全麻下超快速脱瘾治疗对可待因止咳药水成瘾患者神经机制的影响：多模态MRI研究

Substance addiction is a chronic, relapse brain disease. Codeine-containing cough syrups (CCS) are acknowledged as a new kind of addictive drug. Ultra-rapid opioid detoxification under general Anesthesia (UROD) have the advantage of getting patients through detoxification rapidly to minimize the risk of relapse, which is considerd the most effective way for the CCS-dependent individuals. However, the neuromechanism underlying UROD are still not understood. Our previous work had indicated that chronic CCS abuse can disrupt the resting-state brain function, gray matter and white matter microstructure in CCS-dependent individuals, while 2 weeks after UROD treatment, the resting state brain function can recover to some extent. Based on our preliminary work, the blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) in resting state, high resolusion 3D-structural imaging and diffusion tensor imaging (DTI) are performed to investigate the changes of brain function, gray matter volume and white matter microstructure in CCS-dependent individuals before the UROD treatment, and 2 months, 6 months, 12 months after UROD treatment longitudinally. The purposes of this proposal are to investigate the neural mechanisms of UROD on CCS-dependent individudals, to find the functional and structural image biomarker implying the effecacy and prognosis of UROD on CCS-dependent individuals.

药物成瘾是一个慢性、反复的脑部疾病。含可待因的止咳药水是近年来逐渐被认识的新型成瘾药物。全麻下超快速脱瘾（UROD）能有效缩短可待因止咳药水成瘾患者的躯体脱瘾时间，被认为是可待因止咳药水成瘾患者最有效的治疗方法。然而， UROD对可待因止咳药水成瘾患者作用的神经机制目前尚不清楚，临床上也缺乏疗效评价的客观指标。课题组前期研究表明，可待因止咳药水成瘾患者静息态脑功能、灰质体积和白质微结构存在异常；而UROD治疗后2周，可待因止咳药水成瘾患者脑功能存在不同程度恢复。本项目拟在前期研究基础上，采用静息态BOLD-fMRI、高分辨3D-T1WI、DTI成像技术纵向观察可待因止咳药水成瘾患者UROD治疗前、治疗后2个月、6个月及12个月的静息态脑功能及结构的变化情况。探讨UROD对可待因止咳药水成瘾患者作用的神经机制，以期为可待因止咳药水成瘾患者UROD治疗后的疗效评估、预后判断提供客观影像学依据。