fMRI观察强制戒断对海洛因成瘾者渴求任务下大型脑网络的影响

目的 探讨强制戒断对海洛因成瘾者毒品线索任务下心理渴求及脑网络功能的影响。方法 对37例强制戒断的海洛因成瘾者（强制戒断组）和32名正常志愿者（对照组）先行静息态及渴求任务fMRI数据采集，并进行心理渴求量化评分。对静息态fMRI数据进行分析获取任务负相关网络（TNN）和任务正相关网络（TPN）。对任务态fMRI数据进行建模，与对照组比较，获得强制戒断组TNN和TPN中异常激活的脑区，并分析其与心理行为学的相关性。结果 强制戒断组任务线索图片呈现前后渴求评分均显著高于对照组（P均<0.01）。渴求任务下，与对照组比较，强制戒断组在TNN中右侧海马旁回显著激活，TPN中显著性增强的网络包括视觉空间网络（双侧中央前回、额下回）和感觉运动网络（左侧中央后回）。强制戒断组双侧额下回激活强度与吸食海洛因时间呈负相关（右侧：r=－0.37，P=0.02；左侧：r=－0.41，P=0.01）。结论 强制戒断的海洛因成瘾者主观渴求依然增高，多个大型脑网络异常功能尚未完全恢复，可能是导致复吸的神经病理学基础。

fMRI observation on impact of protracted abstinence on large brain networks in heroin addicts on craving tasks

Objective To investigate the impact of protracted abstinence on heroin addicts'' psychological craving and brain network function under drug cue task. Methods Totally 37 heroin addicts (protracted abstinence group) and 32 matched normal volunteers (control group) were recruited. Resting state and craving task fMRI data were acquired, and the psychological craving quantitative scoring was evaluated. Resting fMRI data were analyzed to obtain task negative correlation networks (TNN) and task positive correlation networks (TPN). After modeling task-state fMRI data and comparing with the control group, the abnormal activated brain areas in TNN and TPN in the protracted abstinence group were obtained, and the correlation with psychologic behavior was analyzed. Results The craving scores of the protracted abstinence group were significantly higher than those of control group before and after the presentation of task cues (all P<0.01). Under the craving task, compared with control group, the right para-hippocampal gyrus was significantly activated in the protracted abstinence group in TNN, and the significantly enhanced networks in TPN included visual spatial network (bilateral anterior central gyrus and inferior frontal gyrus) and sensorimotor network (left posterior central gyrus). The activation intensity of bilateral inferior frontal gyrus in protracted abstinence group was negatively correlated with the duration of heroin use (right:r=-0.37, P=0.02; left:r=-0.41, P=0.01). Conclusion The subjective craving of heroin addicts who are forced to quit is still increased, and the abnormal function of multiple large brain networks has not completely recovered, which may be the neuropathological basis of relapse.