海洛因依赖者前额叶皮质及杏仁核1H-MR波谱研究

目的 探讨海洛因依赖(HD)患者前额叶皮质及杏仁核1H-MRS特征,以及与吸食海洛因累计总量的关系.方法 选择14例HD患者(HD组)和12名健康志愿者(HC组)行前额叶皮质及双侧杏仁核1H-MRS检查,测量两组前额叶皮质区及双侧杏仁核N-乙酰天冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)值,并采用独立样本t检验进行比较.对HD患者吸食海洛因累计总量(852±341)g]与前额叶皮质及左、右侧杏仁核区NAA/Cr作直线相关分析.结果 与HC组相比,HD组的前额叶皮质、左侧杏仁核及右侧杏仁核NAA/Cr比值降低,分别为1.44±0.46、1.32±0.08、1.34±0.09,HC组分别为1.50±0.75、1.42±0.08、1.44±0.10,2组间差异有统计学意义(t值分别为1.77、3.41、2.63,JP值均<0.05);HD组前额叶皮质、左侧杏仁核及右侧杏仁核Cho/Cr分别为0.92±0.06、1.20±0.12、1.26±0.15,对照组分别为0.86±0.08、1.07±0.04、1.12±0.11,2组差异有统计学意义(t值分别为2.31、3.60、2.60,P值均<0.05).前额叶皮质、左侧杏仁核及右侧杏仁核代谢物NAA/Cr与海洛因累计吸食总量呈负相关性(r值分别为-0.9159、-0.8756、-0.9399,P值均<0.01).结论 1H-MRS能显示前额叶皮质及杏仁核的神经元受损及神经胶质增生,从该区代谢物的改变反映出HD患者执行及情感功能的异常,其代谢物改变程度与海洛因累计吸食总量有关.

A study of 1H-MR spectroscopy in the prefrontal cortex and amygdala of heroine abusers

Objective To explore the characteristic findings of 1H-MR spectroscopy(1H-MRS) in the prefrontal cortex and amygdala of patients with heroine dependence(HD), and the relationship to total cumulative dose of inhaled heroine.Methods Fourteen male HD patients and 12 healthy controls (HC) underwent 1H-MRS at the prefrontal cortex and amygdala regions.The total cumulative in haled heroin dose was (852±341) g in HD.Ratios of N-acetylaspartate/creatine(NAA/Cr) and choline/creatine (Cho/Cr) were respectively measured in the prefrontal cortex and bilateral amygdale regions.The student's t test and the linear correlation were employed for statistical analysis.Results Compared to HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, t=1.77 ,P <0.05), left amygdala region (1.32±0.08 vs 1.42±0.08, t=3.41, P < 0.05), and right amygdala region (1.34±0.09 vs 1.44±0.10, t=2.63, P <0.05), the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, t=2.31, P < 0.05), left amygdala region (1.20+0.12 vs 1.07±0.04, t=3.60,P<0.05) and right amygdala region(1.26±0.15 vs 1.12±0.11,t=2.60,P <0.05).There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NKA/Cr in the prefrontal cortex (r=-0.9159, P < 0.01), left amygdala region (r=-0.8756, P < 0.01), and right amygdala region (r=-0.9399, P < 0.01) respectively.Conclusions The study indicates that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdala region, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exists between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.