甲基苯丙胺与海洛因使用障碍者脑局部一致性的差异及其精神特征的相关性研究

Disparity of brain regional homogeneity and the correlation research of its mental characteristics in methamphetamine and heroin use disorder patients

目的分析静息状态下甲基苯丙胺使用障碍(methamphetamine use disorder,MAUD)者与海洛因使用障碍(heroinusedisorder,HUD)者脑局部神经元自发活动改变的差异及其与精神行为学的相关性,为进一步探究两者导致不同精神状况的潜在神经机制提供帮助。材料与方法收集男性MAUD患者21例,招募人口学资料与之匹配的HUD患者及健康对照(normal controls,NC)各21例。3.0 T磁共振设备用于脑影像数据的采集,采用症状自评量表(Self-reporting Inventory-90,SCL-90)进行精神症状评价。采用单因素方差分析比较三组静息状态下脑局部一致性(regional homogeneity,ReHo)差异。MAUD组内,采用基于全脑体素的方法分析其脑区与精神症状之间的相关关系。结果 MAUD组焦虑、敌对、偏执及核心精神病性项目得分显著高于健康组,且敌对项目显著高于HUD组(P<0.05);HUD组与NC组无显著差异。三组间右侧小脑、右侧额中回、右侧壳核、右颞下回、左额上回、左顶下小叶、左侧丘脑及左侧梭状回ReHo值存在显著差异(P<0.001)。与健康组相比,MAUD组ReHo值升高的脑区有:右额中回、右侧颞下回;ReHo值降低的脑区有:右侧小脑、左额上回、右壳核;HUD组ReHo值升高的脑区为:右额中回;ReHo值降低的脑区为:左侧丘脑,左侧梭状回,右侧壳核,左顶下小叶。与HUD组相比,相同吸食时间的MAUD组右侧小脑、左额上回ReHo值降低,而右额中回、右侧颞下回、左侧丘脑ReHo值显著增高。MAUD组内未发现脑区与精神量表的明显相关关系。结论与HUD组相比,MAUD组对司职情绪调节、听觉功能及记忆相关脑区的损害更严重,可能是其特殊精神症状发生的潜在病理基础。

Objective:To analyze the differences of brain local neuronal spontaneous activity of methamphetamine and heroin used disorder patients and its relevance to psychoethology.From the perspective of changes in brain activity caused by methamphetamine and heroin used disorder,to explore the underlying neural mechanism that leads to different mental conditions.Materials and Methods:Twenty-one male methamphetamine use disorder(MAUD),21 demography matched heroin use disorder(HUD)and normal controls(NC)participants in this study.All MR imaging were acquired using an eight-channel head coil on a 3.0 T GE-Signa MRI scanner.Psychological situation was evaluated by the Self-reporting Inventory-90(SCL-90).ReHo values were calculated and difference among three groups was analyzed by one-way analysis of variance(ANOVA).The relationship between brain regions and psychological symptoms was performed with total brain voxel-wise analytical method in MAUD group.Results:Two-two comparison between the three groups showed MAUD group showed higher levels of anxiety,hostility,stubborn and core psychotic compared with NC group.Additionally,those in the MAUD group had higher scores of hostility compared with HA group(P<0.05).There was no significant difference between HUD group and NC group.The ReHo values of multiple brain regions between the three groups were different and the brain regions were right cerebellum,right frontal middle gyrus,right putamen,right inferior temporal gyrus,left frontal super gyrus,left parietal inferior gyrus,left thalamus and left fusiform(P<0.001).Compared with the NC group,the MAUD group demonstrated significantly increased ReHo values in right frontal middle gyrus and right inferior temporal gyrus,significantly decreased in right cerebellum,left frontal super gyrus and right putamen.The HUD group demonstrated significantly increased ReHo values in right frontal middle gyrus,significantly decreased in left thalamus,left fusiform,right putamen and left parietal inferior gyrus.On same uptake drug time,compared with the HUD group,the MAUD group demonstrated significantly decreased brain regional homogeneity in resting-state of cerebellum and left frontal super gyrus,but increased in right frontal middle gyrus,right inferior temporal gyrus and left thalamus.In MAUD group,there is no correlation between total brain and psychological scale.Conclusions:Compared with HUD group,MAUD group was more damaging to the moodregulation,auditory-related and memory-related brain regions.It may be the underlying pathological basis for the occurrence of its special mental symptoms.