Wang G J, Volkow N D, Fowler J S, Cervany P, Hitzemann R J, Pappas N R, Wong C T, Felder C
Medical Department, Brookhaven National Laboratory, Upton, NY 11973, USA.
Life Sci. 1999;64(9):775-84. doi: 10.1016/s0024-3205(98)00619-5.
Cocaine cues elicit craving and physiological responses. The cerebral circuits involved in these are poorly understood. The purpose of this study was to assess the relation between regional brain activation and cocaine cue elicited responses. Thirteen right-handed cocaine abusers were scanned with positron emission tomography (PET) and [F-18] fluorodeoxyglucose (FDG) twice; during an interactive interview about neutral themes and during an interactive interview about cocaine themes designed to elicit cocaine craving. In parallel the behavioral (rated from 0: felt nothing to 10: felt extreme) and cardiovascular responses were recorded. During the cocaine theme interview subjects reported higher self reports for cocaine craving (+2.5+/-3.3, p < or = 0.02) and had higher heart rates (+4.7+/-7.2%, p < or = 0.001), systolic (+4+/-4%, p < or = 0.0001), and diastolic blood pressures (+2.6+/-3.8%, p < or = 0.003) than during the neutral interview. Absolute and relative metabolic values in the orbitofrontal (+16.4+/-17.1%, p < or = 0.005; +11.3+/-14.3%, p < or = 0.008) and left insular cortex (+21.6+/-19.6%, p < or = 0.002; +16.7+/-19.7%, p < or = 0.01) and relative values in cerebellum (+17.9+/-14.8%, p < or = 0.0008) were higher during the cocaine theme than during the neutral theme interview. Relative metabolic values in the right insular region (p < or = 0.0008) were significantly correlated with self reports of cocaine craving. Activation of the temporal insula, a brain region involved with autonomic control, and of the orbitofrontal cortex, a brain region involved with expectancy and reinforcing salience of stimuli, during the cocaine theme support their involvement with craving in cocaine addicted subjects.
可卡因线索会引发渴望和生理反应。但人们对参与其中的大脑回路知之甚少。本研究的目的是评估大脑区域激活与可卡因线索引发的反应之间的关系。对13名右利手可卡因滥用者进行了两次正电子发射断层扫描（PET）和[F - 18]氟脱氧葡萄糖（FDG）扫描；一次是在关于中性主题的互动访谈期间，另一次是在关于可卡因主题的互动访谈期间，该访谈旨在引发可卡因渴望。同时记录行为（评分从0：无感觉至10：感觉极度）和心血管反应。在可卡因主题访谈期间，受试者报告的可卡因渴望自我评分更高（+2.5±3.3，p≤0.02），心率更高（+4.7±7.2%，p≤0.001），收缩压更高（+4±4%，p≤0.0001），舒张压更高（+2.6±3.8%，p≤0.003），均高于中性访谈期间。与中性主题访谈相比，在可卡因主题访谈期间，眶额皮质的绝对和相对代谢值（分别为+16.4±17.1%，p≤0.005；+11.3±14.3%，p≤0.008）、左侧岛叶皮质的绝对和相对代谢值（分别为+21.6±19.6%，p≤0.002；+16.7±19.7%，p≤0.01）以及小脑的相对代谢值（+17.9±14.8%，p≤0.0008）更高。右侧岛叶区域的相对代谢值（p≤0.0008）与可卡因渴望的自我报告显著相关。在可卡因主题访谈期间，参与自主控制的颞叶岛叶和参与预期及强化刺激显著性的眶额皮质的激活，支持了它们在可卡因成瘾者渴望中的作用。
