Changes Of Brain ~1H-MRS And Clues-induced Craving FMRI In Heroin Addicts

ObjectiveAddiction is an irresistible force mandatory addiction to drive people to use a substance or a substance addiction to repeat behavior. In China, addicts mainly used mainly heroin, of which the proportion of heroin addicts in drug users accounted for about 90%. Heroin addiction is a very high relapse rate of addicts, survey showed that drug relapse rate was as high as 95%. To address this situation, in-depth study of the mechanism of drug addiction has become a solution to the fundamental approach to addictions. Although the neural mechanisms of heroin addicts from the organization, increased cell level to the molecular, genetic level, but studies are focal, and the tissue samples in vitro studies, the results revealed by the information remains difficult to explain heroin brain complex pathophysiological process. Medical imaging technology, the rapid development, in particular, functional imaging and molecular imaging technology introduction and application of state for the in vivo pathophysiological mechanism of human research has provided new ways and means. Among them, the hydrogen proton magnetic resonance spectroscopy imaging (1H-MRS) and functional magnetic resonance imaging (fMRI) may be from the metabolism, blood flow, biochemical, functional, in terms of oxygen consumption related to activation of brain area-specific and quantitative analysis, can be a means of non-invasive brain heroin reflect changes in the structure of the pathology. This experiment will be used 1H-MRS and fMRI Methods, heroin dependence(HD)-related brain regions and leads metabolites induced by changes in demand, from the corresponding in vivo levels reflect structural changes in brain regions, revealing the neural mechanisms of heroin addiction for the prediction of relapse, clinical treatment and evaluation play an important role.Methods1. Two groups were studied fourteen HD subjects and twelve matched control subjects.All subjects undertook convention MR scan:axial T1-FLAIR,T2WI and arrow T2WI. The oblique-coronal plane should be vertical to the long axis of right hippocampus in the lateral median sagital section.From the oblique-coronal plane,we could identify the demarcation of amydala and hippocampus.The prefrontal cortex voxel was placed the middine and included cortex from left and right hemispheres.The voxel abuted posteriorly upon the anterior portion of the corpus callosum.The caudate was well discoverde visually at this level. The amydala voxel was placed the oblique coronal by T1-FLAIR sequence scanning. The amydala was well formed visually at this level.We examined the change character of ratio of NAA/Cr and Cho/Cr in the prefrontal cortex and amydala. Using correlation test, the correlation between NAA/Cr and t the total cumulative inhaled heroine dose was examined.2. 12 active heroin addicts underwent scanning inside a 3.0T GE MR scanner while exposure to drug-related,sex-related and neutral cues. The fMRI data was collected and analyzed by SPM5(Statistic Parameter Mapping 5)to generate brain active map. At the same time, comparison of natural stimuli (sexual) and the drug to stimulate the activation of the differences between brain regions.Results1.As compared with HC group, HD patients had a significant lower ratio of NAA/Cr in the prefrontal cortex (1.44±0.46 vs 1.50±0.75, P<0.05), left amygdale (1.32±0.08 vs 1.42±0.08, P<0.05), and right amygdale (1.34±0.09 vs 1.44±0.10, P<0.05), while the HD patients had a significant increased ratio of Cho/Cr in the prefrontal cortex (0.92±0.06 vs 0.86±0.08, P<0.05), left amygdale (1.20±0.12 vs 1.07±0.04, P<0.05) and right amygdale (1.26±0.15 vs 1.12±0.11, P<0.05). There was a negative linear correlation between the total cumulative inhaled heroine dose and the ratio of NAA/Cr in the prefrontal cortex (r=-0.8756, P<0.01), left amygdale (r=-0.9159, P<0.01),right amygdale (r=-0.9399, P<0.01)respectively.2. When heroin dependent patients exposed to visual drug-related cue vs neutral visual stimuli, the activation brain regions belonged to three parts, one was limbic system (nucleus accumbens,amygdale, hippocampus, hypothalamus, anterior cingulate cortex and genu of corpus callosum), another was brain cortex (middle frontal cortex, inferior frontal cortex, precentral gyrus, middle temporal cortex, inferior temporal cortex, fusiform gyrus, insula ,precuneus, cuneus and middle occipital gyrus) and cerebellum. When exposed to sexual cues, the main brain regions activated are: the structure of the limbic system (nucleus accumbens, amygdala, hippocampus, putamen, hypothalamus, caudate nucleus, genu of corpus callosum), the other for the cerebral cortex, including amount (middle frontal cortex, inferior frontal cortex, precentral gyrus, middle temporal cortex, inferior temporal cortex, cuneus and middle occipital gyrus) and cerebellum. And exposed to scenes of sexual cues,compared with similar activation of both brain regions, but also different Drug leads to stimulate the desire for more natural and more to stimulate the activation of brain regions and a greater intensity.conclusions1. The data from 1H-MRS study indicate that neuronal damage and glial proliferation may occur in the prefrontal cortex and amygdale, which suggests the abnormalities of executive function and emotion in patients with HD.A relationship exits between the heroin-induced metabolic abnormality and the total cumulative dose of inhaled heroine.2. In heroin addicts ,visual cues related to drug were associated with greater neural activation in corticolimbic reward circuit ,visuospatial attention circuit and working memory areas. Induced by heroin craving-related cues and natural desire to stimulate the neural circuits have a lot of overlap, but are different too. Drug leads to stimulate the desire for more natural and more to stimulate the activation of brain regions and a greater intensity on the drug-induced craving in the brain in the normal cerebral cortex. The edge of a loop that is the role of reward systems, and change the loop so that the normal learning, cognition, memory and emotional changes of things, leading to the complexity of drug dependence. Among them, compared with physical desire, anterior cingulate and insula are the characteristics of drug demand the activation of brain regions.