伏隔核的异常有效连接与尼古丁成瘾者依赖程度的关系研究  

A study on the relationship between abnormally effective connections in the nucleus accumbens and the severity of nicotine addicts

作　　者：高昕宇 张孟哲 杨镇圭 牛晓玉 汪卫建 程敬亮[1] 张勇[1] Gao Xinyu;Zhang Mengzhe;Yang Zhengui;Niu Xiaoyu;Wang Weijian;Cheng Jingliang;Zhang Yong(Department of Magnetic Resonance,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002,China)

机构地区：[1]郑州大学第一附属医院磁共振科,郑州450002

出　　处：《中华精神科杂志》2022年第6期429-435,共7页Chinese Journal of Psychiatry

基　　金：国家重点研发计划(SQ2018YFC130095);河南省重点研发与推广专项(科技攻关)项目(172102310391,212102310712)。

摘　　要：目的利用静息态功能磁共振成像(resting-state functional magnetic resonance,rs-fMRI)技术探讨轻度和重度尼古丁成瘾对大脑伏隔核(nucleus accumbens)定向功能连接的影响,并探究这种异常连接与尼古丁成瘾临床特征之间的关系。方法回顾性收集71例尼古丁成瘾者[依据尼古丁依赖检测量表(Fagerström Test for Nicotine Dependence,FTND)分为轻度尼古丁成瘾组(35例)和重度尼古丁成瘾组(36例)]以及40名健康志愿者(健康对照组)的rs-fMRI数据,采用格兰杰因果分析(Granger causality analysis,GCA)方法,选择双侧伏隔核作为种子点检测与全脑的效应连接,比较3组的有效连接值,并将其与尼古丁成瘾临床特征进行Spearman相关分析。结果与健康对照组相比,尼古丁成瘾组左侧伏隔核到左侧眶部额上回、右侧伏隔核到左侧尾状核、双侧眶部额上回/左侧额中回到左侧伏隔核、右侧眶部额上回/右侧顶下回到右侧伏隔核的效应连接减弱;左侧伏隔核到左侧顶下回、左背外侧额上回,右侧小脑下叶到左侧伏隔核的效应连接增强。与轻度尼古丁依赖组相比,重度尼古丁成瘾组左侧伏隔核到左侧顶下回、左背外侧额上回、左额中回的效应连接增强。在校正年龄、教育程度及灰质体积后,左侧伏隔核到左侧顶下回、左背外侧额上回的GCA值与FTND评分呈正相关(r=0.433,P<0.001;r=0.492,P<0.001)。左侧伏隔核到左背外侧额上回的GCA值与吸烟指数呈正相关(r=0.311,P=0.013)。结论尼古丁成瘾者伏隔核和额顶叶的功能连接改变,且这种改变与尼古丁成瘾者的依赖程度相关。Objective Based on resting-state functional magnetic resonance(rs-fMRI),aim to investigate the effects of mild and severe nicotine addiction on the directional functional connectivity of brain nucleus accumbens(NAc),and to explore the relationship between the abnormal connectivity and the clinical characteristics of nicotine addiction.Methods 71 nicotine addicts were screened and divided into the mild nicotine addiction group(35 cases)and the severe nicotine addiction group(36 cases).Both of them and additional 40 healthy volunteers underwent the rs-fMRI scan.Their effective connectivities between bilateral NAc and the whole brain,detected by Granger Causality Analysis(GCA),were analysed with Spearman correlation to explore the correlation with the clinical characteristics of nicotine addiction.Results Compared with the healthy control group,the effective connectivities of left NAc to left orbitofrontal superior frontal gyrus,right NAc to the left caudate nucleus,bilateral orbitofrontal superior frontal gyrus/left middle frontal gyrus to left NAc,right orbitofrontal superior frontal gyrus/right parietal inferior to right NAc were weakened in nicotine addicted group.The effective connectivities from left NAc to left inferior parietal gyrus,left dorsolateral superior frontal gyrus,and right inferior cerebellar lobe to the left NAc were enhanced.Compared with mild nicotine dependence,the effective connectivities from left NAc to left inferior parietal gyrus,left dorsolateral superior frontal gyrus and left middle frontal gyrus were enhanced in severe nicotine addicts.After adjusting for age,education level,and grey matter volume,GCA values from left NAc to left inferior parietal gyrus and left dorsolateral superior frontal gyrus were positively correlated with FTND score(r=0.433,P<0.001;r=0.492,P<0.001).GCA from left NAc to left dorsolateral superior frontal gyrus was positively correlated with the smoking index(r=0.311,P=0.013).Conclusion Effective connectivity in the nucleus accumbens and frontoparietal lobes was

关 键 词：尼古丁成瘾 伏隔核 磁共振成像 格兰杰因果分析 

分 类 号：R749.6[医药卫生—神经病学与精神病学]