磁共振功能成像对药物依赖者脑温度改变的初步研究

发布时间：2018-04-08 13:31

本文选题：脑温度　切入点：药物依赖　出处：《广州中医药大学》2017年博士论文

【摘要】：目的:探讨氢质子磁共振波谱(1H MRS)显示海洛因依赖者前额叶及海马区损伤后的代谢异常,利用化学位移值温度相关性的原理,应用相关方程转换,测量海洛因依赖者前额叶皮层与海马绝对温度变化,间接反映其存在的微观病理生理变化,探讨其在评估药物成瘾及渴求机制的可行性及意义。方法:选取24例处于戒断治疗期(戒断治疗时间2-6月)的男性海洛因依赖者作为实验组,选取24例年龄及受教育时间与实验组匹配的男性健康志愿者作为对照组。所有被试进行常规轴位T2WI、FLAIR扫描及前额叶皮层(感兴趣区选择跨中线包括左右侧皮层)、双侧海马的单体素磁共振波谱扫描。实验组的磁共振波谱扫描分别在静息状态和视觉刺激(呈现海洛因相关图片)诱导渴求状态下连续进行,两次扫描确保其扫描参数、感兴趣区的位置及体积完全一致。分析波谱图像,测量记录前额叶皮质和双侧海马N-乙酰天门冬氨酸(NAA)/肌酸(Cr)比值及NAA化学位移值;以NAA为参考,根据脑温度(T)与NAA化学位移(CSNAA)之间的关系:T=37+100(CSNAA-2.035),计算前额叶皮层及海马绝对脑温度;将NAA/Cr值、脑温度值作相关统计学分析比较。结果:1.海洛因依赖组及对照组常规MRI脑内均无明显异常信号灶,未见明确结构异常。前额叶皮层及双侧海马1HMRS基线稳定,各主要代谢物波峰清晰可辨。2.比较海洛因依赖组静息态与对照组:海洛因依赖组前额叶皮层及左侧海马NAA/Cr值较正常对照组下降,差异具有统计学意义(P0.05);海洛因依赖组右侧海马NAA/Cr值与对照组比较无显著统计学差异(P0.05)。3.比较海洛因依赖组静息态与视觉刺激态:前额叶皮层及两侧海马温度两种状态的比较均无显著统计学差异(P0.05)。4.比较海洛因依赖组静息态与对照组:海洛因依赖组前额叶皮层温度上升,差异有统计学意义(P0.05)。海洛因依赖组双侧海马温度与对照组比较无显著统计学差异(P0.05)。5.将海洛因依赖组三组脑区静息态NAA/Cr、温度值以及海洛因依赖组静息态-刺激态温度差(△T)与海洛因吸食总量作直线相关与回归分析发现:海洛因组静息态前额叶皮层温度与海洛因吸食总量存在正的直线相关关系(P0.05),其决定系数(R Square,R2)为 0.225。结论:常规MRI对显示海洛因脑损伤微观病理改变有较大的限制,1H MRS可以较好显示及评价早期海洛因毒性效应引起的相应脑区神经元及代谢受损改变。NAA含量变化反映神经元的数量、密度和功能状态,而利用NAA化学位移值可无创性测量药物依赖者相应成瘾脑区脑温度改变。额叶是海洛因成瘾关键及易损脑区,静息态前额叶皮层温度的升高可能是神经元损伤、脑血流量及脑代谢改变的综合体现。尽管脑温度内在机制及影响因素复杂,但对探讨药物依赖机制、评价成瘾与渴求无疑是一个有潜力的评价指标,应用前景较好。
[Abstract]:Objective: To investigate the proton magnetic resonance spectroscopy (1H MRS) that prefrontal and hippocampus injury after the abnormal metabolism of heroin dependence, using the principle of chemical shift temperature dependence, using equation conversion, prefrontal cortex and hippocampus were absolute temperature measuring changes in heroin dependence, indirectly reflect the microscopic pathological physiological changes of its existence, study the feasibility and significance of assessment of drug addiction and craving mechanism. Methods: 24 cases in the treatment of withdrawal period (withdrawal treatment time is 2-6 months) male heroin addicts were selected as experimental group, 24 cases of age and education, and the experimental group of male healthy volunteers as control group. All of the subjects were conventional shaft T2WI, FLAIR scan and prefrontal cortex (including midline lateral cortex region of interest), single bilateral hippocampal magnetic resonance spectroscopy scanning. The experimental group co The vibration spectrum scanning respectively in the resting state and visual stimulation (presentation of heroin related pictures) induced craving state continuously, the two scan to ensure the scanning parameters, the position and volume of the area of interest is exactly the same. The analysis of the spectral image, measuring and recording the prefrontal cortex and hippocampus of N- double N-acetylaspartate (NAA) / creatine (Cr) ratio and NAA chemical shifts; reference to NAA, according to the brain temperature (T) and NAA chemical shift (CSNAA): the relationship between T=37+100 (CSNAA-2.035), prefrontal cortex and hippocampus to calculate absolute brain temperature; the NAA value of /Cr, the relevant statistical analysis and comparison. The value of brain temperature results: 1. heroin dependence group and control group of conventional MRI in the brain were not significantly abnormal signal lesions, no clear structural abnormalities. The prefrontal cortex and bilateral hippocampus 1HMRS baseline stability, the main metabolites peak of.2. is clearly the heroin dependence group and resting state The control group: compared with normal control group decreased prefrontal cortex and left hippocampus NAA/Cr group of heroin dependence, the difference was statistically significant (P0.05); value compared with the control group there was no significant difference between group NAA/Cr of the right hippocampus of heroin dependence group (P0.05) in resting state and visual.3. of heroin dependence: thorn excited state prefrontal cortex and bilateral hippocampus temperature two for the comparison there were no significant differences in resting state (P0.05) group compared with control group.4.: heroin dependence group increased the prefrontal cortex temperature of heroin dependence, the difference was statistically significant (P0.05). The heroin dependence group bilateral hippocampal temperature compared with the control group, there was no statistically significant difference (P0.05.5.) the heroin dependence group three group of brain in the resting state NAA/Cr, temperature value and the heroin dependence group in resting state - thorn excited state temperature difference (delta T) and the total amount of heroin for a straight line correlation and regression analysis. The resting state of prefrontal cortex: heroin group and heroin temperature had a linear relationship is the total (P0.05), the coefficient of determination (R Square, R2 0.225.) conclusion: the conventional MRI to show a change has greatly restricted heroin microscopic pathological brain injury, 1H and MRS can better display the corresponding evaluation of neurons in brain areas and metabolism the effect of early damage caused by heroin toxicity changing.NAA content to reflect changes in the number of neurons, density and functional status, and the use of NAA chemical shift value of noninvasive measurement of brain temperature corresponding drug addicts addiction brain areas change. The frontal lobe is the key of heroin addiction and vulnerable brain regions, resting prefrontal cortex temperature may be neuron injury change, comprehensive reflection of cerebral blood flow and cerebral metabolism. Although the inner mechanism and its influential factors of brain temperature is complex, but to investigate the drug dependent mechanism, evaluation of addiction and thirst There is no doubt that it is a potential evaluation index, and it has a good prospect of application.

【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R445.2;R749.61

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