Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Chin Med J (Engl). 2012 Jan;125(1):63-6.
Stereotactic surgery has been used to treat heroin abstinence in China since 2000 by ablating the amygdaloid nucleus (AMY) and the nucleus accumbens (NAc), which also provides opportunity to identify the relationship between these nuclei and addiction. Our study aimed to explore the physiological and psychological effects of electrically stimulating the AMY and the NAc in heroin addicts after detoxification by observing changes of heart rate, arterial pressure and occurrence of euphoria similar to heroin induced euphoria.
A total of 70 heroin addicts after detoxification were recruited, and 61 of them were eligible to be given stereotactic surgery for heroin abstinence. The operation was carried out after determining the coordinates of all target nucleuses, and stimulation was performed at the AMY and the NAc solely or jointly. Heart rate, arterial pressure and occurrence of euphoria similar to heroin induced euphoria were recorded and analyzed.
The average heat rate was (66 ± 10) beats/min before electric stimulation, and significantly increased to (84 ± 14) beats/min during stimulation, and changed to (73 ± 12) beats/min 10 minutes after stimulation. There was a significant elevation of the average arterial pressure from 83 mmHg before stimulation to 98 mmHg during the stimulation, and it then decreased to 90 mmHg after stimulation. Forty-three of the 61 patients showed intense euphoria similar to heroin induced euphoria. The largest number (118/186) of euphoric responses occurred when the AMY and the NAc were stimulated at the same time. Odds ratio was 5.4 (95%CI: 2.4 - 11.9, P < 0.0001) to quantify the association. Results from a Logistic regression model showed a positive correlation between unilateral stimulation of either the AMY or NAC and induction of euphoria (OR > 1), especially when the left AMY or left NAc was stimulated (P < 0.05).
Our data are consistent with existing results that the AMY and the NAc are related to addiction. Different roles in drug dependence would be suggested according to the location of the AMY and NAc.
自 2000 年以来，立体定向手术已被用于通过消融杏仁核（AMY）和伏隔核（NAc）来治疗海洛因戒断，这也为确定这些核与成瘾之间的关系提供了机会。我们的研究旨在通过观察心率、动脉压的变化和类似于海洛因引起的欣快感的发生，来探讨电刺激 AMY 和 NAc 对海洛因成瘾者戒毒后的生理和心理影响。
共招募 70 名戒毒后的海洛因成瘾者，其中 61 名符合条件接受立体定向手术戒除海洛因。在确定所有目标核坐标后进行手术，单独或联合刺激 AMY 和 NAc。记录和分析心率、动脉压和类似于海洛因引起的欣快感的发生。
电刺激前平均心率为（66±10）次/分，刺激时显著增加至（84±14）次/分，刺激后 10 分钟恢复至（73±12）次/分。刺激前平均动脉压为 83mmHg，刺激时升至 98mmHg，刺激后降至 90mmHg。61 例患者中有 43 例出现强烈的类似于海洛因引起的欣快感。当 AMY 和 NAc 同时刺激时，欣快感反应最多（118/186）。对数回归模型结果显示，单侧刺激 AMY 或 NAc 与欣快感的产生呈正相关（OR>1），尤其是当刺激左侧 AMY 或左侧 NAc 时（P<0.05）。
我们的数据与现有的结果一致，即 AMY 和 NAc 与成瘾有关。根据 AMY 和 NAc 的位置，可能会提出不同的药物依赖作用机制。
