不同程度尼古丁依赖者脑沟深度和脑回指数改变的脑形态学研究

Morphological study on the changes of sulci depth and gyral index in patients with different degrees of nicotine dependence

目的 探讨不同程度尼古丁依赖者脑沟深度和脑回指数改变的影像形态学变化。方法 选取2017年1月至2020年1月在南京医科大学附属无锡精神卫生中心就诊的尼古丁依赖者41例,其中轻度尼古丁依赖组21例,中重度尼古丁依赖组20例,同时招募无尼古丁依赖的健康者41名作为健康对照组。比较三组法氏尼古丁依赖测试(FTND)、汉密尔顿抑郁量表-17(HAMD-17)及汉密尔顿焦虑量表(HAMA)评分,采用3T磁共振成像获取脑结构像数据,并运用基于表面的形态学测量(SBM)方法分析三组、脑沟深度和脑回指数的差异,进一步分析轻、中重度尼古丁依赖组脑沟深度及脑回指数与临床症状的相关性。结果 轻、中重度尼古丁依赖组FTND评分高于健康对照组,中重度尼古丁依赖组高于轻度尼古丁依赖组(P<0.05)。轻、中重度尼古丁依赖组HAMD-17评分高于健康对照组,中重度尼古丁依赖组低于轻度尼古丁依赖组(P<0.05)。轻度尼古丁依赖组HAMA评分高于健康对照组、中重度尼古丁依赖组(P<0.05)。中重度尼古丁依赖组左后扣带回脑沟深度值低于健康对照组(P<0.05)。中重度尼古丁依赖组左顶下缘角回脑回指数低于轻度尼古丁依赖组(P<0.05)。中重度尼古丁依赖组左舌回脑回指数与FTND评分呈正相关(rs>0,P<0.05)。结论 中重度尼古丁依赖者局部脑区脑沟深度减少、脑回指数减少,尼古丁依赖程度与左舌回形态学变化相关。

Objective To investigate the morphological changes of sulci depth and gyral index in patients with different degrees of nicotine dependence.Methods A total of 41 nicotine dependent patients were selected from Wuxi Mental Health Center Affiliated to Nanjing Medical University from January 2017 to January 2020,including 21 cases in the mild nicotine dependent group and 20 cases in the moderate and severe nicotine dependent group.Meanwhile,41 healthy people without nicotine dependence were recruited as the healthy control group.The scores of Fagerström test for nicotine dependence(FTND),Hamilton depression scale-17(HAMD-17),and Hamilton anxiety scale(HAMA)were compared among the three groups.The brain structure image data were obtained by 3T magnetic resonance imaging,and the differences of diencephalic sulci depth and gyral index among the three groups were analyzed by surf-based morphological measurement(SBM).The correlation between sulci depth and gyral index,and clinical symptoms in mild and moderate to severe nicotine dependent groups was further analyzed.Results FTND scores in mild and moderate to severe nicotine dependent groups were higher than those in healthy control group,and those in moderate to severe nicotine dependent group were higher than those in mild nicotine dependent group(P<0.05).The HAMD-17 scores of mild and moderate to severe nicotine dependent groups were higher than those of healthy control group,and those of moderate to severe nicotine dependent group were lower than those of mild nicotine dependent group(P<0.05).The HAMA scores of mild nicotine dependent group were higher than those of healthy control group and moderate to severe nicotine dependent group(P<0.05).The sulci depth of left posterior cingulate cortex in moderate to severe nicotine dependent group was lower than that in healthy control group(P<0.05).The gyral index of left inferior parietal marginal angular gyral in moderate to severe nicotine dependent group was lower than that in mild nicotine dependent group(P<0.05).There was a positive correlation between gyral index of left lingual gyrus and FTND score in moderate to severe nicotine dependent group(rs>0,P<0.05).Conclusion The sulci depth and the gyral index are decreased in moderate to severe nicotine dependence.The degree of nicotine dependence is related to the morphological changes of the left lingual gyrus.