美沙酮维持治疗的前海洛因成瘾者突显网络特征的静息态fMRI研究  

Characteristics of function of salience network in heroin dependent individuals during methadone maintenance treatment: A resting-state fMRI study

作　　者：金龙 李强 王磊 张微 魏熠鑫 陈佳杰 刘为 王玮 魏龙晓 JIN Long;LI Qiang;WANG Lei;ZHANG Wei;WEI Yixing;CHEN Jiajie;LIU Wei;WANG Wei;WEI Longxiao(Department of Nuclear Medicine,Tangdu Hospital,The Air Force Military Medical University,Xi'an,710038;Department of Radiology,Tangdu Hospital,The Air Force Military Medical University,Xi'an,710038)

机构地区：[1]空军军医大学唐都医院核医学科,西安710038 [2]空军军医大学唐都医院放射科,西安710038

出　　处：《中国药物依赖性杂志》2021年第2期123-128,共6页Chinese Journal of Drug Dependence

基　　金：国家自然科学基金(81671661);空军军医大学科技发展基金(2019XB049)。

摘　　要：目的:探讨美沙酮维持治疗(methadone maintenance treatment, MMT)的前海洛因成瘾者突显网络(salience network, SN)的功能连接特点。方法:纳入21例MMT的前海洛因成瘾者(MMT组)与20例年龄、性别、教育程度相匹配的健康者(HC组),采用3.0T磁共振设备进行静息态磁共振成像。基于SN核心感兴趣区计算两组人全脑功能连接,分析两组间SN功能连接差异。再分析差异区功能连接值与基础渴求评分、海洛因吸食史和美沙酮治疗史的相关性。结果:与HC组相比,MMT组SN大脑的左侧前岛叶(SN的核心脑区)与双侧楔前叶/后扣带和双侧背内侧前额叶[默认网络(default mode network, DMN)的核心脑区],左侧枕下回和左侧中央后回功能连接强度明显增强(P<0.05,Gaussian Random Field, GRF校正)。上述区域的功能连接强度值与基础渴求评分,海洛因吸食史和美沙酮治疗史无相关性(P值均>0.05)。结论:MMT组大脑SN与DMN的功能连接较HC组增强,显示海洛因成瘾者SN对DMN的抑制功能异常,可能是MMT的前海洛因成瘾者仍有较高复吸率的原因之一。而SN的左侧岛叶与左侧枕下回和左侧中央后回功能连接增强,可能是MMT的前海洛因成瘾者在毒品线索诱导下仍具有较强渴求的原因。Objective:To investigate the characteristics of functional connectivity of salience network(SN) in heroin dependents during methadone maintenance treatment(MMT). Methods: 21 heroin dependent individuals during MMT(MMT group) and 20 healthy control subjects matched with age, sex and educational level(HC group) were included in the resting-state functional magnetic resonance imaging(fMRI) study performed with 3.0 T magnetic resonance equipment. The functional connectivity of the whole brain was calculated based on the region of interest of the SN, and the differences in functional connectivity of the SN between the MMT group and HC group were analyzed. The correlation between the functional connectivity of the different area and the basal craving score, the history of heroin use and methadone treatment was further analyzed in MMT group. Results:Compared with the HC group, the functional connectivity between left anterior insula(a core region in SN) and bilateral precuneus/post cingulate, bilateral dorsal medial prefrontal cortex [core regions in default mode network(DMN)], left occipital gyrus and left postcentral gyrus of MMT group significantly enhanced.(P<0.05,corrected with GRF). The functional connectivity in the above areas was not correlated with the basal craving score, the history of heroin use and methadone treatment in MMT group(P>0.05 respectively). Conclusion:The functional connectivity between SN and DMN of MMT group is stronger than HC group, which indicate that heroin heroin dependents individuals during MMT have abnormal inhibitory function of SN to DMN. It may be one of the reasons why heroin dependents individuals during MMT still have a high rate of relapse. The increased functional connectivity between left anterior insula and left occipital gyrus, left postcentral gyrus may be the reason why heroin dependent individuals under MMT still have higher drug-cued induced craving.

关 键 词：美沙酮维持治疗 突显网络 功能磁共振成像 海洛因成瘾 

分 类 号：R749[医药卫生—神经病学与精神病学]