酒依赖患者脑N-乙酰天门冬氨酸和执行功能的相关性研究

目的 （1）探讨酒依赖是否能引起不同脑区代谢产物N-乙酰天门冬氨酸（NAA）水平改变和执行功能损害;（2）评估N-乙酰天门冬氨酸水平和执行功能之间的关系.方法 49例酒依赖组患者和45例对照组分别接受磁共振波谱检查（MRS）和威斯康星卡片分类测验（WCST）.结果 与对照组比较,酒依赖组患者前额叶灰质（1.59±0.13）和白质（1.58±0.12）区域N-乙酰天门冬氨酸/肌酸化合物（NAA/Cr）比值明显降低,执行功能[正确数（30.37±3.73）次,持续错误数（11.49±3.39）次,随机错误数（6.18±2.64）次,完成分类数（2.08±1.59）次]明显下降（P＜0.01）.酒依赖组患者前额叶白质的NAA/Cr水平与执行功能测验指标呈正相关（正确数r=0.379,完成分类数r=0.433,均P＜0.05）.结论 长期大量饮酒可以引起大脑神经元损伤和认知功能损害,脑代谢产物NAA/Cr水平改变可作为神经元损害程度的生物学指标.

Correlation study between brain N-acetylaspartate and executive function in alcoholics

Objective To investigate the changes of the N-acetylaspartate（NAA） concentrations in different brain regions and executive function skills in alcohol dependence,and to study the relationship between NAA levels and cognitive functions in subjects.Methods 49 male,non-smoking,alcohol-dependent patients and 45 healthy control subjects were measured with Proton 1H Magnetic resonance spectroscopy （MRS） and Wisconsin Card Sorting Test （WCST）.Results Alcoholics had lower NAA/Cr ratios in prefrontal grey matter（GM） （1.59± 0.13） and white matter（WM） （1.58±0.12） regions and performed poorly on executive function tests compared to controls （P＜0.001）.NAA/Cr in left prefrontal regions positively correlated with certain parameters of EF testing （number of correct responses 30.37± 3.73,perseverative errors 11.49± 3.39,random errors 6.18± 2.64,categories completed 2.08± 1.59）in alcoholic group （P＜0.01）.NAA/Cr in prefrontal WM regions correlated with certain parameters of EF testing in alcoholic group （number of correct responses r=0.379,categories completed r=0.433,P＜ 0.05）.Conclusion Long-term,chronic alcoholism will damage neuronal viability and cognitive functions,which suggests that NAA concentrations can reflect the extent of damage of cognitive functions with decreased levels reflecting neuronal loss.