Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Brain Res. 2012 Aug 21;1469:63-72. doi: 10.1016/j.brainres.2012.06.024. Epub 2012 Jun 30.
Craving is an important factor in relapse to drug abuse, and cue-induced craving is an especially powerful form of this construct. Neuroimaging methods have been utilized to study drug cue-induced craving and neural correlates in the human brain. However, very few studies have focused on characterizing craving and the neural responses to heroin-related cues in short-term abstinent heroin-dependent patients. Twenty-four heroin-dependent subjects and 20 demographically matched drug-naïve subjects participated in this study. An event-related cue-reactivity paradigm was employed, while changes in blood oxygen level-dependent (BOLD) signals were acquired by functional magnetic resonance imaging (fMRI). The heroin-dependent group reported significantly increased craving following exposure to heroin-related cues. Direct comparison between the two groups showed that brain activation to heroin-related minus neutral cues was significantly greater for the heroin-dependent group in the bilateral nucleus accumbens (NAc), caudate, putamen, amygdala, hippocampus/parahippocampus, midcingulate cortex, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), medial frontal gyrus (MeFG), midbrain, thalamus, left anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and subcallosal gyrus. Changes in craving in the heroin-dependent group correlated positively with brain activation in the bilateral NAc, caudate, right putamen, and left ACC. The abstinence duration correlated positively with brain activation in the left caudate and right parahippocampal gyrus. In conclusion, the cue-reactivity paradigm significantly activated neural responses in the mesolimbic dopamine (DA) system and prefrontal cortex (PFC) and induced increased craving in short-term abstinent heroin-dependent patients. We suggest that these response patterns characterize the high vulnerability of relapse in short-term abstinent heroin-dependent subjects.
渴求（Craving）是药物滥用复吸的一个重要因素，而线索诱发的渴求（cue-induced craving）是该结构的一种特别强大的形式。神经影像学方法已被用于研究人类大脑中的药物线索诱发的渴求（drug cue-induced craving）和神经相关性。然而，很少有研究关注描述短期海洛因戒断的海洛因依赖患者对与海洛因相关的线索的渴求（craving）和神经反应。本研究纳入了 24 名海洛因依赖患者和 20 名匹配的药物-naive 对照组参与者。采用事件相关线索反应范式（event-related cue-reactivity paradigm），同时通过功能磁共振成像（functional magnetic resonance imaging，fMRI）获取血氧水平依赖（blood oxygen level-dependent，BOLD）信号变化。结果显示，与中性线索相比，海洛因依赖组在暴露于海洛因相关线索后报告的渴求（craving）显著增加。两组之间的直接比较显示，海洛因依赖组在双侧伏隔核（nucleus accumbens，NAc）、尾状核（caudate）、壳核（putamen）、杏仁核（amygdala）、海马/海马旁回（hippocampus/parahippocampus）、中脑边缘皮质（midcingulate cortex）、背外侧前额叶皮质（dorsolateral prefrontal cortex，DLPFC）、眶额皮质（orbitofrontal cortex，OFC）、额内侧回（medial frontal gyrus，MeFG）、中脑、丘脑、左侧前扣带回（anterior cingulate cortex，ACC）、后扣带回（posterior cingulate cortex，PCC）和胼胝体下回（subcallosal gyrus）对海洛因相关线索与中性线索的差异激活显著更大。海洛因依赖组的渴求（craving）变化与双侧 NAc、尾状核、右侧壳核和左侧 ACC 的脑激活呈正相关。戒断时间与左侧尾状核和右侧海马旁回的脑激活呈正相关。总之，线索反应范式显著激活了中边缘多巴胺（dopamine，DA）系统和前额叶皮质（prefrontal cortex，PFC）的神经反应，并在短期海洛因戒断的海洛因依赖患者中引起了渴求（craving）的增加。我们认为，这些反应模式是短期海洛因戒断的海洛因依赖者易复发的特征。
