Li Chiang-Shan Ray, Kosten Thomas R, Sinha Rajita
Department of Psychiatry, Yale University, New Haven, Connecticut 06519, USA.
Biol Psychiatry. 2005 Mar 1;57(5):487-94. doi: 10.1016/j.biopsych.2004.11.048.
Because stress mediates drug seeking and relapse, and sex differences have been observed in stress and in the development of cocaine addiction, in this study we used functional neuroimaging to examine the effect of sex on stress responses in abstinent cocaine users.
In a functional magnetic resonance imaging session, 17 male and 10 female cocaine-dependent subjects participated in script-guided imagery of neutral or stress situations. Subjects rated imagery vividness, anxiety, and cocaine craving for each trial. Brain activation during the stress and neutral imagery periods relative to their own baseline was examined in individual subjects. Sex contrast was obtained in second-level group analysis.
Female subjects demonstrated more activation, compared with male subjects, in left middle frontal, anterior cingulate, and inferior frontal cortices and insula, and right cingulate cortex during stress imagery. Region of interest analysis showed that the change of activity in left anterior cingulate and right posterior cingulate cortices both correlated inversely with the change of craving rating during stress imagery.
The greater left frontolimbic activity in women suggests that women might use more verbal coping strategies than do men while experiencing stress. The results also suggest a distinct role of the cingulate cortices in modulating stress-induced cocaine craving.
由于应激介导药物寻求和复发，且在应激及可卡因成瘾发展过程中已观察到性别差异，因此在本研究中，我们使用功能神经影像学来研究性别对戒断可卡因使用者应激反应的影响。
在一次功能磁共振成像实验中，17名男性和10名女性可卡因依赖受试者参与了中性或应激情境的脚本引导想象。受试者对每次实验的想象生动程度、焦虑程度及可卡因渴望程度进行评分。在个体受试者中，研究应激和中性想象期间相对于自身基线的脑激活情况。在二级组分析中获得性别对比结果。
与男性受试者相比，女性受试者在应激想象期间，左侧额中回、前扣带回、额下回皮质及脑岛，以及右侧扣带回皮质表现出更多激活。感兴趣区分析显示，左侧前扣带回和右侧后扣带回皮质的活动变化均与应激想象期间渴望评分的变化呈负相关。
女性左侧额边缘叶活动增强表明，女性在经历应激时可能比男性更多地使用言语应对策略。研究结果还表明，扣带回皮质在调节应激诱导的可卡因渴望中具有独特作用。
