长期戒断甲基苯丙胺依赖者大脑微观结构的影像学改变  

Imaging changes in brain microstructural in long-term abstinent from methamphetamine-dependence

作　　者：樊丽丹 张清清 梁胜祥 李华兵[1] 贺忠[1] 孙建宁 司徒卫军[1] 张志学 吴大伟 张子曙[1] 寇志峰 张军 刘军[1] FAN Lidan;ZHANG Qingqing;LIANG Shengxiang;LI Huabing;HE Zhong;SUN Jianning;SITU Weijun;ZHANG Zhixue;WU Dawei;ZHANG Zishu;KOU Zhifeng;ZHANG Jun;LIU Jun(Department of Radiology,Second Xiangya Hospital,Central South University,Changsha 410011,China;College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;Fujian Key Laboratory of Rehabilitation Technology,Fuzhou 350122,China;Department of Radiology,First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Department of Biomedical Engineering and Radiology,Wayne State University,Detroit MI 48201,USA;Hunan Judicial Police Vocational College,Changsha 410131,China)

机构地区：[1]中南大学湘雅二医院放射科,长沙410011 [2]福建中医药大学康复医学院,福州350122 [3]福建中医药大学康复医疗技术国家地方联合工程研究中心,福州350122 [4]福建省康复技术重点实验室,福州350122 [5]湖南中医药大学第一附属医院放射科,长沙410007 [6]韦恩州立大学 [7]湖南省司法警官职业学院,长沙410131

出　　处：《中南大学学报（医学版）》2019年第5期491-500,共10页Journal of Central South University ：Medical Science

基　　金：国家科技重点研发计划(2016YFC0800908);国家自然科学基金(81671671)~~

摘　　要：目的:探究长期戒断甲基苯丙胺依赖者大脑微观结构的影像改变机制。方法:对26例长期戒断依赖者(戒断时间长于14个月)和26例对照组进行认知执行功能测试和扩散张量成像(diffusion-tensor imaging,DTI)检查,利用基于体素的分析方法对两组的部分各向异性(fractional anisotropy,FA)和平均扩散率(mean diffusivity, MD)进行比较,获得组间参数差异脑区,将长期戒断甲基苯丙胺组异常脑区参数值与测试结果行Spearman相关分析。结果:长期戒断甲基苯丙胺组和对照组的认知执行功能测试结果差异无统计学意义(P>0.05);相比对照组,长期戒断甲基苯丙胺依赖组右侧楔前叶、背外侧额上回、距状裂周围皮质及左侧颞下回FA降低;右侧三角部额下回、楔前叶、后扣带回、颞中回、双侧枕中回、左侧顶上回及小脑半球8区MD升高。长期戒断甲基苯丙胺组右侧颞中回MD与数字符号60 s(r=–0.504)和120 s(r=–0.464)内完成个数均呈负相关。结论:甲基苯丙胺依赖者经长期戒断后多个脑区微结构仍存在异常,DTI可为长期戒断甲基苯丙胺依赖者脑微观结构异常提供影像学证据。Objective:To explore the mechanism for changes in brain microstructure in long-term abstinent from methamphetamine-dependence by using the diffusion tensor imaging(DTI).Methods:A total of 26 patients with long-term abstinent methamphetamine-dependence,whose abstinence time more than 14 months,and 26 normal controls all underwent cognitive executive function tests and DTI scans.We used voxel-based analysis to compare the fractional anisotropy(FA)and mean diffusivity(MD)to obtain the abnormal brain regions of DTI parameters between the two groups.Spearman correlation analysis was used to explore the correlation between FA,MD of the brain regions with abnormal parameters and cognitive executive function tests.Results:There were no statistical differences in the cognitive executive function tests between the two groups(P>0.05).Compared with the normal control group,the long-term abstinent from methamphetamine-dependence group showed the decreased FA in the right precuneus,right superior frontal gyrus,right calcarine,left inferior temporal gyrus and the increased MD in the right triangular part of inferior frontal gyrus,right precuneus,right posterior cingulate,right middle temporal gyrus,bilateral middle occipital gyrus,left superior parietal lobule,and lobule VⅢof cerebellar hemisphere.The MD values of the right middle temporal gyrus in the long-term abstinent group were negatively correlated with the number of completions within 60 seconds(r=–0.504)and within 120 seconds(r=–0.464).Conclusion:The DTI parameters in multiple brain regions from the methamphetaminedependence patients are still abnormal after a long-term abstinence.DTI can provide imaging evidence for brain microstructural abnormalities in long-term abstinent from methamphetaminedependence.

关 键 词：长期戒断 甲基苯丙胺依赖 扩散张量成像 部分各向异性 平均扩散率 

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]