强制戒断与美沙酮维持治疗一年对海洛因成瘾者脑功能影响的静息态fMRI研究  

Assessing difference in brain function between heroin dependents after one year methadone maintenance treatment and protracted abstinence:A resting-state fMRI study

作　　者：刘为 陈佳杰 时宏 薛久华 李玮 李永斌 刘艳 王玮 李强 LIU Wei;CHEN Jiajie;SHI Hong;XUE Jiuhua;LI Wei;LI Yongbin;LIU Yan;WANG Wei;LI Qiang(Department of Radiology,Tangdu Hospital,Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院放射科

出　　处：《磁共振成像》2019年第12期890-894,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号：81671661)~~

摘　　要：目的探讨强制戒断和美沙酮维持治疗两种干预措施一年对海洛因成瘾者大脑功能影响的差异。材料与方法招募17名强制戒断约1年的海洛因成瘾者(PA组)、16名美沙酮维持治疗约1年的海洛因成瘾者(MMT组)与35名正常对照组(HC组)参加本研究,对所有受试者进行功能磁共振扫描采集静息态数据,利用低频振幅(amplitude of low frequency fluctuation,ALFF)方法计算3组大脑局部自发性脑活动的强度,方差分析及事后分析比较PA组与MMT组脑活动变化趋势。结果3组间在右侧距状回、左侧小脑上回、右侧内侧额上回、右侧辅助运动区ALFF值存在显著性差异;事后分析发现PA组在距状回与辅助运动区脑活动更趋近于正常组;MMT组右侧内侧额上回ALFF值与美沙酮维持治疗时间(月)呈负相关性(r=-0.67,P=0.004),PA组右侧距状回ALFF与强制戒断时间(月)呈负相关性(r=-0.54,P=0.02)。结论经过1年干预后,美沙酮维持治疗者与强制戒断者在部分成瘾脑区仍存在异常,但强制戒断可能更有利于海洛因成瘾者脑功能恢复。Objective:To investigate the difference in effect of one year protracted abstinence and the methadone maintenance treatment on brain function in heroin addicts.Materials and Methods:Seventeen heroin dependent patients during abstinence(PA group),16 heroin dependent patients during methadone maintenance treatment(MMT group)and 35 healthy control group(HC group)were enrolled in this study.The resting-state data were collected by functional magnetic resonance scanning(fMRI).The intensity of local spontaneous brain activity in the three groups was calculated by the amplitude of low frequency fluctuation(ALFF)method.The variance analysis and post-event analysis were used to compare the changes of brain activity between PA group and MMT group.Results:There were significant differences in ALFF values in the right calcarine gyrus,the left superior cerebellar gyrus,the right medial superior frontal gyrus and the right supplementary motor area among the three groups.The brain activity in the calcarine gyrus and the supplementary motor area in the PA group was closer to the normal group.The ALFF value of the right medial frontal gyrus of the MMT group was negatively correlated with the methadone maintenance treatment time(month)(r=-0.67,P=0.004),and the right margin of the PA group was ALFF and the forced withdrawal time(month)was negatively correlated(r=-0.54,P=0.02).Conclusions:After one year of intervention,there are still abnormalities in some brain areas of heroin addicts in methadone maintenance therapy and protracted abstinence,but protracted abstinence may be more conducive to the recovery of brain function in heroin addicts.

关 键 词：强制戒断 美沙酮 成瘾 海洛因 低频振幅 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.64[医药卫生—诊断学]