MRI扩散张量成像在评估短期戒断甲基苯丙胺成瘾者脑白质改变中的价值

The value of MR diffusion tensor imaging in assessing white matter changes in short-term methamphetamine withdrawal

目的探讨MRI扩散张量成像(DTI)在短期戒断甲基苯丙胺(MA)成瘾者脑白质改变中的价值。方法自2017年8月至2018年12月招募55例短期戒断MA成瘾者,男40例,女15例,年龄14~45(37.24±7.31)岁,均来自湖南省长沙市、株洲市和岳阳市强制戒毒所;同期招募52名健康对照者,男40名,女12名,年龄18~59(40.3±9.1)岁。收集受试者的DTI数据、人口统计学特征、成瘾一般信息及冲动性量表第十一版评分(BIS-11)。采用基于纤维束的空间统计分析技术(TBSS)比较两组间DTI指标的差异,然后将差异有统计学意义的指标与首次使用MA的年龄、使用MA时间、每天使用的剂量、BIS-11总分及3个子量表评分进行相关性分析。结果MA组和健康对照组BIS-11总分、BIS动机冲动及BIS注意冲动得分差异具有统计学意义(均P<0.05)。与对照组相比,MA组各向异性分数(FA)(0.58±0.02比0.56±0.02,0.77±0.02比0.75±0.04,0.79±0.04比0.76±0.06;均P<0.05)、轴向扩散系数(AD)(0.57±0.01比0.56±0.02,P=0.001)及平均扩散系数(MD)(0.66±0.02比0.65±0.02,0.52±0.07比0.51±0.06,均P<0.05)值均升高,而两组间径向扩散系数(RD)值差异无统计学意义(P>0.05)。FA值升高的白质区域位于胼胝体膝部及体部、双侧放射冠前部及左侧放射冠上部,AD值升高的区域位于胼胝体膝部、体部、压部,双侧内囊前肢、内囊后肢、放射冠前部,放射冠上部、放射冠后部、外囊及上纵束,MD值升高的区域主要位于右侧上纵束、内囊前肢和内囊后肢,且胼胝体体部的FA值与每天使用MA的剂量呈正相关(r=0.301,P=0.026)。结论短期戒断的MA成瘾者存在白质纤维水肿及损伤,并且胼胝体体部损伤程度与每天使用MA剂量呈正相关。

Objective To explore the value of MRI diffusion tensor imaging(DTI)in the white matter changes of short-term methamphetamine(MA)abstinence.Methods The data of DTI,demographics features,general information of addiction and impulsivity scale eleven(BIS-11)of 55 short-term MA addicts who were from Changsha,Zhuzhou and Yueyang compulsory detoxification centers in Hunan province,including 40 males and 15 females,aged 14-45(37.24±7.31)years old,and 52 healthy controls,including 40 males and 12 females aged 18-59(40.3±9.1)years were collected prospectively from August 2017 to December 2018.The differences of DTI indicators between the two groups were compared by tract-based spatial statistics(TBSS),and then the correlation between the different indicators and the age of first MA use,time of MA use,daily dose used,BIS-11 score were performed.Results There were significant differences in BIS total score(P<0.001),BIS motivational impulsivity(P<0.001)and BIS attentional impulsivity(P=0.003)between MA group and healthy control group in short-term withdrawal.And compared with the healthy control group,the fractional anisotropy(FA)(0.58±0.02 vs 0.56±0.02,0.77±0.02 vs 0.75±0.04,0.79±0.04 vs 0.76±0.06;all P<0.05),axial diffusivity(AD)(0.57±0.01 vs 0.56±0.02,P=0.001)and mean diffusivity(MD)(0.66±0.02 vs 0.65±0.02,0.52±0.07 vs 0.51±0.06;both P<0.05)values in the MA group were all increased(P<0.05),but there was no significant difference in the radial diffusivity(RD)value(P>0.05).The white matter areas with increased FA value were located in the knee and body of corpus callosum,bilateral anterior corona radiata and left superior corona radiata;the areas with increased AD value were located in the knee,body and pressure of corpus callosum,bilateral anterior limb of internal capsule,posterior limb of internal capsule,anterior,superior and posterior corona radiata,external capsule and superior longitudinal fasciculus;and the areas with increased MD value were mainly located in the right superior longitudinal fasciculus,anterior and posterior limb of internal capsule.The corpus callosum,where there was a difference in FA between the two groups,was positively correlated with the daily dose of MA(r=0.301,P=0.026).Conclusion MA addicted individuals with short-term withdrawal have white matter edema and damage,and the degree of corpus callosum damage is positively correlated with the daily dose of MA,which is helpful to understand the pathophysiological process of white matter damage in the nervous system and the potential mechanism of neuropsychiatric symptoms in short-term withdrawal MA addicted individuals.