【摘要】：目的 伏隔核是人類獎賞系統(tǒng)的重要結構，它參與人類的自然獎賞行為和藥物獎賞行為，研究表明，伏隔核還可能參與了獎賞行為中的渴求處理過程，本研究通過觀察分析探討了伏隔核缺失的海洛因成癮者，在完成藥物線索誘導的渴求任務時大腦的反應及其與主觀渴求程度之間變化的關系，探討伏隔核缺失對人類渴求處理過程的影響，研究伏隔核缺失的海洛因成癮者在完成藥物線索誘導渴求任務時大腦反應及其與主觀渴求程度變化的關系。 方法 10例伏隔核缺失的男性海洛因成癮者(平均年齡33.8±6.6歲，受教育程度12±3年，，日吸毒量0.4~1g)和10例人口學及吸毒史相匹配的海洛因成癮者(平均年齡30.7±5.5歲，受教育程度10.5±2.7年，日吸毒量0.4~1g)納入該實驗。研究對象接受圖片藥物線索誘導渴求的fMRI掃描。采集到的數據由SPM5軟件進行分析。在完成圖片藥物線索誘導渴求任務的前后對被試者進行海洛因渴求程度評分，以獲得被試者主觀渴求的變化。 結果 1)暴露于圖片藥物線索之前，海洛因成癮組平均渴求為（3.10±2.51），暴露于圖片藥物線索之后，海洛因成癮組平均渴求為（4.40±3.36）。前后比較有明顯的統(tǒng)計學差異（t4.713p0.019）。 2)呈現的藥物相關圖片成功激發(fā)了成癮者的渴求，其被藥物線索激活的腦區(qū)包括海馬、尾狀核，額下回、顳中回、顳下回、枕中回、頂下小葉（p0.001Voxel≥5）。 3)伏隔核缺失組暴露于藥物圖片線索前后其渴求均為0，無統(tǒng)計學差異（p0.05）。 4)被藥物線索激活的腦區(qū)包括海馬，顳中回、顳下回、頂下小葉、枕中回（p0.001Voxel≥5）。 5)伏隔核缺失組與海洛因成癮組暴露于圖片藥物線索下倆組相比伏隔核活動減弱，楔前葉和舌回活動增強。 結論 伏隔核在海洛因成癮者大腦對藥物線索誘導渴求的過程中可能起重要作用。
[Abstract]:Objective Nucleus accumbens is an important structure of human reward system, which is involved in human natural reward behavior and drug reward behavior. Studies have shown that nucleus accumbens may also be involved in the craving process of reward behavior. In this study, we investigated the relationship between brain response and subjective craving degree in heroin addicts with nucleus accumbens deletion during drug-induced craving tasks. To investigate the effect of nucleus accumbens deletion on craving process in human, and to study the relationship between brain response and subjective craving degree in heroin addicts with nucleus accumbens deletion during drug cue-induced craving task. Methods Ten male heroin addicts with nucleus accumbens absence (mean age 33.8 鹵6.6 years, education level 12 鹵3 years) were enrolled in this study. 10 heroin addicts (mean age 30.7 鹵5.5 years, education level 10.5 鹵2.7 years, daily dose of drug use 0.4 g) matched with demography and history of drug use were included in the experiment. Subjects received fMRI scans for craving induced by pictorial drug cues. The collected data were analyzed by SPM5 software. Before and after completing the drug cue-induced craving task, the subjects were assessed with heroin craving degree to obtain the change of subjective craving. Results 1) before exposure to picture drug clues, the average craving was (3.10 鹵2.51) in heroin addiction group, and (4.40 鹵3.36) in heroin addiction group after exposure to picture drug clue. There was a significant statistical difference (t4.713p0.019) between before and after. 2) the drug-related images successfully stimulated the craving of drug addicts. The brain areas activated by drug clues included hippocampus, caudate nucleus, inferior frontal gyrus, middle temporal gyrus, inferior temporal gyrus, middle occipital gyrus and inferior parietal lobule (p0.001Voxel 鈮

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