本文選題：海洛因 + 功能連接�。� 參考：《第四軍醫(yī)大學(xué)》2015年碩士論文

【摘要】：目的探討單純海洛因成癮者(heroin addicts,HA)大腦獎賞環(huán)路伏隔核(Naccumbens nucleus,Nacc)功能連接特點及其在成癮中的作用。進(jìn)一步探討長期美沙酮治療的海洛因成癮者(methadone maintenance treatment,MMT)Nacc功能連接的變化,明確MMT對成癮者渴求影響的潛在神經(jīng)機(jī)制。方法實驗一:采集26例單純海洛因成癮者(HA組)和25例人口學(xué)特征相匹配的健康被試(對照組)靜息態(tài)功能磁共振(functional Magnetic Resonance Imaging,f MRI)數(shù)據(jù),以雙側(cè)Nacc為ROI,與全腦其他所有體素的時間序列做相關(guān)分析,使用兩樣本t檢驗比較兩組間功能連接的差異;將HA組功能連接強(qiáng)度值與海洛因使用總時間及總劑量做偏相關(guān)分析。實驗二:37例MMT海洛因成癮者(MMT組)和25例人口學(xué)特征、海洛因使用情況相匹配的單純海洛因成癮者(HA組)進(jìn)行藥物渴求程度評分和f MRI靜息態(tài)掃描。以雙側(cè)Nacc為種子點,使用兩樣本t檢驗做組間分析。將組間差異區(qū)內(nèi)MMT組功能連接強(qiáng)度值與美沙酮使用時間及劑量做偏相關(guān)分析。結(jié)果實驗一:與對照組相比,HA組與右側(cè)Nacc功能連接增強(qiáng)的腦區(qū)包括雙側(cè)距狀回、左枕中回,未發(fā)現(xiàn)減低的腦區(qū);與左側(cè)Nacc功能連接增強(qiáng)的腦區(qū)包括左梭狀回和右楔前葉,減弱的腦區(qū)包括左背內(nèi)、外側(cè)前額葉、雙背側(cè)前扣帶;HA組功能連接強(qiáng)度值與海洛因使用時間、劑量之間無相關(guān)性(P值0.05)。實驗二:與HA組相比,MMT組右側(cè)Nacc與左背內(nèi)、外側(cè)前額葉、右背側(cè)前扣帶功能連接增強(qiáng),與右內(nèi)側(cè)眶額回功能連接減弱;左側(cè)Nacc與左背內(nèi)、外側(cè)前額葉、右背外側(cè)前額葉、右背側(cè)前扣帶、左側(cè)島葉功能連接增強(qiáng),未發(fā)現(xiàn)功能連接減低的腦區(qū);MMT組主觀渴求評分顯著小于HA組(t=-2.03,P0.05)。MMT組存在顯著差異腦區(qū)的功能連接強(qiáng)度值與美沙酮使用時間及劑量無明顯相關(guān)性(P0.05)。結(jié)論海洛因成癮可能與獎賞環(huán)路關(guān)鍵腦區(qū)Nacc和認(rèn)知控制及視覺空間注意力相關(guān)腦區(qū)的相互作用異常有關(guān)。MMT可能通過認(rèn)知控制環(huán)路與動機(jī)驅(qū)動環(huán)路的共同作用來影響?yīng)勝p環(huán)路Nacc的功能,從而降低海洛因成癮者的毒品渴求。
[Abstract]:Objective to investigate the functional connections of Naccumbens nucleusus Nacca in the brain reward loop of heroin addicts and its role in addiction. To further explore the changes of methadone maintenance treatment in heroin addicts treated with methadone for a long period of time, and to clarify the potential neural mechanism of the effect of MMT on craving of heroin addicts. Methods: in experiment 1, 26 heroin addicts (HA group) and 25 healthy subjects (control group) with matched demographic characteristics were collected data of resting functional Magnetic Resonance imagingf MRIs. Using bilateral Nacc as roi, correlation analysis was made with time series of all other voxels in the whole brain, and the difference of functional connection between the two groups was compared by using two samples t test, and partial correlation analysis was made between the intensity of functional connection of HA group and the total time and dose of heroin use. The drug craving scores and f MRI resting state scanning were performed in experiment 2: 37 cases of MMT heroin addicts (n = 37) and 25 cases of demographic characteristics of heroin addicts (n = 25). The drug craving degree and the rest state of f MRI were evaluated in simple heroin addicts with matched heroin use. Using bilateral Nacc as seed point, two samples t test was used for inter-group analysis. The partial correlation analysis was made between the MMT group and the time and dose of methadone use. Results: compared with the control group, the areas with enhanced right Nacc functional junctions in HA group included bilateral talus gyrus, left middle occipital gyrus, no decreased brain area, and left fusiform gyrus and right anterior wedge lobe. The attenuated brain regions included left dorsalis, lateral prefrontal lobe, bilateral dorsal anterior cingulate band HA group. There was no correlation between the intensity of functional connection and the time of heroin use, and there was no correlation between the dose and the dose (P = 0.05). Experiment 2: compared with HA group, the functional connections of right Nacc and left dorsalis, lateral prefrontal lobe, right dorsolateral anterior cingulate band were enhanced, and the functional connections with right medial orbital frontal gyrus were weakened, while left Nacc was associated with left dorsolateral, lateral prefrontal lobe, right dorsolateral prefrontal lobe, left Nacc and left dorsolateral frontal lobe. Right dorsal anterior cingulate band, left islet functional connection enhanced, The score of subjective craving in the MMT group was significantly lower than that in the HA group (P < 0.05). There was no significant correlation between the functional connection strength and the time and dose of methadone use. Conclusion heroin addiction may be related to the abnormal interaction between Nacc and cognitive control and visual spatial attention related brain regions in the critical brain region of the reward loop. MMT may be influenced by the interaction between the cognitive control loop and the motivation-driven loop. The function of the reward loop Nacc, In order to reduce heroin addicts drug craving.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R445.2;R749.64

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本文編號：1824632