美沙酮对不同TaqI A1基因型海洛因依赖者伏隔核功能连接的影响  

Effects of methadone on nucleus accumbens functional connectivity in heroin addicts with different TaqI A1 genotypes

作　　者：李永斌 王宁[2] 杨姣 杨延延 周琪[2] 罗春海[2] 倪锋[2] LI Yongbin;WANG Ning;YANG Jiao;YANG Yanyan;ZHOU Qi;LUO Chunhai;NI Feng(Department of Imaging,Xi'an No.1 Hospital,Xi'an 710002,China;Department of Imaging,the Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,China)

机构地区：[1]西安市第一医院影像科,陕西西安710002 [2]西安医学院第二附属医院影像科,陕西西安710038

出　　处：《实用放射学杂志》2023年第7期1055-1058,1070,共5页Journal of Practical Radiology

基　　金：陕西省教育厅一般自然专项科学研究计划项目(20JK0903);陕西省自然科学基础研究计划一般项目(青年)(2020JQ-883)。

摘　　要：目的探讨美沙酮维持治疗(MMT)1年对A1+型与A1-型海洛因依赖者伏隔核(NAc)功能连接的影响。方法招募接受MMT的A1+组(26例)和A1-组(21例)海洛因依赖者,采集静息态功能MRI、心理渴求和戒断症状评分。计算NAc与双侧眶额回、内侧前额叶及楔前叶功能连接强度。纵向自身比较脑区间功能连接强度及心理渴求、戒断症状的变化。结果接受MMT 1年后,A1+组渴求与戒断症状评分增加,差异有统计学意义(t=-2.35,P=0.03;t=-2.67,P=0.01),A1-组渴求与戒断症状评分无显著性变化(t=0.54,P=0.60;t=1.33,P=0.22)。A1+组NAc与内侧前额叶功能连接降低(t=2.20,P=0.04),且与戒断症状呈负相关(r=-0.68,P=0.01);A1-组NAc与眶额回功能连接降低(t=4.27,P<0.01),与内侧前额叶功能连接增加(t=-3.13,P=0.01)。结论经1年MMT后,A1+型海洛因依赖者的心理渴求与戒断症状加重,奖赏与抑制性控制功能脑区连接减弱;A1-型海洛因依赖者奖赏与动机驱动功能脑区连接降低,与抑制性控制功能脑区连接增强。Objective To investigate the effect of methadone maintenance treatment(MMT)for one year on the functional connectivity of nucleus accumbens(NAc)in heroin addicts with A1+and Al-types.Methods Heroin addicts in A1+group(n=26)and Al-group(n=21)who were treated with MMT were recruited.The data of resting state functional MRI,and the scores of psychological craving and withdrawal symptoms were all collected.The functional connectivity intensity between NAc and bilateral orbitofrontal gyrus,medial prefrontal lobe and anterior cuneiform lobe were calculated,respectively.The changes of functional connectivity intensity,psychological craving and withdrawal symptoms of brain regions were longitudinally compared.Results Receiving MMT for one year,the scores of craving and withdrawal symptoms in A1+group increased significantly(t=-2.35,P=0.03;t=-2.67,P=0.01),but the scores of craving and withdrawal symptoms in A1-group did not change significantly(t=0.54,P=0.60;t=1.33,P=0.22).In A1+group,functional connectivity decreased between NAc and medial prefrontal lobe(t=2.20,P=0.04),and it was a negative correlation with withdrawal symptoms(r=-0.68,P=0.01);in A1-group,the functional connectivity between NAc and orbitofrontal gyrus significantly decreased(t=4.27,P<0.01),while the functional connectivity between NAc and medial prefrontal lobe significantly increased(t=-3.13,P=0.01).Conclusion MMT for one year,the psychological craving and withdrawal symptoms of A1+type heroin addicts are aggravated,with the weakened connection between reward and inhibitory control function brain areas.The connection between reward and motivation driving brain areas of Al-type heroin addicts significantly decreased,while the connection between reward and inhibitory control function brain areas significantly increased.

关 键 词：TaqIA1基因 伏隔核 美沙酮 海洛因依赖 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R995[医药卫生—临床医学] R445.2