He Fei, Guan Hao, Zhao Zhijing, Miao Xinfang, Zhou Qin, Li Lihong, Huang Dongmei, Liu Anheng, Miao Danmin
Department of Psychology, Faculty of Aerospace Medicine, Fourth Military Medical University, Xi'an, Shannxi, China.
Stereotact Funct Neurosurg. 2008;86(5):320-9. doi: 10.1159/000160155. Epub 2008 Oct 8.
To investigate the short-term psychological function of opiate addicts who have undergone ablative stereotactic surgery targeting the nucleus accumbens (NAc) for alleviating opiate drug psychological dependence.
The psychological functional status of 14 opiate addicts was assessed by standardized psychological tests both before and approximately 3 months after stereotactic surgery. Standardized tests included the Wechsler Adult Intelligence Scale-Revised Chinese (WAIS-RC), the Clinical Memory Scale of Chinese (CMS), the Eysenck Personality Questionnaire (EPQ) and the Symptom Checklist 90 (SCL-90). The evaluation of psychological dimensions included intelligence, memory, personality characteristics and mental health symptoms.
Compared with the preoperative state, there was no statistically significant difference in full-scale intelligence quotient (IQ) postoperatively, but without Bonferroni correction a significant decline by 13.55% (p < 0.05) was observed in the Digit Symbol-Substitution subtest of WAIS-RC. The memory quotient (MQ) of CMS demonstrated a significant decline of 10.65% (p < 0.05) postoperatively. Concerning the participants' personality characteristics, a significant postoperative increase (p < 0.05) was detected in the Psychoticism (P) trait of EPQ. The mental healthy severity indexes of SCL-90 were decreased postoperatively. After Bonferroni correction, however, there was no statistical difference between pre- and postoperative results on all assessments.
Although the patients' intelligence measures were not changed significantly, their short-term memory and attention appeared to decline postoperatively. In addition, there was a trend towards change in some personality characteristics postoperatively. The postoperative mental health levels of the patients increased, indicating a trend towards improvement. Stereotactic ablation of the NAc in opiate addicts may be associated with short-term negative psychological functions. Advisement regarding the safety of the new surgical modality and recommendations for further investigation are necessary.
探讨针对伏隔核(NAc)进行毁损性立体定向手术以减轻阿片类药物心理依赖的阿片类成瘾者的短期心理功能。
对14名阿片类成瘾者在立体定向手术前及术后约3个月通过标准化心理测试评估其心理功能状态。标准化测试包括中国修订韦氏成人智力量表(WAIS-RC)、中国临床记忆量表(CMS)、艾森克人格问卷(EPQ)和症状自评量表90(SCL-90)。心理维度评估包括智力、记忆、人格特征和心理健康症状。
与术前状态相比,术后全量表智商(IQ)无统计学显著差异,但未进行Bonferroni校正时,WAIS-RC数字符号替换分测验中观察到显著下降13.55%(p<0.05)。CMS的记忆商数(MQ)术后显著下降10.65%(p<0.05)。关于参与者的人格特征,EPQ的精神质(P)特质术后显著增加(p<0.05)。SCL-90的心理健康严重程度指数术后下降。然而,经过Bonferroni校正后,所有评估的术前和术后结果之间无统计学差异。
虽然患者的智力指标没有显著变化,但他们的短期记忆和注意力术后似乎有所下降。此外,术后一些人格特征有变化趋势。患者术后心理健康水平提高,显示出改善趋势。对阿片类成瘾者进行NAc立体定向毁损可能与短期负面心理功能有关。有必要就这种新手术方式的安全性提供建议并提出进一步研究的建议。