功能磁共振成像观察长期美沙酮维持治疗对海洛因依赖者抑制性控制功能的影响  

Functional MRI observation on impact of long-term Methadone maintenance treatment on inhibitory control in former heroin dependent individuals

作　　者：张东升[1] 王亚蓉[1] 李强[1] 王丽娜[1] 郑颖[1] 李玮[1] 王涵月[1] 王玮[1] 

机构地区：[1]第四军医大学唐都医院放射科,陕西西安710038

出　　处：《中国医学影像技术》2013年第10期1580-1584,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81071142;81071143;81201081)

摘　　要：目的利用fMRI观察长期美沙酮维持治疗(MMT)对海洛因依赖者抑制性控制功能的影响。方法根据MMT时间将34例接受MMT的海洛因依赖者分为短期治疗(SMMT)组(<2年,18例)和长期治疗(LMMT)组(≥2年,16例)。利用GE 3.0T MR仪在被试执行事件相关go/nogo任务的同时进行fMRI,利用SPM8及SPSS 16.0软件进行fMRI和行为学数据处理。结果两组患者反应时间、正确率、nogo错误率差异均无统计学意义(P均>0.05)。相对于LMMT组,SMMT组背侧前扣带(dACC)激活程度显著升高;同时dACC激活程度与美沙酮维持总量呈负相关(r=-0.58,P=0.001)。结论长期MMT可能损伤海洛因依赖者的抑制性控制功能,这可能是导致MMT患者较高复吸率的相关因素之一。Objective To explore the impact of long-term Methadone maintenance treatment （MMT） on inhibitory control in former heroin dependent individuals with fMRI. Methods Thirty-four Heroin-dependent patients under MMT were divided into short-term MMT （SMMT） group （n=18, duration of MMT〈2 years） and long-term MMT （LMMT） group （n=16, duration of MMT≥2 years） according to the duration of MMT. fMRI was performed in all patients while they were executing an event-related go/nogo task at 3.0T MR scanner. The differences of brain activated images and behavioral data between the two groups were analyzed with SPM 8 and SPSS 16.0 software, respectively. Results There was no significant difference of reaction time, accuracy and false alarm rates between the two groups （P〉0.05）. Compared with LMMT group, stronger activation in the dorsal anterior cingulate cortex （dACC） in response inhibition condition was demonstrated in SMMT group. Meanwhile, the activation of dACC was negatively associated with the total dose of Methadone used （r=-0.58, P=0.001）. Conclusion Long-term MMT can injure the inhibitory control of former Heroin dependents, which may be one of the relevant factors related to high relapse rate in patients receiving MMT.

关 键 词：美沙酮维持治疗 海洛因依赖 抑制性控制 磁共振成像 

分 类 号：R749.6[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]