长期强制戒断的海洛因依赖者对毒品线索反应的fMRI研究

fMRI Study on Craving and Brain Response to Heroin Related Clues in Heroin Dependent Patients During Long Term Abstinence

目的探讨长期强制戒断对海洛因依赖者在毒品线索条件下渴求及大脑反应的影响。方法 18名经过长期强制戒断的海洛因依赖者及20名年龄、受教育程度相关匹配的健康受试者参加本研究。本研究采用事件相关的实验范式,利用3.0 T磁共振设备采集功能数据,并利用SPM 8及SPSS 16.0软件进行大脑激活区差异分析及渴求变化分析。结果长期强制戒断的海洛因依赖者在毒品线索条件下主观渴求无明显变化(t=1.51,P=0.15)。与健康对照组相比,强制戒断组在毒品线索>中性线索条件下明显激活的脑区包括条件/记忆相关脑区(右侧杏仁核、海马旁回)及视觉空间注意力相关脑区(双侧额下回,左侧顶上小叶)。结论长期强制戒断可能有利于海洛因依赖者保持低的渴求水平,但海洛因依赖者对毒品相关线索的学习性反应可能长期存在。

Objective To investigate the effect of long term abstinence on the craving and brain response to heroin re- lated clues in former heroin dependent patients. Methods 18 former heroin dependent patients during long term absti- nence and 20 demographically matched healthy subjects participated in this study. An event related clue reactivity paradigm was used and functional magnetic resonance imaging （fMRI） data were acquired using 3.0 T MRI scanner. The fMRI data and behavior data were processed with SPM8 and SPSS 16.0 software respectively. Results No significant craving chan- ges were identified for the heroin dependent patients during long term abstinence. Compared with the healthy group, the heroin dependent group demonstrated significantly greater activation in response to heroin 〉 neutral cues in conditioning/ memory related regions （right amygdala and parahippocampus） and visuospatial attention related regions （bilateral inferior frontal gyms and left superior parietal lobule）. Conclusion The results indicated that long term abstinence may be useful for heroin dependent patients to keep low craving level, but the learned brain response of former heroin dependent patients to drug related stimuli may persist for a long time.