Department of Diagnostic Radiology, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
PLoS One. 2012;7(4):e33809. doi: 10.1371/journal.pone.0033809. Epub 2012 Apr 9.
Methadone maintenance treatment (MMT) has elevated rates of co-morbid memory deficit and depression that are associated with higher relapse rates for substance abuse. White matter (WM) disruption in MMT patients have been reported but their impact on these co-morbidities is unknown. This study aimed to investigate changes in WM integrity of MMT subjects using diffusion tensor image (DTI), and their relationship with history of heroin and methadone use in treated opiate-dependent individuals. The association between WM integrity changes from direct group comparisons and the severity of memory deficit and depression was also investigated. Differences in WM integrity between 35 MMT patients and 23 healthy controls were evaluated using DTI with tract-based spatial statistical analysis. Differences in DTI indices correlated with diminished memory function, Beck Depression Inventory, duration of heroin use and MMT, and dose of heroin and methadone administration. Changes in WM integrity were found in several WM regions, including the temporal and frontal lobes, pons, cerebellum, and cingulum bundles. The duration of MMT was associated with declining DTI indices in the superior longitudinal fasciculus and para-hippocampus. MMT patients had more memory and emotional deficits than healthy subjects. Worse scores in both depression and memory functions were associated with altered WM integrity in the superior longitudinal fasciculus, para-hippocampus, and middle cerebellar peduncle in MMT. Patients on MMT also had significant WM differences in the reward circuit and in depression- and memory-associated regions. Correlations among decreased DTI indices, disease severity, and accumulation effects of methadone suggest that WM alterations may be involved in the psychopathology and pathophysiology of co-morbidities in MMT.
美沙酮维持治疗（MMT）的共病记忆缺陷和抑郁发生率较高，这与物质滥用的复发率较高有关。已经报道了 MMT 患者的白质（WM）破坏，但它们对这些共病的影响尚不清楚。本研究旨在使用弥散张量图像（DTI）研究 MMT 受试者 WM 完整性的变化，并研究它们与接受治疗的阿片依赖个体中海洛因和美沙酮使用史之间的关系。还研究了 WM 完整性变化与记忆缺陷和抑郁严重程度之间的直接组比较的关系。使用基于束的空间统计分析评估 35 名 MMT 患者和 23 名健康对照者之间的 WM 完整性差异。DTI 指数的差异与记忆功能下降、贝克抑郁量表、海洛因使用和 MMT 时间、海洛因和美沙酮给药剂量相关。在颞叶和额叶、脑桥、小脑和扣带回束等多个 WM 区域发现了 WM 完整性变化。MMT 的持续时间与上纵束和海马旁回的 DTI 指数下降有关。与健康受试者相比，MMT 患者的记忆和情绪缺陷更多。在 MMT 中，记忆功能和抑郁功能的评分越差，与上纵束、海马旁回和小脑中脑脚的 WM 完整性改变越相关。MMT 患者的奖励回路和与抑郁和记忆相关的区域也存在明显的 WM 差异。DTI 指数下降、疾病严重程度和累积美沙酮效应之间的相关性表明，WM 改变可能与 MMT 共病的精神病理学和病理生理学有关。
