皮质 认知过程 自然风 正相关 脑区 激活 特异 脑扫描 吸毒量 额下回 

分 类 号：R445.2[医药卫生—影像医学与核医学]