吸烟者戒断的脑结构和功能影像学研究

Tobacco dependence is recognized as a chronic recurrent disease by International Classification of Diseases (ICD-10). Mesolimbic dopamine reward system plays an important role on the pathogenesis of tobacco dependence. Even with the most effective smoking cessation treatment, there was only about 25% of smokers could quit more than one year. It will provide the theoretical support for smoking cessation treatment by understanding the changes of the structure and function in smokers' brain. It was reported that the structure and function of reward-related brain regions between smokers and non-smokers were different. However, it is not clear that the changes of the structure and function in smokers' brain after cessation. This study will use multi-modal magnetic resonance imaging to investigate the characteristic of the structual and functional changes in smokers'brain after cessation. The main contents including: ①the characteristic of resting state functional changes in smokers' brain region related when quitting in 24 hours without task. ②the characteristic of gray matter density, white matter integrity and resting state functional connectivity changes in smokers' brain when quitting in 3 months without task. If this study was successful completed, it will provide the experimental evidence for revealing the characteristic of the structure and function in smokers' brain after cessation, and will be helpful to develop reasonable personalized smoking cessation treatment and improve the successful cessation rates.

烟草依赖已被列入国际疾病分类(ICD-10)，是一种慢性高复发性疾病，其发病与中脑边缘系统的奖赏通路有关。即使给予最有效的戒烟治疗，目前也仅有约25%的吸烟者能成功戒烟1年以上。理解吸烟者戒烟后脑结构和功能的变化可为戒烟治疗提供理论依据。研究发现吸烟者奖赏相关脑区的结构及功能与不吸烟者存在差异，但尚不清楚吸烟者戒烟后脑结构和功能的变化情况。本研究拟在既往研究基础上，采用多模态磁共振技术，探究吸烟者戒烟后奖赏相关脑区的结构和功能变化特点。研究内容包括：① 24小时戒断无任务状态下，吸烟者相关脑区静息态功能连接的变化特点；② 3个月持续戒断无任务状态下，吸烟者相关脑区皮层厚度、白质纤维连接和静息态功能连接的变化特点。项目若顺利完成，将为揭示吸烟者戒断后的脑结构和功能特点提供实验依据，并为将来开发合理化戒烟治疗、提高戒烟成功率奠定理论基础。

背景：烟草依赖已被列入国际疾病分类(ICD-10)，是一种慢性高复发性疾病，其发病与中脑边缘系统的奖赏通路有关。即使给予最有效的戒烟治疗，目前也仅有约25%的吸烟者能成功戒烟1 年以上。理解吸烟者戒烟后脑结构和功能的变化可为戒烟治疗提供理论依据。研究发现吸烟者奖赏相关脑区的结构及功能与不吸烟者存在差异，但尚不清楚吸烟者戒烟后脑结构和功能的变化情况。主要研究内容：① 24 小时戒断无任务状态下，吸烟者相关脑区静息态功能连接的变化特点；② 3 个月持续戒断无任务状态下，吸烟者相关脑区皮层厚度、白质纤维连接和静息态功能连接的变化特点。重要结果：①吸烟者在静息状态下成瘾相关的脑区活动增加。②与非吸烟者相比，中青年男性轻度和重度吸烟者都表现出了比非吸烟者更小的灰质和白质体积，且在重度吸烟者中更明显。关键数据：①与不吸烟者相比，吸烟者在左枕中回、左边缘叶和左小脑后叶显示了明显的fALFF（分数低频率波动振幅）增加，与轻度吸烟者相比，重度吸烟者在右颞上回、右中央前回和右枕叶/楔叶显示了明显的fALFF增加，与不严重的尼古丁依赖者（FTND≦6）相比，严重的尼古丁依赖者（FTND﹥6）在右/左额中回、右额上回和左顶下小叶显示了明显的fALFF增加。②轻度和重度吸烟者中灰质更小的主要脑区有颞上回、岛叶、枕中回、后扣带回、楔前叶，白质更小的主要脑区有后扣带回、丘脑和中脑。科学意义：该项目为揭示吸烟者戒断后的脑结构和功能特点提供了实验依据，并为将来开发合理化戒烟治疗、提高戒烟成功率奠定理论基础。