药物依赖患者伏隔核毁损后行为选择变化的初步研究

Study on decision-making alternation after bilateral nucleus accumbens ablation in drug addicts.

目的探讨伏隔核毁损对于阿片类药物成瘾患者行为选择缺陷的影响并初步分析原因。方法对伏隔核毁损前后阿片药物依赖患者(15例)以及正常对照组(14例)进行爱荷华赌博任务测验(IOWA gambling test,IGT),剑桥赌博任务测验(Cambridge gambling test,CGT),go／nogo逆转学习／行为抑制测验以及数字记忆广度的测评,采用LSD-t检验、配对t检验以及levene方差齐性检验法进行统计学分析。结果IGT测试显示手术组术前较术后和正常组成绩均偏低,术前与术后差异有统计学意义(t=2．547,P<0．01),术后与正常对照组差异无统计学意义(t=0．746,P>0．1)。CGT测试术前与术后差异无统计学意义(t=1．254,P>0．1)。go／no-go行为抑制测试术前与术后差异无统计学意义(t=1．036,P> 0．1)。数字广度测评手术组成绩较正常对照组偏低,术前及术后差异无统计学意义(t=1．126,P>0．1)。结论伏隔核毁损可以改善成瘾患者行为选择的缺陷,这种改善作用与冒险行为、工作记忆及逆转学习／行为抑制等神经心理机制无关。

Objective To explore decision-making alternation after bilateral nucleus accumbens ablation in drug addicts and analyse the reason. Method We tested 15 opiate-dependent individuals by using IOWA gambling test, Cambridge gambling task,Go/no-go test and digit span test before and 14 days after bilateral nucleus accumbens ablation and campared their performances with those of 14 normal controls. Levene test of homogeneity of varianc and LSD-t test was used in statistics analysis. Result It was shown that the opiatedependent subjects＇ IGT performances became better after surgery （ t = 0. 05, P 〈 0. 01 ） and had no significant difference compared with the controls （ t = 0.05, P 〈 0. 01 ）. While difference of their performances in other three test had no statistical significance （ t = 0. 1 ,P 〉 0. 1 ）. Conclusions Nucleus Accumbens ablation can improve opiate-dependent subjects＇ performances in IGT and has no effect on such neuropsychological functions as working memory,risk-taking and behavior inhibition.