文拉法辛对健康成人皮层语言功能区兴奋性的影响

Effect of venlafaxine on excitability of cortical language function area in healthy subjects

目的采用功能磁共振成像技术结合行为学评估的方法，观察文拉法辛对健康男性志愿者皮层语言功能的影响。方法8例男性健康成年志愿者，按随机数字表法分为2组（各4例1．一组受试者第一阶段先服用文拉法辛胶囊连续7d，间隔3d后，第二阶段服用安慰剂胶囊7d；另一组受试者服药顺序与之相反。实验7d、18d后应用1min自发语词频度和改良图片命名测试观察文拉法辛、安慰剂对受试者行为学的影响；功能磁共振检查受试者执行动物、工具命名任务时脑区的激活情况。结果文拉法辛、安慰剂处理对受试者命名和自发语词频度测试结果的差异有统计学意义（氏0．05）。测定阶段对两项行为学检测结果均无影响，差异无统计学意SL（P〉0．05）。功能磁共振数据表明．与安慰剂处理对比。文拉法辛处理后，所有受试者在执行命名任务时左侧额中回背后部Broca区上部与运动前区的结合部位出现显著功能磁共振激活增强；受试者用药后左额中回后部的功能磁共振激活增强值与改良图片命名测试的分值存在正相关关系（动物命名：r=0．972，P=0．000；工具命名：r=0．944，P=-0．000）。结论口服文拉法辛7d可促进健康个体优势半球额叶区域的皮层兴奋性增高，同时影响语言行为能力。

Objective To observe the effect of serotonin-norepinephrine reuptake inhibitor （SNRI） venlafaxine on cortex language area excitability in healthy subjects by means of functional MRI （fMRI） and behavioral language tests. Methods In a randomized, double-blind, crossover study, 8 right-handed healthy subjects received 75 mg daily of either venlafaxine or placebo over a period of 7 d separated by a period of 3 d washing-out. Parallel behavioral language tests, including fluency of spontaneous language （1 min） and the naming testing, were performed before treatment, 7 and 18 d after treatment in each volunteer. The repeated fMRI examination was employed to exam the activation of the brain when performing the tasks （animal naming and tool naming）. The test results were analyzed with SPSS13.0 software using the cross-analysis of two-stage test. Results Naming scores in velafaxine session was significantly higher than that in placebo session （P〈0.05）; and the performance of spontaneous language frequency in venlafaxin session was significantly higher than that in placebo session （P〈0.05）. As compared with the administration of placebo, the fMRI data suggested that venlafaxine induced hyperactivation on the superior part of the left middle front gyri （BA44/45） and the premotor area （PMA） （BA6） in the left-sided brain; the hyperactivation of these areas were positively correlated with the naming scores （animal naming： r=0.972, P=0.000; tool naming： r=0.944, P=-0.000）. Conclusion In healthy subjects, venlafaxine for 7 d might promote the output of phonetic cortex on frontal lobe of language dominant hemisphere and the ability of language behavior.