Preliminary findings in ablating the nucleus accumbens using stereotactic surgery for alleviating psychological dependence on alcohol
Preliminary findings in ablating the nucleus accumbens using stereotactic surgery for alleviating psychological dependence on alcohol
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DOI：
10.1016/j.neulet.2010.02.019
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发表时间：
2010-04
影响因子：
2.5
通讯作者：
He-Ming Wu;Xuelian Wang;Chong-wang Chang;Nan Li;L. Gao;Ning Geng;Jiu-Hong Ma;Wei Zhao;G. Gao
中科院分区：
文献类型：
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作者：
He-Ming Wu;Xuelian Wang;Chong-wang Chang;Nan Li;L. Gao;Ning Geng;Jiu-Hong Ma;Wei Zhao;G. Gao
我们研究了立体定向手术治疗酒精依赖的效果。采用立体定向手术双侧切除伏隔核（NAC）治疗12例酒精心理依赖患者（此前在各康复中心系统接受戒毒治疗3-8次，停药后2周内复发）。分析手术治疗效果及安全性评价指标。进行评估的时间为术前和术后第六个月。目前9例未复发。术后复发3例。6个月内复发率为16.7%，12个月内复发率为25%。未观察到此类手术的非特异性并发症（如颅内血肿、感染）。12例患者中有1例出现嗅觉障碍，但术后4个月后完全恢复。与术前相比，术后6个月患者的全量表智商（FSIQ）和记忆智商（MQ）均有显著提高。这些患者的酒精依赖严重程度量表和测量酒精渴望的量表显着降低。随着时间的推移，明尼苏达多相人格量表（MMPI）也发生了显著变化，表明抑郁、易怒和精神病有所减少。使用立体定向手术消融特定靶点（NAC）是一种安全的方法，可以减轻酒精依赖患者的酒精渴望，降低复发率并改善生活质量。
We studied the effect of stereotactic surgery in cases of alcohol dependence. Twelve patients with a psychological dependence on alcohol (treated systematically with medication for detoxification 3–8 times in various rehabilitation centers before, but had relapsed within 2 weeks after withdrawal) were treated by ablating the nucleus accumbens (NAC) bilaterally using stereotactic surgery. The therapeutic effect and safety evaluation index of the surgery were analyzed. The timing of the conducted evaluations was preoperatively and in the sixth postoperative month. Currently, relapse has not occurred in 9 cases. Relapse occurred in 3 cases after surgery. The prevalence of relapse was 16.7% within 6 months, and 25% within 12 months. Non-specific complications of this type of surgery (e.g., intracranial hematoma, infection) were not observed. One case in 12 patients suffered dysosmia, but he recovered completely 4 months later after surgery. The full-scale intelligence quotient (FSIQ) and memory quotient (MQ) of these patients were significantly improved 6 months postoperatively compared with preoperatively. The severity of alcohol dependence scale and a scale measuring alcohol craving in these patients were significantly decreased. There were also significant changes over time in the Minnesota multiphasic personality inventory (MMPI) profile, suggesting a decrease in depression, irritability, and psychopathy. Ablating specified targets (NAC) using stereotactic surgery is a safe method to alleviate alcohol craving, reduce relapse rates and improve quality-of-life in patients with psychological dependence on alcohol.