甲基苯丙胺成瘾患者局部一致性及镜像同伦功能连接研究

Alterations of regional homogeneity and interhemispheric voxel-mirrored homotopic connectivity in patients with methamphetamine dependence

目的探讨甲基苯丙胺(MA)成瘾患者与健康人之间静息态局部脑区神经自发活动以及两侧半球对称体素间功能连接的差异。方法选择自2014年2月至2019年10月于宁波市康宁医院首次接受戒毒治疗的46例MA成瘾患者进入MA成瘾组, 同期招募与MA成瘾组年龄、性别、受教育程度相匹配的46例健康志愿者为健康对照组。采集2组受试静息态功能磁共振成像(rs-fMRI)数据, 应用局部一致性(ReHo)与镜像同伦功能连接(VMHC)的分析方法, 分别从动态(d-ReHo、d-VMHC)、静态(ReHo、VMHC)两个角度评估MA成瘾患者的静息态局部脑区神经自发活动以及两侧半球对称体素间功能连接的改变, 并将组间差异脑区检测值与简明精神病评定量表(BPRS)评分等进行相关性分析。结果与健康对照组比较, MA成瘾组左侧内侧眶额皮层(mOFC)ReHo值显著减低, 左侧mOFC、左侧额中回、双侧额下回、左侧中央前回及左侧中央后回d-ReHo值显著升高, 差异均有统计学意义(P<0.05)。与健康对照组相比, MA成瘾组双侧mOFC、中央前回以及中央后回VMHC值显著减低, 差异有统计学意义(P<0.05)。此外, MA成瘾组显著差异脑区ReHo值、d-ReHo值、VMHC值与BPRS量表总分、各项因子分以及服用MA总剂量(去除离群值后)之间均不存在相关性(P>0.05)。结论静息状态下, MA成瘾患者局部脑区(尤其是mOFC)神经自发活动协同性、稳定性以及半球间活动的协同性均出现显著异常;左侧mOFC异常的ReHo值、d-ReHo值以及VMHC值可能是MA成瘾重要的影像学标记物。

Objective To investigate the differences of spontaneous neural activity and functional connectivity between bilateral symmetrical voxels in the local brain regions at resting-state of methamphetamine(MA)dependent patients and healthy controls(HCs).Methods Forty-six MA-dependent patients,admitted to and received drug rehabilitation treatment for the first time in our hospital from February 2014 to October 2019,and 46 HCs matched with age,gender and education level during the same period were enrolled in this study.The resting state functional magnetic resonance imaging(rs-fMRI)data of these subjects were collected;the static and dynamic regional homogeneity(ReHo,d-ReHo)and static and dynamic voxel-mirrored homotopic connectivity(VMHC,d-VMHC)were used to evaluate MA-related alterations of brain spontaneous activity and interhemispheric functional connectivity.The correlations of brief psychiatric rating scale(BPRS)scores with above values in the brain regions with significant inter-group differences were analyzed.Results As compared with the HCs,the MA-dependent patients had significantly decreased ReHo in the left medial orbitofrontal cortex(mOFC),and significantly increased d-ReHo in the left mOFC,left middle frontal gyrus,bilateral inferior frontal gyrus,left precentral gyrus and left postcentral gyrus(P<0.05).As compared with the HCs,the MA-dependent patients had significantly decreased VMHC in the bilateral mOFC,precentral gyrus and postcentral gyrus(P<0.05).The ReHo,VMHC,d-ReHo,and d-VMHC were not significantly correlated with total scores and each factor scores of BPRS,and total dose of MA(after removing outliers)in MA-dependent patients(P>0.05).Conclusion During resting state,MA-dependent patients show obvious abnormalities in the coordination and stability of spontaneous neural activity and the coordination of interhemispheric activity in local brain regions,especially in the mOFC;abnormal ReHo,d-ReHo and VMHC in left mOFC may be important neuroimaging biomarkers for MA-dependence.