Department of Neurosurgery and Institute for Functional Brain Disorders, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China.
Neurosci Lett. 2010 Apr 5;473(2):77-81. doi: 10.1016/j.neulet.2010.02.019. Epub 2010 Feb 13.
We studied the effect of stereotactic surgery in cases of alcohol dependence. Twelve patients with a psychological dependence on alcohol (treated systematically with medication for detoxification 3-8 times in various rehabilitation centers before, but had relapsed within 2 weeks after withdrawal) were treated by ablating the nucleus accumbens (NA(C)) bilaterally using stereotactic surgery. The therapeutic effect and safety evaluation index of the surgery were analyzed. The timing of the conducted evaluations was preoperatively and in the sixth postoperative month. Currently, relapse has not occurred in 9 cases. Relapse occurred in 3 cases after surgery. The prevalence of relapse was 16.7% within 6 months, and 25% within 12 months. Non-specific complications of this type of surgery (e.g., intracranial hematoma, infection) were not observed. One case in 12 patients suffered dysosmia, but he recovered completely 4 months later after surgery. The full-scale intelligence quotient (FSIQ) and memory quotient (MQ) of these patients were significantly improved 6 months postoperatively compared with preoperatively. The severity of alcohol dependence scale and a scale measuring alcohol craving in these patients were significantly decreased. There were also significant changes over time in the Minnesota multiphasic personality inventory (MMPI) profile, suggesting a decrease in depression, irritability, and psychopathy. Ablating specified targets (NA(C)) using stereotactic surgery is a safe method to alleviate alcohol craving, reduce relapse rates and improve quality-of-life in patients with psychological dependence on alcohol.
我们研究了立体定向手术在酒精依赖病例中的作用。12 名有心理依赖酒精的患者（在不同的康复中心接受过系统的药物解毒治疗，次数为 3-8 次，但在戒断后 2 周内复发）通过立体定向手术双侧毁损伏隔核（NA(C)）进行治疗。分析了手术的治疗效果和安全性评价指标。手术前和术后第 6 个月进行了评估。目前，9 例无复发，3 例术后复发。6 个月内复发率为 16.7%，12 个月内复发率为 25%。未观察到这种手术的非特异性并发症（如颅内血肿、感染）。12 例患者中有 1 例出现嗅觉障碍，但术后 4 个月完全恢复。这些患者的全量表智商（FSIQ）和记忆商（MQ）在术后 6 个月明显高于术前。这些患者的酒精依赖严重程度量表和酒精渴求量表明显降低。明尼苏达多项人格问卷（MMPI）的剖面图也随着时间的推移发生了显著变化，表明抑郁、易怒和精神病态程度降低。使用立体定向手术消融特定靶点（NA(C)）是一种安全的方法，可以减轻酒精渴求、降低复发率并改善有心理依赖酒精的患者的生活质量。
