Human Brain Function And Drug Abuse

美沙酮维持治疗是阿片类药物成瘾的主要治疗方法，但围绕其在长期治疗中使用的优点存在争议。15名无美沙酮（6-24个月）阿片类药物滥用者，12名接受美沙酮维持（稳定剂量超过6个月）的阿片类药物滥用者和13名对照受试者参加了本研究。通过F-18氟脱氧葡萄糖和PET测量，美沙酮戒断受试者双侧膝周和左侧扣带回中部的相对代谢活性低于对照受试者。相比之下，美沙酮维持受试者在左丘脑、丘脑和左顶下小叶中表现出较低的相对活性（与对照组相比）;然而，他们在膝周前扣带回和右顶下小叶中表现出对照组活性。在美沙酮戒断受试者中，抑郁的测量与左膝周回和中扣带回的相对活动呈正相关;在对照受试者中，类似的关联呈负相关。美沙酮维持的受试者表现出负协方差之间的状态措施的抑郁症和相对活动的右下顶叶小叶和右膝周前扣带回，抑郁症和相对活动的左下顶叶小叶之间的特质措施。美沙酮维持治疗可改善负性情感状态下神经回路的功能异常，但可抑制阿片受体密度高的某些区域的脑功能。

Methadone maintenance is the primary treatment for opiate addiction, but controversy surrounds the merits of its use in long-term treatment. Fifteen methadone-free (6-24 months) opiate abusers, twelve opiate abusers receiving methadone maintenance (stable dose over 6 months), and thirteen control subjects participated in this study. Methadone-withdrawn subjects had lower relative metabolic activity measured by F-18fluorodeoxyglucose and PET than control subjects in bilateral perigenual and the left middle cingulate gyrus. In contrast, methadone-maintained subjects exhibited lower relative activity (vs. control) in the left insula, the thalamus, and the left inferior parietal lobule; however, they exceedded control activity in the perigenual anterior cingulate gyrus and the right inferior parietal lobule. Measures of depression covaried positively with relative activity in the left perigenual and mid-cingulate gyrus in methadone-withdrawn subjects; analogous associations in control subjects covaried negatively. Methadone-maintained subjects exhibited negative covariance between state measures of depression and relative activity in the right inferior parietal lobule and the right perigenual anterior cingulate, and between trait measures of depression and relative activity in the left inferior parietal lobule. Methadone maintenance ameliorates functional abnormalities in the neural circuitry subserving negative affective states, but depresses brain function in some regions of high opiate receptor density.