Yousefzadeh-Fard Yashar, Gharedaghi Mohammad Hadi, Esmaeili Sara, Pourbakhtyaran Elham, Sadaghiani Mohammad Salehi, Ghorbani Askar, Sahraian Mohammad-Ali
Students' Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Basic Clin Neurosci. 2013 Fall;4(4):307-14.
Addiction imposes a large medical, social and economic burden on societies. Currently, there is no effective treatment for addiction. Our struggle to decipher the different mechanisms involved in addiction requires a proper understanding of the brain regions which promote this devastating behavior. Previous studies have shown a pivotal role for insula in cigarette smoking. In this study we investigated the change in opium consumption after CVA.
This study took place in three referral academic hospitals affiliated to Tehran University of Medical Sciences. Patients who suffered a CVA and were addicted to opium were recruited during their hospitalization or visit to the neurology clinic in this study. Age, sex and the route and mean amount of opium use of each patient before CVA and 1, 3 and 6 months post-CVA was asked using a questionnaire. The patients were divided into three groups based on the location of brain ischemia (insula, basal ganglia and non-insula non-basal ganglia group).
Seventy five percent of the patients with ischemia of the insula changed the route or amount of opium use after CVA and 37.5% of them stopped opium use after CVA. These values were significantly higher than patients with non-insula nonbasal ganglia ischemia (p values 0.005 and 0.03 for change in route or amount and stopping opium use, respectively). This was not true in patients with ischemia of the basal ganglia. Younger patients were more likely to change the route or amount of opium use and stop opium use after CVA (p values 0.002 and 0.026, respectively).
The results of the present study indicate a possible role for the insula in opium addiction, especially in younger individuals.
成瘾给社会带来了巨大的医学、社会和经济负担。目前，尚无有效的成瘾治疗方法。我们在努力破解成瘾所涉及的不同机制时，需要正确理解促使这种破坏性行为产生的脑区。先前的研究表明，脑岛在吸烟行为中起关键作用。在本研究中，我们调查了脑血管意外（CVA）后鸦片消费量的变化。
本研究在德黑兰医科大学附属的三家转诊学术医院进行。本研究招募了患有CVA且对鸦片成瘾的患者，他们在住院期间或到神经科门诊就诊时被纳入研究。通过问卷调查询问每位患者在CVA前以及CVA后1个月、3个月和6个月的年龄、性别、鸦片使用途径和平均使用量。根据脑缺血的位置将患者分为三组（脑岛组、基底神经节组和非脑岛非基底神经节组）。
脑岛缺血患者中有75%在CVA后改变了鸦片使用途径或使用量，其中37.5%在CVA后停止使用鸦片。这些数值显著高于非脑岛非基底神经节缺血的患者（使用途径或使用量的改变以及停止使用鸦片的p值分别为0.005和0.03）。基底神经节缺血的患者情况并非如此。年轻患者在CVA后更有可能改变鸦片使用途径或使用量并停止使用鸦片（p值分别为0.002和0.026）。
本研究结果表明脑岛在鸦片成瘾中可能发挥作用，尤其是在年轻个体中。
