fMRI观察美沙酮维持治疗时间对海洛因依赖者毒品线索反应的影响  

Functional MRI observation on effect of methadone maintenance treatment duration on brain response to drug cues in former heroin-dependent individuals

作　　者：王涵月[1] 王巍[2] 王亚蓉[1] 李强[1] 李玮[1] 郑颖[1] 张东升[1] 王丽娜[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 [2]中国人民解放军第304医院超声科,北京100085

出　　处：《中国医学影像技术》2014年第1期6-10,共5页Chinese Journal of Medical Imaging Technology

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

摘　　要：目的探讨美沙酮维持治疗(MMT)时间对海洛因依赖者在毒品线索下主观渴求及大脑反应的影响。方法收集15例接受连续MMT≤1年的海洛因依赖者(≤1年组)与11例人口学特征相匹配且连续接受MMT 2~3年的海洛因依赖者(2~3年组),采用3.0T MR仪采集功能数据,试验设计采用事件相关的毒品线索诱导渴求设计,应用SPM 8及SPSS 16.0软件进行数据处理。结果在毒品线索下,两组被试渴求变化程度差异无统计学意义(t=2.9,P>0.05)。与2~3年组相比,≤1年组双侧尾状核激活明显增强。控制年龄、受教育程度、每日吸烟量和海洛因使用情况,右侧尾状核激活程度与美沙酮使用总剂量和总时间分别呈负相关(r=-0.54,P=0.01;r=-0.51,P=0.01),左侧尾状核激活程度与美沙酮使用总剂量呈负相关(r=-0.60,P=0.003)。结论在海洛因渴求明显改善之前,接受MMT 2~3年的海洛因依赖者可能通过调节尾状核功能来改善其大脑渴求反应。Objective To investigate the effect of methadone maintenance treatment （MMT） duration on brain activity in response to heroin-related cues in former heroin dependent individuals using fMRI. Methods Fifteen heroin-dependent pa- tients under MMT shorter than 1 year （41 year group） and 11 demograghically-matched heroin-dependent patients under MMT for 2--3 years （2--3 years group） were enrolled and underwent fMR1 using 3.0T MRI scanner, then an event-relat- ed cue-reactivity paradigm was employed. Analysis of image and behavioral difference was carried out with SPM 8 and SPSS 16.0 soft ware. Results The craving changes between the two groups had no significant difference （t= 2.9, P^0.05）. Patients in 41 year group demonstrated greater activation in bilateral caudate. Meanwhile, taking controlling age, educa- tion, daily cigarette consumption and heroin as condition, the activation of right caudate negatively correlated with the total dose of MMT and the duration Of MMT respectively （r= -0.54, P=0.01 r= -0.51, P=0.01）. The activation of left caudate negatively correlated with the total dose of MMT （r= -0. 60, P = 0. 003）. Conclusion Heroin-dependent pa- tients under MMT for 2--3 years may improve their brain craving response by regulating the function of caudate nucleus before the heroin craving have been significantly improved.

关 键 词：海洛因依赖 美沙酮维持治疗 磁共振成像 尾状核 

分 类 号：R9[医药卫生—药学] R445.2