目的 探讨甲基苯丙胺依赖者脑灰质体积的变化特点及相关因素.方法 应用结构MRI完成对35例恢复期甲基苯丙胺依赖者(甲基苯丙胺组)和34名年龄、性别及受教育年限匹配的健康志愿者(对照组)的扫描;采用基于体素的形态学分析方法比较2组受试者脑灰质体积的差异,采用Pearson相关分析方法分析2组差异有统计学意义的灰质体积与甲基苯丙胺使用情况的相关性.结果 与对照组相比,甲基苯丙胺组右侧额极[MNI坐标(x、y、z):24、53、3]、右侧额中回[MNI坐标(x、y、z):9、44、-14]、右侧眶额皮质[MNI坐标(x、y、z):15、62、-15]、双侧前扣带回[左侧前扣带回:MNI坐标(x、y、z):-11、47、0;右侧背侧前扣带:MNI坐标(x、y、z):3、30、33]、左侧后扣带回[MNI坐标(x、y、z):-11、-72、22]、双侧颞中回[左侧颞中回:MNI坐标(x、y、z):-57、-52、3;右侧颞中回:MNI坐标(x、y、z):65、-25、-9]和双侧枕叶[左侧枕叶:MNI坐标(x、y、z):-15、-96、15;右侧楔叶:MNI坐标(x、y、z):21、-94、27]的灰质体积减少(Z=3.78、3.86、3.43、3.78、4.00、3.92、3.65、3.37、4.55、3.48;均P〈0.001);甲基苯丙胺组左侧后扣带回的灰质体积与戒断天数呈正相关(r=0.348,P〈0.05).结论 甲基苯丙胺依赖者额叶、颞叶和枕叶皮质的灰质体积减少,戒断天数越长左侧后扣带回的灰质体积减少越轻.
Objective To investigate volumetric abnormalities of grey matter in methamphetamine (MA) dependent subjects and its related factors. Methods Differences in grey matter volume between MA dependent individuals (n=35) and controls (n=34) were assessed with voxel-based morphometry and three dimensional magnetic resonance imaging technology. The volume changes of regional brain grey matters were compared between the groups. And its correlation to MA dependence was analyzed with Pearson correlation. Results Compared to the controls, the grey matter volume of MA dependent patients was significantly smaller in right frontal pole(MNI(x,y,z): 24, 53, 3), right middle frontal gyrus(MNI (x,y,z): 9, 44, -14), right orbitofrontal cortex(MNI(x,y,z): 15, 62, -15), bilateral anterior cingulate cortex(left: MNI(x,y,z): -11, 47, 0; right: MNI(x,y,z): 3, 30, 33), left posterior cingulate cortex(MNI (x,y,z): -11, -72, 22), bilateral middle temporal gyrus(left: MNI(x,y,z):-57,-52, 3; right: MNI(x,y,z):65,-25,-9) and bilateral occipital cortex(left:MNI(x,y,z):-15,-96, 15;right:MNI(x,y,z):21,-94, 27, Z=3.78, 3.86, 3.43, 3.78, 4.00, 3.92, 3.65, 3.37, 4.55, 3.48, all P〈0.001). Grey matter volume in left posterior cingulate cortex was positively correlated with time length of being abstinence from MA( r=0.348, P〈0.05). Conclusions There is significant volume reduction in frontal, temporal and occipital grey matter in chronic MA users. The longer being abstinence from MA, the more volume of left posterior cingulate cortex may be preserved.