立体定向伏隔核射频毁损对吸毒者尼古丁依赖的影响

目的:研究立体定向射频毁损双侧伏隔核对吸毒者尼古丁依赖的影响. 方法:对接受立体定向双侧伏隔核毁损术的42例阿片类物质伴尼古丁依赖志愿者进行随访,用尼古丁依赖自评量表(Fagerstrom Test for Nicotine Dependence)对术后不同时期志愿者的尼古丁依赖程度进行评分,研究吸毒者立体定向双侧伏隔核毁损术前后尼古丁依赖程度变化,分析伏隔核在尼古丁成瘾机制中的作用. 结果:术后志愿者阿片类物质复吸率明显降低,1 a复吸率为54.8%,尼古丁依赖程度术前吸毒时和术前脱毒治疗时无明显差异,术后尼古丁依赖程度为:术后2 wk<术后3 mo<术后6 mo,术后6 mo与术后1 a无明显差异,但仍远低于术前脱毒治疗时的水平. 结论:针对阿片类物质成瘾的吸毒者实施的立体定向双侧伏隔核毁损术不但可明显降低吸毒者阿片类物质依赖程度,而且对尼古丁依赖也有明显的抑制作用.

Influence of stereotactic lesions of nucleus accumbens on thenicotine and opioid dependency

AIM: To study the influence of stereotactic lesions of bilateral nucleus accumbens(NAc)on the nicotine and opioid dependency. METHODS: Forty-two opioid and nicotine-dependant volunteers who had underwent stereotactic lesions of bilateral nucleus accumbens were followed up and Fagerstrom test for nicotine dependence was used to grade the nicotine dependency of the volunteers in the different stages following the operation. Relapse rates of the volunteers were recorded and the changes in the opioid and nicotine dependency before and after stereotactic lesions of bilateral nucleus accumbens were explored to identify the function of the nucleus accumbens in opioid and nicotine habituation. RESULTS: The volunteers' relapse rates of opioid were remarkably decreased after operation. The one-year relapse rate of was 54.8% and nicotine dependency was markedly alleviated two weeks after operation but increased slightly 3-6 months after operation. One year after the operation, nicotine dependency was still significantly lower than that pre-operation. CONCLUSION: Stereotactic lesions of bilateral nucleus accumbens might greatly alleviate the opiord and nicotine dependency.