大脑局部灰质体积与戒烟结果的关系——基于体素的形态学分析

Correlation between Cerebral Regional Gray Matter Volume and Smoking Cessation Treatment Outcome: A Voxel-Based Morphometric Analysis

目的运用基于体素的形态学分析(VBM)方法寻找与戒烟治疗结果(4周持续戒断率)相关的脑结构。方法对23名慢性吸烟者于戒烟治疗前采用MR三维成像技术进行脑结构扫描,利用VBM方法对戒烟成功和戒烟失败两组之间的脑灰质体积进行比较,并采用统计学方法行两样本t检验。结果 23名接受戒烟治疗的慢性吸烟者中,10名戒烟成功,13名戒烟失败。戒烟成功组右侧额下回和右侧颞下回区灰质体积较戒烟失败组大(P<0.001)。未发现戒烟成功组存在灰质体积较小的脑区。结论慢性吸烟者的持续戒断与具有调节认知(注意力、冲动控制、学习及记忆)、延时兴奋、情绪等功能的前额叶皮层及视空间注意力皮层相关。大脑可能存在某些可作为戒断及复吸的预测器或生物标记的结构。

Objective To investigate the relationship between regional gray matter （GM） volume measured by voxelbased morphometry （VBM） and smoking cessation outcomes （ point prevalence abstinence at 4 weeks）. Methods A total of 23 chronic smokers were enrolled in this study. All patients received 12-week smoking cessation treatment. Before smoking cessation treatment, MRI scanning together with 3D imaging technique of the brain was performed in all participants.By using VBM analysis together with the independent two-sample t test, the gray matter volumes were compared between quitting smoking group and smoking cessation failure group. Results Of the 23 participants, successfully quitting smoking was obtained in 10, while smoking cessation failure was seen in 13. The gray matter volume of the right inferior frontal gyrus and right inferior temporal gyrus in successful smoking cessation participants was significantly larger than that in smoking cessation failures （P 〈 0. 001 ）. No cerebral region which had smaller gray matter volume was observed in successful smoking cessation participants. Conclusion The results suggest that maintaining smoking abstinence is correlated with greater pre-quit brain volume in the prefrontal cortex, which is the area that can regulate the cognitive function, i.e. attention, impulsive control, learning and memory, delaying exciting and emotion, etc. And greater volume of visual-spatial attention cortex, which plays a key role in visual information processing, is also associated with maintaining smoking abstinence. Maybe there are some brain structure variables which can be used as clinically useful predictors for smoking cessation treatment outcomes, and further large-scale studies are still needed.