药物滥用者的脑功能显像研究

Brain functional imaging studies in drug abusers

采用单光子发射计算机断层扫描技术研究长期滥用海洛因和摇头丸对局部脑血流量、脑功能活动和多巴胺系统的影响以及电针的效应机制。通过观察摇头丸滥用者和健康志愿者在电针前后的脑血流变化 ,以及摇头丸和海洛因滥用者与正常志愿者的脑多巴胺转运蛋白显像的对比研究 ,通过对采集的影像数据进行视觉和定量分析 ,结果发现 ,摇头丸滥用组 94 .1 % ( 1 6 /1 7)存在单侧额 脑岛 基底节 颞叶区局限性血流灌注和脑功能活动异常增高 ,而且所有滥用者大脑皮质都存在不同区域的局限性血流灌注和脑功能活动低下区。多巴胺转运蛋白显像更清晰地表明 ,摇头丸、海洛因滥用者和正常志愿者相比 ,双侧纹状体明显变小、形态异常 ,而且 ,纹状体的长度、宽度及纹状体 /全脑比值都与正常志愿者差异明显 ,有非常显著的统计学意义。此外 ,滥用者的颅板、头皮和窦汇皆显影 ,表明血 脑脊液屏障的通透性亦明显增高。综合研究结果 ,摇头丸和海洛因对脑的损害是广泛的 ,包括血流灌注、脑细胞功能活动、多巴胺系统和血脑屏障。电针治疗可以显著增加或调整局部脑血流量 ,并改善大脑的功能活动。提示针刺可以作为一种简便、有效。

The effects of chronic abuse of heroin and 3,4-methylenediox ymethamphe tamine (MDMA) on regional cerebral blood flow(rCBF), cerebral functional acti vity , dopamine system and the mechanisms of effects of electronic acupuncture(EA) w ere investigated with single-photon emission computed tomography (SPECT). By ob s erving the cerebral blood changes in MDMA abusers and healthy volunteers before and after EA treatment, and comparing the images of dopamine transporter (DAT) i n MDMA abusers and heroin abusers with those in healthy volunteers, after the vi sual and quantitative analyses on the acquired data, the results demonstrated abnorm al in crease of insula-basal ganglia-temporal regional cerebral blood flow and cere br al cellular functions of 94.6%(16/17) MDMA abuser group, and an existence reg ional cerebral blood flow and cerebral cell function decreasing region. SPECT DA T images showed that both sides of striatum became smaller and morphologicall a bnormal, and the length ,width of striatum and striatum/whole brain ratio all had significant difference in MDMA abusers or heroin abusers with respect t o healthy volunteers. In addition, DAT imaging studies showed visualizat ion of calvarium , scalp and sinusoid in the abusers, indicating an increased pe rmeability in blood-brain barrier. The results showed universal damages to the brain by heroin and MDMA , including cerebral blood flow, cerebral fun ctional a ctivity, dopamine (DA) system and blood-brain barrier. EA treatment can increa se significantly or adjust the regional cerebral blood flow, and improve the cerebral cell function significantly,suggesting that EA might work as a non invasive,convenient and effective therapy for the pathological damages by MDMA a buse.