基于静息态功能连接探讨重复经颅磁刺激治疗尼古丁成瘾者海马亚区的变化  

Exploring changes in hippocampal subregions of repetitive transcranial magnetic stimulation on nicotine addiction based on resting-state functional connectivity

作　　者：李志强 谢梅 汪涛[2] 陈懂燕 张巧丽 李思茵 杨笛 张建军[2] Li Zhiqiang;Xie Mei;Wang Tao;Chen Dongyan;Zhang Qiaoli;Li Siyin;Yang Di;Zhang Jianjun(the Second School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Radiology,Zhejiang Hospital,Hangzhou 310013,China;Department of Radiology,Affiliated Zhejiang Hospital,Zhejiang University School of Medicine,Hangzhou 310030,China)

机构地区：[1]浙江中医药大学第二临床医学院,杭州310053 [2]浙江医院放射科,杭州310013 [3]浙江大学医学院附属浙江医院放射科,杭州310030

出　　处：《中华放射学杂志》2024年第12期1388-1395,共8页Chinese Journal of Radiology

基　　金：浙江省部共建项目(WKJ-ZJ-2015);浙江省医药卫生科技计划项目(2022KY011,2021KY427)。

摘　　要：目的利用静息态功能连接(FC)探讨尼古丁成瘾者重复经颅磁刺激(rTMS)治疗后海马亚区的变化。方法该研究为横断面研究。前瞻性分析2022至2024年在浙江医院纳入的20例男性尼古丁成瘾者的临床及影像资料。所有被试者均接受rTMS治疗并在治疗前后接受烟瘾相关临床量表评估及静息态FC分析。临床量表评估包括法氏烟草依赖评估量表(FTND)、吸烟严重度指数表、明尼苏达烟草戒断症状量表(MNWS)、吸烟渴求简短问卷(sTCQ)及视觉模拟量表(VAS)。采用配对t检验及Wilcoxon符号秩检验比较治疗前后临床评估量表评分差异性。以双侧海马10个亚区(包括双侧海马体、齿状回、内嗅皮质、海马-杏仁核过渡区、下托区)为种子点,采用配对t检验比较被试者治疗前后海马亚区FC差异性。采用Pearson及Spearman分析rTMS组静息态FC的变化与临床评估量表评分的相关性。结果与治疗前相比,尼古丁成瘾者经rTMS治疗后FTND、吸烟严重度指数、MNWS、sTCQ、VAS总疗程评分均下降(P均<0.05)。与治疗前相比,治疗后左侧海马齿状回亚区与双侧补充运动区及左侧中扣带回的FC出现减低,左侧海马内嗅皮质亚区与右侧颞中回及右侧颞上回的FC增高,左侧海马-杏仁核过渡区亚区与双侧距状裂周围皮层、楔叶的FC增高(高斯随机场校正,P体素水平均<0.01,P团块水平均<0.05)。治疗前后左侧海马-杏仁核过渡区亚区与右侧距状裂周围皮层FC差值和sTCQ冲动评分差值呈负相关(r=-0.447,P=0.048);左侧海马-杏仁核过渡区亚区与右侧楔叶FC差值和sTCQ预期评分差值呈负相关(r=-0.559,P=0.010);左侧海马-杏仁核过渡区亚区与左侧距状裂周围皮层FC差值和sTCQ情绪、sTCQ预期评分差值呈负相关(r=-0.516,P=0.020;r=-0.466,P=0.038);左侧海马-杏仁核过渡区亚区与左侧楔叶FC差值与sTCQ情绪、sTCQ预期评分差值呈负相关(r=-0.459,P=0.042;r=-0.501,P=0.024)。结论尼古Objective To explore the changes in the functional connectivity(FC)of hippocampal subregions in nicotine addicts after repetitive transcranial magnetic stimulation(rTMS)using resting-state FC.Methods This study was a cross-sectional study.The clinical and imaging data from 20 male nicotine addicts at Zhejiang Hospital between 2022 and 2024 were analyzed prospectively.All participants received rTMS treatment and were assessed with nicotine-related clinical scales and resting-state FC analysis before and after treatment.The clinical scale evaluations included the Fagerström test for nicotine dependence(FTND),smoking severity index,Minnesota nicotine withdrawal scale(MNWS),short tobacco craving questionnaire(sTCQ),and visual analog scale(VAS).Paired t-tests and Wilcoxon signed-rank tests were used to compare the differences in clinical scale scores before and after treatment.Ten subregions of the bilateral hippocampus(including the hippocampus,dentate gyrus,entorhinal cortex,hippocampus-amygdala transition area,and subiculum)were used as seed points,and paired t-tests were conducted to compare the FC differences in these subregions before and after treatment.Pearson and Spearman correlation analyses were used to assess the correlation between changes in resting-state FC in the rTMS group and clinical scale scores.Results Compared to pre-treatment,the scores on the FTND,smoking severity index,MNWS,sTCQ,and VAS all significantly decreased after rTMS treatment in nicotine addicts(all P<0.05).Compared to pre-treatment,post-treatment FC was reduced between the left dentate gyrus subregion and the bilateral supplementary motor area and left middle cingulate gyrus,while it increased between the left entorhinal cortex subregion and the right middle and superior temporal gyri,and between the left hippocampus-amygdala transition area subregion and the bilateral calcarine cortex and cuneus(Gaussian random field correction,voxel-level P<0.01,cluster-level P<0.05).Negative correlations were observed between the FC difference in

关 键 词：磁共振成像 行为 成瘾 尼古丁 重复经颅磁刺激 功能连接 海马亚区 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.6[医药卫生—诊断学]