美沙酮维持治疗开始时海洛因依赖者的脑磷代谢物及横向弛豫时间异常

Cerebral phosphorus metabolite and transverse relaxation time abnormalities in heroin-dependent subjects at onset of methadone maintenance treatment.

作者信息

Silveri Marisa M, Pollack Mark H, Diaz Claudia I, Nassar Leanne E, Mendelson Jack H, Yurgelun-Todd Deborah A, Renshaw Perry F, Kaufman Marc J

机构信息

Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.

出版信息

Psychiatry Res. 2004 Sep 15;131(3):217-26. doi: 10.1016/j.pscychresns.2004.05.003.

DOI:10.1016/j.pscychresns.2004.05.003

PMID:15465291

Abstract

Cerebral bioenergetic and phospholipid abnormalities have been reported in heroin-dependent subjects. The goal of the present study was to characterize the neurochemical profile of subjects voluntarily enrolled in a methadone maintenance (MM) treatment program to overcome their heroin addiction. Participants included 43 heroin-dependent subjects during their first month of MM and 15 age-matched healthy individuals. Phosphorus magnetic resonance spectroscopy ((31)P MRS) and transverse relaxation times (T2-RT), which can reflect steady state cerebral perfusion and metabolism, were acquired at 1.5 T from an axial slice prescribed through the orbitofrontal and occipital cortices, including basal ganglia and frontal cortex. MM subjects exhibited reduced phosphocreatine (PCr) levels (-15.3%), elevated phosphodiesters (+ 12.9%, PDE) and significantly longer T2-RT ((+) 2.1%) compared with healthy comparison subjects. When MM subjects were stratified into subgroups based on treatment duration, we found a treatment duration effect on metabolite values but not T2-RT; reduced PCr was observed only after 8+ days of MM, and phosphomonoesters (PME) were elevated in the 15-28 day MM group. Taken together, these cross-sectional data suggest that the first month of MM treatment may be associated with altered cerebral bioenergetics and phospholipid metabolite levels.

摘要

据报道，海洛因依赖者存在脑生物能量和磷脂异常。本研究的目的是描述自愿参加美沙酮维持（MM）治疗项目以克服海洛因成瘾的受试者的神经化学特征。参与者包括43名处于MM治疗第一个月的海洛因依赖者和15名年龄匹配的健康个体。在1.5T磁场下，从一个穿过眶额皮质和枕叶皮质（包括基底神经节和额叶皮质）的轴向切片获取可反映脑稳态灌注和代谢的磷磁共振波谱（(31)P MRS）和横向弛豫时间（T2-RT）。与健康对照受试者相比，MM受试者的磷酸肌酸（PCr）水平降低（-15.3%），磷酸二酯升高（+12.9%，PDE），T2-RT显著延长（(+)2.1%）。当根据治疗持续时间将MM受试者分层为亚组时，我们发现治疗持续时间对代谢物值有影响，但对T2-RT没有影响；仅在MM治疗8天以上后观察到PCr降低，在MM治疗15 - 28天组中磷酸单酯（PME）升高。综上所述，这些横断面数据表明，MM治疗的第一个月可能与脑生物能量和磷脂代谢物水平的改变有关。