Department of Radiology, Tangdu Hospital, the Air Force Medical University, Xi'an, China.
Canon Organization, Canon Medical Systems (China) Co., LTD, MR Division, Xi'an, China.
Ann Palliat Med. 2021 Sep;10(9):9497-9507. doi: 10.21037/apm-21-2012.
Methadone maintenance treatment (MMT) is widely used for heroin use disorder. Although its curative effect is remarkable, there are problems associated with its use. While previous studies have found that methadone use may have certain effects on cerebral white matter, its effect on gray matter (GM) and its related neural networks is unclear. This study aimed to observe the effects of long-term methadone use on cerebral GM and the changes in related neural networks.
Patients receiving MMT treatment for heroin use disorder (N=50) were recruited. Longitudinal self-control was adopted, and the voxel-based morphometry (VBM) was used to compare the difference in cerebral GM volume before and after 1 year of methadone use, then we select the brain region where the GM volume changed as the region of interest (ROI), and use the DPARSF software for the whole brain function connection, and the differences in brain function connections before and after 1year MMT treatment were compared.
Our results demonstrated that, after 1 year of MMT, patients showed smaller GM volume in the bilateral insula, occipital lingual gyrus, right cingulate gyrus, middle temporal gyrus, left inferior parietal lobule, caudate nucleus, temporal, and occipital regions, and the resting neural network of the brain also changed.
We speculate that long-term methadone use can lead to damage to GM structure and adaptive changes in the neural network of patients with heroin use disorder, mainly involving emotional perception, spatial localization, working memory, and other related functions.
美沙酮维持治疗（MMT）被广泛用于治疗海洛因使用障碍。尽管其疗效显著，但仍存在一些使用问题。虽然先前的研究发现美沙酮的使用可能对脑白质有一定影响，但它对灰质（GM）及其相关神经网络的影响尚不清楚。本研究旨在观察长期使用美沙酮对大脑 GM 的影响以及相关神经网络的变化。
招募了接受美沙酮维持治疗的海洛因使用障碍患者（N=50）。采用纵向自身对照，使用基于体素的形态计量学（VBM）比较 1 年美沙酮使用前后大脑 GM 体积的差异，然后选择 GM 体积变化的脑区作为感兴趣区（ROI），并使用 DPARSF 软件进行全脑功能连接，比较 1 年后 MMT 治疗前后脑功能连接的差异。
我们的研究结果表明，经过 1 年的 MMT 治疗后，患者双侧岛叶、枕叶舌回、右侧扣带回、中颞叶、左侧顶下小叶、尾状核、颞叶和枕叶 GM 体积减小，大脑静息神经网络也发生了变化。
我们推测，长期使用美沙酮会导致海洛因使用障碍患者 GM 结构受损和神经网络适应性变化，主要涉及情绪感知、空间定位、工作记忆等相关功能。
