重复经颅磁刺激对海洛因成瘾者左侧执行控制网络影响的fMRI研究  

The effects of repetitive transcranial magnetic stimulation on the left executive control network in heroin dependent individuals:a resting-state fMRI study

作　　者：金龙 付艳文 王澍 张微 魏熠鑫 王玮 袁梦晖 李强 魏龙晓 JIN Long;FU Yanwen;WANG Shu;ZHANG Wei;WEI Yixin;WANG Wei;YUAN Menghui;LI Qiang;WEI Longxiao(Department of Nuclear Medicine,Tangdu Hospital,the Air Force Military Medical University,Xi'an 710038,China;Department of Neurology,Rugao Fourth People's Hospital,Jiangsu Province,Rugao 226511,China;MR Division,Canon Medical Systems(China)Co.,LTD,Xi'an 710016,China;Department of Radiology,Tangdu Hospital,The Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院核医学科,西安710038 [2]江苏省如皋市第四人民医院神经内科,如皋226511 [3]佳能医疗系统(中国)有限公司MR产品事业部,西安710016 [4]空军军医大学唐都医院放射科,西安710038

出　　处：《磁共振成像》2021年第9期40-44,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81671661);唐都医院尖子人才项目(编号:2019)。

摘　　要：目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对海洛因成瘾者左侧执行控制网络(executive control network,ECN)的影响。材料与方法纳入海洛因成瘾者19例(rTMS组)和年龄、性别、受教育年限相匹配的健康对照组(healthy control,HC组)22名。收集rTMS组治疗前后的影像学与行为学数据及HC组影像学数据。分析rTMS组治疗前后线索诱导渴求及左侧ECN的功能连接差异。结果rTMS组被试治疗后的海洛因线索诱导渴求评分(1.47±2.61)较治疗前(1.82±2.91)显著下降(P<0.05);rTMS组被试治疗后其异常增高的左侧背外侧前额叶(dorsolateral prefrontal cortex,DLPFC)与右侧DLPFC(坐标:x=27,y=39,z=51;体素:73;GRF校正,P<0.05)的功能连接值明显减少且接近健康人水平。结论rTMS可降低海洛因成瘾者的毒品线索诱导渴求,并利于恢复海洛因成瘾者异常的左侧ECN功能。Objective:To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on the left executive control network(ECN)in heroin dependent individuals.Materials and Methods:Nineteen heroin dependent individuals(rTMS group)and 22 healthy control subjects(HC group)matched with age,sex and education level were included.The fMRI and behavioral data of the rTMS group were collected before and after treatment,and the fMRI data of the HC group were collected.The differences of cue-induced craving and left ECN before and after treatment in the rTMS group were analyzed.Results:The heroin cue-induced craving score of the rTMS group after treatment(1.47±2.61)was significantly decreased than before treatment(1.82±2.91)(P<0.05).The abnormally increased functional connectivity between the left dorsolateral prefrontal cortex(DLPFC)and the right DLPFC(MINI coordinate:x=27,y=39,z=51;voxels:73;corrected by GRF,P<0.05)was significantly decreased in the rTMS group after treatment with similar tendency toward that of the HC group.Conclusions:It suggested that rTMS can reduce drug cue-induced craving of heroin dependent individuals and help restore abnormal left ECN function of heroin dependent individuals.

关 键 词：重复经颅磁刺激 海洛因成瘾 左侧执行控制网络 功能连接 功能磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.81[医药卫生—诊断学]