美沙酮对海洛因成瘾患者脑功能影响的静息态功能磁共振成像研究  

Changes in brain function after methadone use in heroin users:A resting state fMRI study

作　　者：江桂华[1] 汪天悦 邱迎伟[1] 田军章[1] 黎程[1] 李淑美[1] 吕晓飞[2] 李黎明[1] 林楚岚[1] 马晓芬[1] 李盟[1] 张雪林[2] 

机构地区：[1]广东省第二人民医院影像科,广州510317 [2]南方医科大学南方医院

出　　处：《功能与分子医学影像学（电子版）》2014年第4期5-10,共6页Functional and Molecular Medical Imaging(Electronic Edition)

基　　金：国家自然科学基金(81471639);广东省科技计划项目(2011B031800044;2012B031800170;2012A030400019)

摘　　要：目的利用静息态功能磁共振成像技术,通过低频振幅分析方法研究海洛因成瘾者局部脑功能活动改变,探讨海洛因成瘾患者局部脑功能改变与海洛因成瘾时间与美沙酮用量的相关性。方法收集24例海洛因依赖者及24名正常志愿者行静息状态下f MRI扫描,利用低频振幅分析方法对受试者的功能MR数据进行分析,得出受试者ALFF统计图。采用两独立样本t检验,评价海洛因成瘾患者和正常被试者的年龄、教育程度、吸烟和头动的差异,以及两组低频振幅的差异。采用Pearson相关性分析,分析海洛因成瘾者ALFF改变与海洛因食用时间及美沙酮使用量的相关性。结果 1两组之间年龄、性别、教育程度、时间头运动,吸烟差异无统计学意义;2同正常对照比较,海洛因成瘾患者双侧背侧扣带回、双侧内侧眶额叶皮层、左侧背外侧前额叶皮层、左侧颞中回、左侧颞下回、后扣带回及左侧楔叶低频振幅明显减低;双侧角回,双侧后扣带回/双侧楔前叶,双侧缘上回和左侧额中回低频振幅显著增高;3海洛因成瘾患者成瘾时间与组间显著差异的ALFF值之间相关性无统计学意义;4海洛因成瘾患者低频振幅显著升高的区域ALFF值与美沙酮用量呈正相关性,降低区域则无明显相关性。结论海洛因成瘾者存在多个脑区功能活动异常,而美沙酮能有效改善这种影响,特别是在双侧顶叶。这些脑区的自发神经元活动异常可能与海洛因成瘾者潜在的病理生理机制有关。Objective To investigate the heroin-related changes of amplitude of low frequency fluctuation （ALFF） in the resting state fMRI, and the correlation between the duration of heroin use, the dosage of methadone use and these brain function abnormalities. Methods The subject group included 24 chronic heroin users and 24 normal controls. The fMRI data were acquired during resting state and analyzed with ALFF. Twosample t-test was performed to assess the differences in age, duration of education, cigarette smoking and ALFF values between HDI and control groups using SPSS （version 1 3.0）. A Pearson correlation analysis was also performed to identify the association between the alteration of ALFF and the duration of heroin usage as well as the dosage of methadone at the time of the FMRI study. Results 1 There were no differences in significant age, gender, duration of education, head motions, and cigarette smoking between the two groups; 2 Compared to the controls, the HDI group showed significantly decreased ALFF in the bilateral dorsal anterior cingulate cortex （dACe）, bilateral medial orbit frontal cortex （mOFC）, left dorsal lateral prefrontal cortex （DLPFC）, left middle temporal gyms, left inferior temporal gYms, posterior cingulate cortex and left cuneus. The significant increase ALFF in the bilateral angular gyrus （BA39）, bilateral post cingulate cortex/bilateral precuneus, bilateral supramarginal gyms （BA40） and left middle frontal gyms was observed; @ Significant positive correction was observed between the ALFF values in the increased regions the dosage of the methadone at the time of fMRI study; @ No significant correlations were observed between ALFF values in the reduced regions in the patients with the duration of the heroin usage, nor the elevated regions. Conclusion HDI shows abnormal brain functional organization in resting state, the abnormal spontaneous activity of these regions may implicate the underlying pathophysiology in heroin users. The reduced ALFF may be the result o

关 键 词：静息态功能磁共振 低频振幅 海洛因成瘾:美沙酮 

分 类 号：R445.2[医药卫生—影像医学与核医学] R338.2[医药卫生—诊断学]