强制戒断时间对海洛因成瘾者大脑局部一致性影响的静息态功能MRI

Resting state functional MRI evaluation of constraint abstinence duration for regional homogeneity in heroin addicts

目的探讨静息态下强制戒断时间对海洛因成瘾者大脑局部一致性(ReHo)的影响。方法纳入20例强制戒断6个月(戒断6个月组)、16例戒断11个月(戒断11个月组)的海洛因成瘾者和30名(正常对照组)人口学数据相匹配的健康受试者,采集其静息态fMRI数据,计算并比较3组间ReHo值,利用Pearson相关分析法分析差异脑区ReHo值与戒断时间的关系。结果 3组间ReHo值有统计学差异的脑区为左侧海马旁回、尾状核、岛叶、扣带回、中央后回及右侧眶额回。戒断11个月组ReHo值低于戒断6个月组的脑区为左侧海马旁回、尾状核、岛叶、扣带回及中央后回,右侧眶额回ReHo值高于戒断6个月组及正常组。左侧海马旁回(r=0.53,P=0.000 8)、尾状核(r=0.54,P=0.000 6)、岛叶(r=0.62,P<0.000 1)、扣带回(r=0.47,P=0.003 5)及中央后回(r=0.35,P=0.034 8)的ReHo值分别与戒断时间呈负相关,右侧眶额回(r=0.66,P<0.000 1)ReHo值与戒断时间呈正相关。结论海洛因成瘾者多数受损脑区(渴求、抑制性控制及学习记忆等)经长期戒断后功能趋于恢复正常,而动机/驱动脑区(眶额回)活动异常增高可能是戒断后复吸的原因之一。

Objective To investigate the effect of constraint abstinence duration on regional homogeneity（ReHo）of heroin addicts in resting state.Methods Twenty heroin addicts abstinent for 6 months（PA6 group）,sixteen heroin addicts abstinent for 11 months（PA11 group）and 30 demographically matched healthy controls（HC group）were enrolled.ReHo values were calculated and difference among three groups was analyzed.The relationship between ReHo values of differential brain regions and abstinent duration was performed with Pearson method.Results The results demonstrated statistically significant difference in ReHo values among three groups in the left parahippocampal gyrus,caudate,insula,cingulate gyrus,postcentral gyrus and right orbitofrontal cortex.Compared with the PA6 group,the PA11 group demonstrated lower ReHo value in left parahippocampal gyrus,caudate,insula,cingulate gyrus and postcentral gyrus,ReHos value were higher than PA6 and HC in right orbitofrontal cortex.Meanwhile,the ReHo values of left parahippocampal gyrus（r=0.53,P=0.0008）,caudate（r=0.54,P=0.0006）,insula（r=0.62,P〈0.0001）,cingulate gyrus（r=0.47,P=0.003 5）and postcentral gyrus（r=0.35,P=0.0348）were negatively correlated with abstinence duration and ReHo value of right orbitofrontal cortex（r=0.66,P〈0.0001）were positively correlated with abstinence duration.Conclusion During long-term abstinence,most of heroin addicts＇ damaged brain regions（mainly involved in craving,inhibitory control,learning and memory）tends to be normal,thus benefit reducing the risk of relapse,but motivation related brain region＇s（orbitofrontal cortex）neural activity increases abnormally,that may be one of the important reasons for relapse after abstinence.