海洛因成瘾者大脑伏隔核功能连接变化及MMT对其影响的fMRI研究

发布时间：2018-04-30 12:53

本文选题：海洛因 + 功能连接　；参考：《第四军医大学》2015年硕士论文

【摘要】：目的探讨单纯海洛因成瘾者(heroin addicts,HA)大脑奖赏环路伏隔核(Naccumbens nucleus,Nacc)功能连接特点及其在成瘾中的作用。进一步探讨长期美沙酮治疗的海洛因成瘾者(methadone maintenance treatment,MMT)Nacc功能连接的变化,明确MMT对成瘾者渴求影响的潜在神经机制。方法实验一:采集26例单纯海洛因成瘾者(HA组)和25例人口学特征相匹配的健康被试(对照组)静息态功能磁共振(functional Magnetic Resonance Imaging,f MRI)数据,以双侧Nacc为ROI,与全脑其他所有体素的时间序列做相关分析,使用两样本t检验比较两组间功能连接的差异;将HA组功能连接强度值与海洛因使用总时间及总剂量做偏相关分析。实验二:37例MMT海洛因成瘾者(MMT组)和25例人口学特征、海洛因使用情况相匹配的单纯海洛因成瘾者(HA组)进行药物渴求程度评分和f MRI静息态扫描。以双侧Nacc为种子点,使用两样本t检验做组间分析。将组间差异区内MMT组功能连接强度值与美沙酮使用时间及剂量做偏相关分析。结果实验一:与对照组相比,HA组与右侧Nacc功能连接增强的脑区包括双侧距状回、左枕中回,未发现减低的脑区;与左侧Nacc功能连接增强的脑区包括左梭状回和右楔前叶,减弱的脑区包括左背内、外侧前额叶、双背侧前扣带;HA组功能连接强度值与海洛因使用时间、剂量之间无相关性(P值0.05)。实验二:与HA组相比,MMT组右侧Nacc与左背内、外侧前额叶、右背侧前扣带功能连接增强,与右内侧眶额回功能连接减弱;左侧Nacc与左背内、外侧前额叶、右背外侧前额叶、右背侧前扣带、左侧岛叶功能连接增强,未发现功能连接减低的脑区;MMT组主观渴求评分显著小于HA组(t=-2.03,P0.05)。MMT组存在显著差异脑区的功能连接强度值与美沙酮使用时间及剂量无明显相关性(P0.05)。结论海洛因成瘾可能与奖赏环路关键脑区Nacc和认知控制及视觉空间注意力相关脑区的相互作用异常有关。MMT可能通过认知控制环路与动机驱动环路的共同作用来影响奖赏环路Nacc的功能,从而降低海洛因成瘾者的毒品渴求。
[Abstract]:Objective to investigate the functional connections of Naccumbens nucleusus Nacca in the brain reward loop of heroin addicts and its role in addiction. To further explore the changes of methadone maintenance treatment in heroin addicts treated with methadone for a long period of time, and to clarify the potential neural mechanism of the effect of MMT on craving of heroin addicts. Methods: in experiment 1, 26 heroin addicts (HA group) and 25 healthy subjects (control group) with matched demographic characteristics were collected data of resting functional Magnetic Resonance imagingf MRIs. Using bilateral Nacc as roi, correlation analysis was made with time series of all other voxels in the whole brain, and the difference of functional connection between the two groups was compared by using two samples t test, and partial correlation analysis was made between the intensity of functional connection of HA group and the total time and dose of heroin use. The drug craving scores and f MRI resting state scanning were performed in experiment 2: 37 cases of MMT heroin addicts (n = 37) and 25 cases of demographic characteristics of heroin addicts (n = 25). The drug craving degree and the rest state of f MRI were evaluated in simple heroin addicts with matched heroin use. Using bilateral Nacc as seed point, two samples t test was used for inter-group analysis. The partial correlation analysis was made between the MMT group and the time and dose of methadone use. Results: compared with the control group, the areas with enhanced right Nacc functional junctions in HA group included bilateral talus gyrus, left middle occipital gyrus, no decreased brain area, and left fusiform gyrus and right anterior wedge lobe. The attenuated brain regions included left dorsalis, lateral prefrontal lobe, bilateral dorsal anterior cingulate band HA group. There was no correlation between the intensity of functional connection and the time of heroin use, and there was no correlation between the dose and the dose (P = 0.05). Experiment 2: compared with HA group, the functional connections of right Nacc and left dorsalis, lateral prefrontal lobe, right dorsolateral anterior cingulate band were enhanced, and the functional connections with right medial orbital frontal gyrus were weakened, while left Nacc was associated with left dorsolateral, lateral prefrontal lobe, right dorsolateral prefrontal lobe, left Nacc and left dorsolateral frontal lobe. Right dorsal anterior cingulate band, left islet functional connection enhanced, The score of subjective craving in the MMT group was significantly lower than that in the HA group (P < 0.05). There was no significant correlation between the functional connection strength and the time and dose of methadone use. Conclusion heroin addiction may be related to the abnormal interaction between Nacc and cognitive control and visual spatial attention related brain regions in the critical brain region of the reward loop. MMT may be influenced by the interaction between the cognitive control loop and the motivation-driven loop. The function of the reward loop Nacc, In order to reduce heroin addicts drug craving.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.2;R749.64

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