视觉线索诱发酒精渴求状态的事件相关电位研究

An event-related potentials study of alcohol craving state evoked by visual cues

目的探讨酒依赖(alcohol dependence,AD)患者不同视觉线索下事件相关电位(event-related potentials,ERPs)反应及其与酒精渴求的关系。方法收集男性AD住院患者20例为酒依赖组,健康男性18名为对照组,进行含有酒精线索图片的视觉Oddball范式诱发ERPs检测,并以视觉模拟标尺(visual analogue scale,VAS)、宾夕法尼亚酒精渴求量表(Penn alcohol craving scale,PACS)评估AD患者主观渴求程度。结果混合设计方差分析显示,与对照组比较,酒依赖组N200波幅降低(P<0.001)、潜伏期延长(P=0.004),组别主效应均有统计学意义(P<0.01)。酒依赖组中酒精线索图片在Fz(P<0.001)、Cz(P<0.001)、Pz(P=0.003)电极点的N200波幅均低于水果图片。与对照组比较,酒依赖组的酒精线索图片P300波幅增高(P=0.009)、潜伏期延长(P=0.004),而水果图片P300波幅、潜伏期的组间差异均无统计学意义(P>0.05)。酒依赖组中酒精线索图片和水果图片P300波幅的差异无统计学意义(P>0.05)。酒依赖组酒精线索图片N200波幅(负值)与PACS评分正相关(r=0.552,P=0.012),P300波幅与VAS(r=0.630,P=0.003)、PACS(r=0.677,P=0.001)评分正相关。结论酒精视觉线索诱发ERPs能客观反映渴求相关心理活动,表现为冲突监测和决策执行受损,结合主观、客观指标检测有助于判断AD临床疗效及预测疾病复发。

Objective To investigate the event-related potentials(ERPs)responses to different visual cues and their correlations with alcohol craving in patients with alcohol dependence(AD).Methods Twenty male inpatients with AD were selected as alcohol-dependent group,and 18 healthy men as control group.An ERP visual Oddball paradigm containing alcohol cues,was conducted in both groups.Visual Analogue Scale(VAS)and Penn Alcohol Craving Scale(PACS)were used for subjective craving assessment.Results Compared with control group,the alcohol-dependent group showed significantly lower N200 amplitude(P<0.001)and longer N200 latency(P=0.004).In alcohol-dependent group,the amplitude of N200 evoked by alcohol cues was significantly lower than that of fruits in Fz(P<0.001),Cz(P<0.001)and Pz(P=0.003).Compared with control group,the alcohol-dependent group showed significantly higher P300 amplitude(P=0.009)and longer P300 latency(P=0.004)when viewing alcohol cues images,while there were no significant differences in P300 amplitude or latency when viewing fruits images(P>0.05).In alcohol-dependent group,there was no significant difference in the amplitude of P300 evoked by alcohol cues compared with fruits(P>0.05).In alcohol-dependent group,the amplitude of N200(negative value)evoked by alcohol cues was positively correlated with PACS scores(r=0.552,P=0.012),and the P300 amplitude was positively correlated with VAS(r=0.630,P=0.003)and PACS(r=0.677,P=0.001)scores.Conclusions ERPs evoked by visual alcohol cues can objectively assess craving-related psychological activities as manifested by impaired conflict monitoring and decision-making response.The combination of subjective and objective indicators can be helpful to evaluate the curative effect and predict the recurrence of AD.