DTI评价戒断时间对海洛因成瘾者大脑白质完整性的影响

Diffusion tenser imaging evaluation of effects of abstinence time on white integrity of heroin addicts

目的采用DTI研究戒断的时间效应对海洛因成瘾者大脑白质微结构的影响。方法对28例短期戒断(sa组)与17例长期戒断(la组)的海洛因成瘾者进行DTI数据采集,组间FA比较采用白质骨架的空间统计(TBSS)方法,对组间人口学资料、径向弥散(RD)值和轴向弥散(AD)值比较采用两样本t检验,对脑白质差异区的FA值与戒断时间进行相关分析。结果与sa组比较,la组FA值升高的脑区包括左侧后冠状辐射、左侧外囊、左侧内囊后肢、右侧上纵束、右侧前冠状辐射、右侧皮质脊髓束、双侧上冠状辐射、胼胝体体部和压部(P<0.05,TFCE及FWE校正),la组上述脑区的RD值降低(P<0.05),两组的AD值差异无统计学意义(P>0.05)。sa组和la组大脑白质差异区FA值与戒断时间呈正相关(r=0.361、0.380,P=0.019、0.013)。结论接受长期戒断的海洛因成瘾者大脑多个区域的脑白质完整性较短期戒断者显著改善。长期戒断有利于海洛因所导致的白质损伤恢复,也可能有利于海洛因成瘾者认知功能等脑功能的改善。

Objective To observe the effects of abstinence time on white matter integrity of heroin addicts with DTI.Methods All of 28short-time abstinents（sa group）and 17long-time abstinents（la group）were recruited,and the DTI data were obtained.Tract-Based Spatial Statistics were used for FA comparison between two groups.Demographic data,radial diffusivity and axial diffusivity value between two groups were compared using two sample t test.Correlation analysis between FA and duration of abstinence was performed.Results Compared with the sa group,FA significant increased in la group were found in several white matter regions including left posterior coronal radiation,left external capsule,left posterior limb of the internal capsule,right superior longitudinal fasciculus,right anterior coronary radiation,right corticospinal tract,bilateral anterior corona radiata,body and splenium of corpus callosum（corrected by TFEC and FWE）.The radial diffusivity of la group was lower than that of sa group（P〈0.05）.The axial diffusivity in two groups had no significant difference（P〉0.05）.FA of white matter was positively related to the abstinent time of sa group and la group（r=0.361,0.380,P=0.019,0.013）.Conclusion Extensive regions of brain white matter is improved significantly integrity in heroin addicts who reserves long-term abstinent treatment.The long-term abstinence is more beneficial to the recovery of white matter impairment caused by heroin and may be beneficial to the recover of cognition and brain function.