Cue-induced brain activity changes and relapse in cocaine-dependent patients
Cue-induced brain activity changes and relapse in cocaine-dependent patients
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DOI：
10.1038/sj.npp.1300851
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发表时间：
2006-03-01
影响因子：
7.6
通讯作者：
Wexler, BE
中科院分区：
文献类型：
--
作者：
Kosten, TR;Scanley, BE;Wexler, BE
本研究使用功能性磁共振成像（fMRI）检查可卡因依赖（CD）患者暴露于可卡因相关线索期间的大脑激活与药物使用复发之间的关联。我们在2周的住院期间对17名CD受试者进行成像。然后，受试者进入为期10周的门诊安慰剂对照，双盲随机临床试验，每周三次评估尿液毒理学，以计算治疗有效性评分（TES）。更差的TES与左侧中央前、上级颞叶和后扣带回皮质（PCC）以及右侧颞叶和舌叶皮质的BOLD激活相关（R > 0.65; P < 0.005）。左侧PCC激活也区分了8名非复发者（TES高于平均值并完成治疗）和9名复发者。非复发者（92%）的无可卡因尿液显著高于复发者（66%），后者平均仅接受3.2周的治疗。在功能磁共振成像中，自我报告的渴望在非复发者和复发者之间没有差异，并且与TES无关。可卡因滥用的复发与观看可卡因相关线索的图像时感觉联合皮层、运动皮层和PCC的激活增加有关。这些结果表明，可卡因滥用的复发与感觉，运动和认知情感处理区域的可卡因线索的大脑激活增加有关。这种生理激活是一个更好的预测复发比主观报告的渴望，并可能是一个有用的目标，治疗开发。
This study used functional magnetic resonance imaging (fMRI) to examine the association between brain activation during exposure to cocaine-related cues and relapse to drug use in cocaine-dependent (CD) patients. We imaged 17 CD subjects during a 2-week in-patient stay. The subjects then entered a 10-week outpatient placebo-controlled, double-blind randomized clinical trial where urine toxicologies were assessed three times weekly to calculate the treatment effectiveness score (TES). Worse TES correlated with BOLD activation in the left precentral, superior temporal, and posterior cingulate cortices (PCC), and right middle temporal and lingual cortices (R > 0.65; P < 0.005). The left PCC activation also distinguished eight nonrelapsers (TES above mean and completed treatment) from nine relapsers. Cocaine-free urines were significantly greater in the nonrelapsers (92%) than in the relapsers (66%), who also remained in treatment for an average of only 3.2 weeks. Self-reports of craving during fMRI did not differ between nonrelapsers and relapsers and did not correlate with TES. Relapse to cocaine abuse was associated with increased activation in the sensory association cortex, the motor cortex, and PCC while viewing images of cocaine-related cues. These results suggest that relapse to cocaine abuse is associated with increased brain activation to cocaine cues in sensory, motor, and cognitive-emotional processing areas. This physiological activation was a better predictor of relapse than subjective reports of craving, and may be a useful target for treatment development.