呈現檳榔視覺線索誘發渴求相關腦區活化

Neural response to betel-quid cues in chewers: a functional magnetic resonance imaging study

黃國洲(Guo-Joe Huang)

指導教授 ： 何明洲

中山醫學大學/醫學科技學院/心理學系暨臨床心理學碩士班/碩士(2016年)

摘要

目的：功能性磁振造影 (fMRI) 已被普遍用在物質成癮的研究中，以線索 – 反應典範 (the cue-reactivity paradigm) 呈現相關線索可以有效地誘發成癮者的渴求反應，但仍然沒有以檳榔相關線索誘發渴求反應的研究。本研究的目的是要探討檳榔高渴求狀態下經由視覺線索誘發活化的腦區。
材料與方法：16名檳榔成癮者、15名菸酒使用者及16名從未使用檳榔、菸、酒的健康男性成人，掃描取得在視覺線索刺激下的任務態 (task-based) 功能性磁振造影，探討檳榔高渴求狀態下經由線索刺激誘發的活化腦區。使用3.0 T的梯度面迴成像 (gradient echo planar imaging, GRE-EPI) 掃描。
結果：檳榔高渴求者比一般控制組經由線索刺激還要活化的腦區包括：(1) 有關視覺訊息處理的枕葉的梭狀迴 (fusiform gyrus)、舌迴 (lingul gyrus)，以及 (2) 同樣負責視覺訊號處理，位於顳葉的顳中迴 (middle temporal gyrus)、顳下迴 (inferior temporal gyrus)， (3) 位於頂葉次級感覺皮質，負責體感覺訊號整合的右側島蓋 (operculum)、(4) 位於額葉，負責包含情緒、酬賞有關決策的眼眶額葉皮質 (OFC)、直迴 (rectal gyrus) 這些腦區的活化反應較低渴求或無渴求的參與者高。
結論：只有在高渴求狀態下，經由線索刺激所活化的腦區，與過去其他物質渴求的研究結果類似。我們認為，這種反應模式是檳榔成癮者持續使用檳榔可能原因。

關鍵字

渴求 ； 線索 ； 反應典範 ； 檳榔 ； 成癮 ； 功能性磁振造影

並列摘要

PURPOSE: Functional neuroimaging studies, which have recently demonstrated that specific brain regions become active in substance-related addicts when they are exposed to specific substance stimuli. There are very few studies have focused on characterizing craving and the neural responses to Betel nut-related cues in short-term abstinent Betel nut-dependent subject. Previous studies have shown that arecoline (the primary ingredient in betel nut) can have widespread effect in cortical and subcortical areas. The purpose of this study was to investigate the cue-elicited craving by exposure in the visual cue.

MATERIALS AND METHODS: 16 betel-quid addicts, 15 tabacco or alcohol user and 16 healthy male adult participants were collected. Scanning were performed by 3.0T gradient echo planar imaging, GRE-EPI. The visual cues were presented in the scanning. A t-test was used to exploring the brain activation

RESULTS: The cue-elicited activation brain area include: (1) visual information related fusiform gyrus, lingul gyrus, and (2) middle temporal gyrus, inferior temporal gyrus. (3) Secondary sensory cortex related operculum. (4) And the emotions, reward, decision-making related orbital frontal cortex. The brain activation were higher than low craving participants.

CONCLUSION: The activation in specific brain area via visual cue stimulation were only in high craving betel-quid chewers. These finding is similar to previous substance craving studies. We suggest that these response patterns characterize the high vulnerability of relapse in short-term abstinent betel-quid dependent chewers.

並列關鍵字

craving ； cue-reactivity paradigm ； betel-quid ； addiction ； fMRI

參考文獻

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