Wu He-Ming, Ge Shun-Nan, Dai Hai-Bin, Wang Ling, Chang Chong-Wang, Wang Xue-Lian, Li Nan, Gao Guo-Dong
Department of Neurosurgery, Jingdu Hospital, Nanjing, PR China.
Stereotact Funct Neurosurg. 2015;93(6):407-14. doi: 10.1159/000441392. Epub 2016 Jan 6.
The nucleus accumbens (NAcc) has been proven to be associated with drug and food craving. NAcc ablative neurosurgery has been suggested to modulate the balance of the brain reward system and thus alleviate drug dependence in patients. It has been hypothesized that it would also alleviate food craving in patients as well as altering their nutritional status.
This study aimed to estimate the effect of NAcc neurosurgery on drug craving and nutritional status in patients with drug dependence at 5 years postoperatively.
The study included 100 patients with NAcc surgery and 92 patients without surgery. Body mass index (BMI) and body fat percentage (BF%) were examined to assess nutritional status, and questionnaires were administered to assess drug craving.
Compared with the nonsurgery group and the relapse patients from the surgery group, the nonrelapse patients from the surgery group had higher BMI and BF% but lower drug craving. There were no significant differences between the nonsurgery group and the relapse patients in BMI, but the relapse patients had higher drug craving than the nonsurgery group.
Long-term follow-up suggested that NAcc ablative neurosurgery would alleviate drug craving and yield a better nutritional status if individuals sustained abstinence. It would increase drug craving but would not ruin the nutritional status of patients even when individuals relapsed postoperatively.
伏隔核(NAcc)已被证明与药物和食物渴望有关。有人提出,伏隔核毁损性神经外科手术可调节大脑奖赏系统的平衡,从而减轻患者的药物依赖。据推测,该手术还可减轻患者的食物渴望,并改变其营养状况。
本研究旨在评估伏隔核神经外科手术对药物依赖患者术后5年的药物渴望和营养状况的影响。
该研究纳入了100例行伏隔核手术的患者和92例未手术的患者。检测体重指数(BMI)和体脂百分比(BF%)以评估营养状况,并通过问卷调查评估药物渴望程度。
与非手术组及手术组中的复吸患者相比,手术组中的未复吸患者BMI和BF%更高,但药物渴望程度更低。非手术组与复吸患者的BMI无显著差异,但复吸患者的药物渴望程度高于非手术组。
长期随访表明,伏隔核毁损性神经外科手术可减轻药物渴望,且如果患者持续戒断,营养状况会更好。即使患者术后复吸,该手术也会增加其药物渴望,但不会破坏患者的营养状况。