长期戒断海洛因成瘾者冲动性相关脑区的结构及功能特征

doi:10.3724/SP.J.1041.2021.00861

摘要/Abstract

摘要：

冲动性是药物成瘾者的典型特征, 它既包含了抑制控制成瘾者药物使用的力量, 也包含驱动成瘾者使用药物的成分, 两者不平衡导致冲动性用药行为。海洛因成瘾者本身具有冲动性人格特质, 长时间的海洛因使用又会造成成瘾者冲动性相关的大脑结构与功能的异常。目前难以确定戒断后, 冲动性及相关的大脑结构与功能是否还呈异常状态。本研究采用基于体素的形态学分析、低频振幅、局部一致性和功能连接方法, 以35例海洛因成瘾戒断者和无任何成瘾史的健康个体26人为研究对象, 探索在长期戒断后, 海洛因成瘾者与其冲动性相关的驱动、控制系统脑网络的结构和功能情况。结果显示, 相比对照组, 戒断组灰质总体积及右内侧额上回的灰质体积显著减小, 右侧颞中回和左内侧旁扣带回的灰质体积随用药总量的增加而降低; 右侧眶部额下回与尾状核功能连接显著增强, 右侧颞中回和左侧中央前回功能连接显著降低; 右眶额中回的ReHo值、右眶额下回和左海马体的ALFF值比对照组显著更低, 而右中央后回的ReHo值显著更高。这些脑区的状况与冲动性的神经基础相吻合, 说明海洛因成瘾戒断者在戒断44个月, 奖赏、凸显、习惯性行为等网络系统仍然呈现异常状态, 且与成瘾药物使用总量有关。这些异常可能是成瘾冲动性的驱动力的神经基础, 可以作为解释成瘾者戒断后容易复吸的因素之一。

关键词: 海洛因成瘾, 基于体素的形态学分析, 低频振幅, 局部一致性, 静息态功能连接

Abstract:

Impulsivity is a typical characteristic of drug addiction. In addition to the problems of inhibition and executive control, the driving force from multiple dimensions is also an important reason for impulsive drug use. The psychological drive stems from a variety of sources, including reward effect, S-R related cue response through conditioning. Low levels of inhibition are insufficient to resist the effects of the drive. This leads to an unbalanced state, which results in habitual behavior tendency.
Impulsivity has both a behavioral and neural basis. Although impulsivity may be a precursor of drug use, long-term use may also damage brain structures and functions related to the inhibition of impulsive behavior. There is an open question about whether these structures and functions recover after withdrawal. In this research we used multiple imaging methods to study the extent of recovery in heroin addicts who had been abstinent for several years on average.
Thirty-five abstinent heroin addicts (26 males; average period of abstinence = 43.55 months) and 26 healthy controls (26 males) were recruited using advertisements in the community. The heroin group and the healthy control group were compared on multiple measures of brain structure and function related to inhibition using the imaging methods of voxel-based morphometry (VBM), amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo). Based on the amplitude of low-frequency fluctuation (ALFF), right inferior frontal gyrus (15, 60, -6) was selected as the region of interest in which to study functional connectivity (FC).
Heroin addicts showed damage in inhibition-related brain structures and functions an average of 44 months after withdrawal, and the extent of damage was correlated with lifetime dose. (1) Compared to the healthy control group, the heroin group had significantly (a) lower gray matter volume (p = 0.03) and lower whole-brain volume (p = 0.05); (b) lower gray matter in the right superior frontal gyrus (p_AlphaSim < 0.01); (c) higher regional homogeneity in right posterior central gyrus and lower regional homogeneity in right middle frontal gyrus of the orbitofrontal cortex (p_AlphaSim < 0.01); (d) lower amplitude of low-frequency fluctuation in right inferior frontal gyrus of the orbitofrontal cortex and left hippocampus (p_AlphaSim < 0.01); (e) higher functional connectivity between right inferior frontal gyrus of the orbitofrontal cortex and the right caudate, and lower functional connectivity between the right inferior frontal gyrus and right middle temporal gyrus as well left precentral gyrus (p_AlphaSim < 0.01). (2) Within the heroin group, higher lifetime dose of heroin was significantly associated with lower gray matter volume in the right middle temporal gyrus and left middle cingulate (p_AlphaSim < 0.01).
The results showed that compared to healthy controls, heroin addicts had significant damage in brain structure and functions related to impulsivity even after an average period of 44 months of abstinence. In addition, the extent of damage was correlated with the lifetime dose of heroin. These results suggest that heroin addicts could continue to show impulsive behavior even after several years of abstinence, perhaps explaining the high rate of relapse in this population. Future research could test this conclusion by examining correlations between brain damage in areas related to inhibition and behavioral measures of impulsivity after a period of abstinence. The current evidence underscores the need to take impulsivity into account in relapse prevention programs for heroin addicts.

Key words: heroin addiction, voxel-based morphometry, amplitude of low-frequency fluctuation, regional homogeneity, functional connectivity

中图分类号:

B849

蔡惠燕, 苗心, 王鹏飞, 林志为, 王孟成, 杨文登, 麻彦坤, 曾红. (2021). 长期戒断海洛因成瘾者冲动性相关脑区的结构及功能特征. 心理学报, 53(8), 861-874.

CAI Huiyan, MIAO Xin, WANG Pengfei, LIN Zhiwei, WANG Mengcheng, YANG Wendeng, MA Yankun, ZENG Hong. (2021). Structural and functional characteristics of impulsive-related brain regions in heroin addicts with long-term withdrawal. Acta Psychologica Sinica, 53(8), 861-874.

图/表 18

参考文献 55

[1]	Albein-Urios, N., Verdejo-Román, J., Asensio, S., Soriano- Mas, C., Martínez-gonzález, J. M., & Verdejo-Garcia, A. (2014). Re-appraisal of negative emotions in cocaine dependence: Dysfunctional corticolimbic activation and connectivity. Addiction Biology, 19(3),415-426. doi: 10.1111/j.1369-1600.2012.00497.x pmid: 22978709
[2]	Belin, D., Mar, A. C., Dalley, J. W., Robbins, T. W., & Everitt, B. J. (2008). High impulsivity predicts the switch to compulsive cocaine-taking. Science, 320(5881),1352-1355. doi: 10.1126/science.1158136 URL
[3]	Cheng, G. L. F., Liu, Y. -P., Chan, C. C. H., So, K. -F., Zeng, H., & Lee, T. M. C. (2015). Neurobiological underpinnings of sensation seeking trait in heroin abusers. European Neuropsychopharmacology, 25(11),1968-1980. doi: 10.1016/j.euroneuro.2015.07.023 URL
[4]	Connock, M., Stevens, C., Fry-Smith, A., Jowett, S., Fitzmaurice, D., Moore, D., & Song, F. (2007). Clinical effectiveness and cost-effectiveness of different models of managing long-term oral anticoagulation therapy: A systematic review and economic modelling. Health Technology Assessment, 11(38),iii-iv, ix-66.
[5]	Dalley, J. W., Fryer, T. D., Brichard, L., Robinson, E. S. J., Theobald, D. E. H., Lääne, K., … Robbins, T. W. (2007). Nucleus accumbens D2/3 receptors predict trait impulsivity and cocaine reinforcement. Science, 315(5816),1267-1270. doi: 10.1126/science.1137073 URL
[6]	Dalley, J. W., & Robbins, T. W. (2017). Fractionating impulsivity: Neuropsychiatric implications. Nature Reviews Neuroscience, 18(3),158-171.
[7]	Deserno, L., Wilbertz, T., Reiter, A., Horstmann, A., Neumann, J., Villringer, A., … Schlagenhauf, F. (2015). Lateral prefrontal model-based signatures are reduced in healthy individuals with high trait impulsivity. Translational Psychiatry, 5(10),1-9.
[8]	du Boisgueheneuc, F., Levy, R., Volle, E., Seassau, M., Duffau, H., Kinkingnehun, S., … Dubois, B. (2006). Functions of the left superior frontal gyrus in humans: A lesion study. Brain, 129(12),3315-3328. doi: 10.1093/brain/awl244 URL
[9]	Ersche, K. D., Jones, P. S., Williams, G. B., Smith, D. G., Bullmore, E. T., & Robbins, T. W. (2013). Distinctive personality traits and neural correlates associated with stimulant drug use versus familial risk of stimulant dependence. Biological Psychiatry, 74(2),137-144. doi: 10.1016/j.biopsych.2012.11.016 pmid: 23273722
[10]	Ersche, K. D., Jones, P., Williams, G., Turton, A., Robbins, T., & Bullmore, E. (2012). Abnormal brain structure implicated in stimulant drug addiction. Science, 335(6068),601-604. doi: 10.1126/science.1214463 pmid: 22301321
[11]	Ersche, K. D., Turton, A. J., Pradhan, S., Bullmore, E. T., & Robbins, T. W. (2010). Drug addiction endophenotypes: Impulsive versus sensation-seeking personality traits. Biological Psychiatry, 68(8),770-773. doi: 10.1016/j.biopsych.2010.06.015 pmid: 20678754
[12]	Everitt, B. J., & Robbins, T. W. (2016). Drug Addiction: Updating actions to habits to compulsions ten years on. In S. T. Fiske (Ed.), Annual Review of Psychology, 67,23-50. doi: 10.1146/annurev-psych-122414-033457 pmid: 26253543
[13]	Fu, L. -P., Bi, G. -H., Zou, Z. -T., Wang, Y., Ye, E. -M., Ma, L., … Yang, Z. (2008). Impaired response inhibition function in abstinent heroin dependents: An fMRI study. Neuroscience Letters, 438(3),322-326. doi: 10.1016/j.neulet.2008.04.033 URL
[14]	Gallagher, H. L., Happe, F., Brunswick, N., Fletcher, P. C., Frith, U., & Frith, C. D. (2000). Reading the mind in cartoons and stories: An fMRI study of “theory of mind” in verbal and nonverbal tasks. Neuropsychologia, 38(1),11-21. pmid: 10617288
[15]	Gardini, S., & Venneri, A. (2012). Reduced grey matter in the posterior insula as a structural vulnerability or diathesis to addiction. Brain Research Bulletin, 87(2-3),205-211.
[16]	Goldstein, R. Z., & Volkow, N. D. (2002). Drug addiction and its underlying neurobiological basis: Neuroimaging evidence for the involvement of the frontal cortex. American Journal of Psychiatry, 159(10),1642-1652. pmid: 12359667
[17]	Grusser, S. M., Wrase, J., Klein, S., Hermann, D., Smolka, M. N., Ruf, M., … Heinz, A. (2004). Cue-induced activation of the striatum and medial prefrontal cortex is associated with subsequent relapse in abstinent alcoholics. Psychopharmacology, 175(3),296-302. doi: 10.1007/s00213-004-1828-4 URL
[18]	Hassani-Abharian, P., Ganjgahi, H., Tabatabaei-Jafari, H., Oghabian, M. A., Mokri, A., & Ekhtiari, H. (2015). Exploring neural correlates of different dimensions in drug craving self-reports among heroin dependents. Basic and Clinical Neuroscience, 6(4),271-283. pmid: 26649165
[19]	He, Z., Zhou, X. -H., Wang, X. -Y., Liu, J., & Hao, W. (2008). Longitudinal observation on brain structure in the heroin dependence patients during abstince. Chinese Journal of Clinical Psychology, 16(4),358-359.
	[ 贺忠, 周旭辉, 王绪轶, 刘军, 郝伟.(2008). 海洛因依赖者停药后脑灰质密度的纵向研究. 中国临床心理学杂志, 16(4),358-359+354.]
[20]	Hobkirk, A. L., Bell, R. P., Utevsky, A. V., Huettel, S., & Meade, C. S. (2019). Reward and executive control network resting-state functional connectivity is associated with impulsivity during reward-based decision making for cocaine users. Drug and Alcohol Dependence, 194,32-39. doi: 10.1016/j.drugalcdep.2018.09.013
[21]	Hogarth, L., Chase, H. W., & Baess, K. (2012). Impaired goal-directed behavioural control in human impulsivity. Quarterly Journal of Experimental Psychology, 65(2),305-316. doi: 10.1080/17470218.2010.518242 URL
[22]	Hu, Y., Salmeron, B. J., Gu, H., Stein, E. A., & Yang, Y. (2015). Impaired functional connectivity within and between frontostriatal circuits and its association with compulsive drug use and trait impulsivity in cocaine addiction. Jama Psychiatry, 72(6),584-592. doi: 10.1001/jamapsychiatry.2015.1 URL
[23]	Jia, X. Z., Wang, J., Sun, H. Y., Zhang, H., Liao, W., Wang, Z., … Zang, Y. F. (2019). RESTplus: An improved toolkit for resting-state functional magnetic resonance imaging data processing. Science Bulletin, 64(14),953-954. doi: 10.1016/j.scib.2019.05.008 URL
[24]	Keihani, A., Ekhtiari, H., Batouli, S. A. H., Shahbabaie, A., Sadighi, N., Mirmohammad, M., & Oghabian, M. A. (2017). Lower gray matter density in the anterior cingulate cortex and putamen can be traceable in chronic heroin dependents after over three months of successful abstinence. Iranian Journal of Radiology, 14(3),e41858.
[25]	Koob, G. F., & Volkow, N. D. (2010). Neurocircuitry of addiction. Neuropsychopharmacology, 35(1),217-238. doi: 10.1038/npp.2009.110 URL
[26]	Koob, G. F., & Volkow, N. D. (2016). Neurobiology of addiction: A neurocircuitry analysis. Lancet Psychiatry, 3(8),760-773. doi: 10.1016/S2215-0366(16)00104-8 URL
[27]	Lench, D. H., DeVries, W., & Hanlon, C. A. (2017). The effect of task difficulty on motor performance and frontal-striatal connectivity in cocaine users. Drug and Alcohol Dependence, 173,178-184. doi: 10.1016/j.drugalcdep.2016.12.008 URL
[28]	Li, M., Tian, J., Zhang, R., Qiu, Y., Wen, X., Ma, X., … Huang, R. (2014). Abnormal cortical thickness in heroin-dependent individuals. Neuroimage, 88,295-307. doi: 10.1016/j.neuroimage.2013.10.021 URL
[29]	Liu, H., Hao, Y., Kaneko, Y., Ouyang, X., Zhang, Y., Xu, L., … Liu, Z. (2009). Frontal and cingulate gray matter volume reduction in heroin dependence: Optimized voxel- based morphometry. Psychiatry and Clinical Neurosciences, 63(4),563-568. doi: 10.1111/pcn.2009.63.issue-4 URL
[30]	Martz, M. E., Zucker, R. A., Schulenberg, J. E., & Heitzeg, M. M. (2018). Psychosocial and neural indicators of resilience among youth with a family history of substance use disorder. Drug and Alcohol Dependence, 185,198-206. doi: 10.1016/j.drugalcdep.2017.12.015 URL
[31]	McHugh, M. J., Gu, H., Yang, Y., Adinoff, B., & Stein, E. A. (2015). Executive control network connectivity strength protects against relapse to cocaine use. Addiction Biology, 22(6),1790-1801. doi: 10.1111/adb.12448 URL
[32]	Morein-Zamir, S., & Robbins, T. W. (2015). Fronto-striatal circuits in response-inhibition: Relevance to addiction. Brain Research, 1628,117-129. doi: 10.1016/j.brainres.2014.09.012 pmid: 25218611
[33]	Pattij, T., & de Vries, T. J. (2013). The role of impulsivity in relapse vulnerability. Current Opinion in Neurobiology, 23(4),700-705. doi: 10.1016/j.conb.2013.01.023 pmid: 23462336
[34]	Prisciandaro, J. J., Myrick, H., Henderson, S., McRae-Clark, A. L., & Brady, K. T. (2013). Prospective associations between brain activation to cocaine and no-go cues and cocaine relapse. Drug and Alcohol Dependence, 131(1-2),44-49. doi: 10.1016/j.drugalcdep.2013.01.023 URL
[35]	Qiu, Y. W., Su, H. H., Lv, X. F., Ma, X. F., Jiang, G. H., & Tian, J. Z. (2017). Intrinsic brain network abnormalities in codeine-containing cough syrup-dependent male individuals revealed in resting-state fMRI. Journal of Magnetic Resonance Imaging, 45(1),177-186. doi: 10.1002/jmri.25352 URL
[36]	Ray, S., Gohel, S., & Biswal, B. B. (2015). Altered functional connectivity strength in abstinent chronic cocaine smokers compared to healthy controls. Biological Psychiatry, 5(8),476-486.
[37]	Shen, Y., Wang, E., Wang, X., & Lou, M. (2012). Disrupted integrity of white matter in heroin-addicted subjects at different abstinent time. Journal of Addiction Medicine, 6(2),172-176. doi: 10.1097/ADM.0b013e318252db94 URL
[38]	Tabatabaei-Jafari, H., Ekhtiari, H., Ganjgahi, H., Hassani- Abharian, P., Oghabian, M. -A., Moradi, A., … Zarei, M. (2014). Patterns of brain activation during craving in heroin dependents successfully treated by methadone maintenance and abstinence-based treatments. Journal of Addiction Medicine, 8(2),123-129. doi: 10.1097/ADM.0000000000000022 pmid: 24637623
[39]	Vaquero, L., Cámara, E., Sampedro, F., Pérez de los Cobos, J., Batlle, F., Fabregas, J. M., … Riba, J. (2017). Cocaine addiction is associated with abnormal prefrontal function, increased striatal connectivity and sensitivity to monetary incentives, and decreased connectivity outside the human reward circuit. Addiction Biology, 22(3),844-856. doi: 10.1111/adb.12356 pmid: 26786150
[40]	Wang, L., Zou, F., Zhai, T., Lei, Y., Tan, S., Jin, X., … Yang, Z. (2016). Abnormal gray matter volume and resting-state functional connectivity in former heroin-dependent individuals abstinent for multiple years. Addiction Biology, 21(3),646-656. doi: 10.1111/adb.12228 URL
[41]	Wang, P., Yan, R., Miao, X., & Zeng, H. (2019). Impulsivity or habitual behavior? The function and mechanism of impulsivity in different phases of drug addiction. Advances in Psychological Science, 27(5),834-842. doi: 10.3724/SP.J.1042.2019.00834 URL
	[ 王鹏飞, 严瑞婷, 苗心, 曾红.(2019). 冲动还是习惯? 成瘾不同阶段中冲动性的性质与机制. 心理科学进展, 27(5),834-842.]
[42]	Wang, X., Li, B., Zhou, X., Liao, Y., Tang, J., Liu, T., … Hao, W. (2012). Changes in brain gray matter in abstinent heroin addicts. Drug and Alcohol Dependence, 126(3),304-308. doi: 10.1016/j.drugalcdep.2012.05.030 URL
[43]	Wei, X., Li, W., Chen, J., Li, Y., Zhu, J., Shi, H., … Wang, W. (2019). Assessing drug cue-induced brain response in heroin dependents treated by methadone maintenance and protracted abstinence measures. Brain Imaging and Behavior, 14(4),1221-1229. doi: 10.1007/s11682-019-00051-5 URL
[44]	Wollman, S. C., Alhassoon, O. M., Stern, M. J., Hall, M. G., Rompogren, J., Kimmel, C. L., & Perez-Figueroa, A. M. (2015). White matter abnormalities in long-term heroin users: A preliminary neuroimaging meta-analysis. American Journal of Drug and Alcohol Abuse, 41(2),133-138. doi: 10.3109/00952990.2014.985829 URL
[45]	Yan, X., Li, W., Wang, Y., Li, Q., Li, Y., Zhu, J., … Wang, W. (2015). A DTI study of brain white matter integrity in heroin addicts under short-time abstinence. Chinese Journal of Magnetic Resonance Imaging, 6(2),98-103.
	[ 严雪娇, 李玮, 王亚蓉, 李强, 李永斌, 朱佳, … 王玮.(2015). 短期戒断的海洛因成瘾者大脑白质完整性的DTI研究. 磁共振成像, 6(2),98-103.]
[46]	Yan, X., Li, W., Wang, Y., Li, Q., Zhu, J., Li, Y., & Wang, W. (2016). Diffsion tensor imgaing evalutaion of effects of abstinence tiime on white integrity of heroin addicts. Chinese Journal of Medical Imaging Technology, 32(1),25-29.
	[ 严雪娇, 李玮, 王亚蓉, 李强, 朱佳, 李永斌, 王玮.(2016). DTI评价戒断时间对海洛因成瘾者大脑白质完整性的影响. 中国医学影像技术, 32(1),25-29.]
[47]	Yang, L., Zhang, Y., Cao, H., Xu, J., Du, J. -H., & Zhang, J. -X. (2019). Restorability of Working Memory in Heroin Addicts with Short-term Withdrawal. Chinese Journal of Clinical Psychology, 27(4),652-656.
	[ 杨玲, 张炀, 曹华, 徐景, 杜军红, 张建勋.(2019). 海洛因依赖短期戒断者工作记忆的可恢复性. 中国临床心理学杂志, 27(4),652-656.]
[48]	Yuan, Y., Zhu, Z., Shi, J., Zou, Z., Yuan, F., Liu, Y., … Weng, X. (2009). Gray matter density negatively correlates with duration of heroin use in young lifetime heroin-dependent individuals. Brain and Cognition, 71(3),223-228. doi: 10.1016/j.bandc.2009.08.014 pmid: 19775795
[49]	Zeng, H., Su, D., Wang, P., Wang, M., Vollstädt-Klein, S., Chen, Q., & Ye, H. (2018). The action representation elicited by different types of drug-related cues in heroin-abstinent individuals. Frontiers in Behavioral Neuroscience, 12,1-11. doi: 10.3389/fnbeh.2018.00001 URL
[50]	Zeng, H., Su, D. Q., Jiang, X., Chen, Q., & Ye, H. S. (2015). Activations of sensory-motor brain regions in response to different types of drug-associated cues. Acta Psychologica Sinica, 47(7),890-902. doi: 10.3724/SP.J.1041.2015.00890 URL
	[ 曾红, 苏得权, 姜醒, 陈骐, 叶浩生.(2015). 不同药物相关线索反应下感觉-运动脑区的激活及作用. 心理学报, 47(7),890-902.]
[51]	Zhang, R., Geng, X., & Lee, T. M. C. (2017). Large-scale functional neural network correlates of response inhibition: An fMRI meta-analysis. Brain Structure & Function, 222(9),3973-3990.
[52]	Zhou, P., Liu, D., Zhou, R., Sun, B., Xiao, J., & Li, S. (2014). Sensitivity to monetary reward in drug abstainers at different post-drug withdrawal phases: An ERP study. Chinese Journal of Clinical Psychology, 22(4),571-576.
	[ 周平艳, 刘丹玮, 周仁来, 孙本良, 肖洁, 李松.(2014). 不同戒断期毒品戒断者对金钱奖赏敏感性的ERP研究. 中国临床心理学杂志, 22(4),571-576.]
[53]	Zhou, P., Zhou, R., Hui, Y., Fan, W., Sun, B., & Xiao, J. (2014). Different healing phases of heroin abstainers' processing to emotional stimuli: The evidence from erp research. Psychological Exploration, 34(2),172-178.
	周平艳, 周仁来, 惠颖, 范文勇, 孙本良, 肖洁.(2014). 不同戒断期海洛因戒断者情绪加工的损伤和恢复. 心理学探新, 34(2),172-178.
[54]	Zhu, X., Cortes, C. R., Mathur, K., Tomasi, D., & Momenan, R. (2017). Model-free functional connectivity and impulsivity correlates of alcohol dependence: A resting-state study. Addiction Biology, 22(1),206-217. doi: 10.1111/adb.12272 pmid: 26040546
[55]	Zilverstand, A., Huang, A. S., Alia-Klein, N., & Goldstein, R. Z. (2018). Neuroimaging impaired response inhibition and salience attribution in human drug addiction: A systematic review. Neuron, 98(5),886-903. doi: S0896-6273(18)30282-4 pmid: 29879391

基本信息	完全戒断组(23)	美沙酮戒断组(12)	t	p	Cohen'sd
年龄(岁)	40.20 ± 3.54	41.82 ± 3.69	-1.25	0.22	-0.45
受教育程度(年)	9.04 ± 1.40	9.45 ± 1.04	-0.88	0.38	-0.33
香烟用量/天(根)	12.99 ± 5.42	15.48 ± 7.76	-1.11	0.27	-0.41
酒精用量/天(ml)	18.40 ± 10.02	18.48 ± 12.42	-0.02	0.98	-0.01
戒断前海洛因用量/天(g)	0.55 ± 0.28	0.65 ± 0.27	-0.78	0.44	-0.36
戒断前用量海洛因/月(g)	16.34 ± 8.31	18.75 ± 8.10	-0.78	0.44	-0.29
用药时长(月)	200.76 ± 40.84	223.80 ± 56.86	-1.35	0.19	-0.47
使用总量(g)	3417.44 ± 2102.84	4107.75 ± 2102.78	-0.88	0.39	-0.33
戒断时长(月)	42.43 ± 6.48	44.25 ± 5.28	-0.83	0.41	-0.31
灰质总量(mm³)	637.39 ± 63.43	664.90 ± 47.69	-1.24	0.23	-0.49
白质总量(mm³)	535.40 ± 59.03	537.40 ± 41.85	-0.10	0.92	-0.03
脑脊液总量(mm³)	234.49 ± 30.49	232.02 ± 23.93	0.23	0.82	0.09
颅内总体积(mm³)	1407.28 ± 132.81	1434.33 ± 97.14	-0.58	0.56	-0.23

基本信息	完全戒断组(23)	美沙酮戒断组(12)	t	p	Cohen'sd
年龄(岁)	40.20 ± 3.54	41.82 ± 3.69	-1.25	0.22	-0.45
受教育程度(年)	9.04 ± 1.40	9.45 ± 1.04	-0.88	0.38	-0.33
香烟用量/天(根)	12.99 ± 5.42	15.48 ± 7.76	-1.11	0.27	-0.41
酒精用量/天(ml)	18.40 ± 10.02	18.48 ± 12.42	-0.02	0.98	-0.01
戒断前海洛因用量/天(g)	0.55 ± 0.28	0.65 ± 0.27	-0.78	0.44	-0.36
戒断前用量海洛因/月(g)	16.34 ± 8.31	18.75 ± 8.10	-0.78	0.44	-0.29
用药时长(月)	200.76 ± 40.84	223.80 ± 56.86	-1.35	0.19	-0.47
使用总量(g)	3417.44 ± 2102.84	4107.75 ± 2102.78	-0.88	0.39	-0.33
戒断时长(月)	42.43 ± 6.48	44.25 ± 5.28	-0.83	0.41	-0.31
灰质总量(mm³)	637.39 ± 63.43	664.90 ± 47.69	-1.24	0.23	-0.49
白质总量(mm³)	535.40 ± 59.03	537.40 ± 41.85	-0.10	0.92	-0.03
脑脊液总量(mm³)	234.49 ± 30.49	232.02 ± 23.93	0.23	0.82	0.09
颅内总体积(mm³)	1407.28 ± 132.81	1434.33 ± 97.14	-0.58	0.56	-0.23

基本信息	戒断组(35)	对照组(26)	t	p	Cohen'sd
年龄(岁)	40.69 ± 3.61	42.31 ± 8.45	-0.90	0.37	0.25
受教育程度(年)	9.17 ± 1.30	10.50 ± 1.55	-3.48	0.00	0.93
香烟用量/天(根)	13.81 ± 8.27	11.43 ± 9.72	0.99	0.33	0.26
酒精用量/天(ml)	19.74 ± 13.93	8.84 ± 8.70	3.45	0.00	0.94
戒断前海洛因用量/天(g)	0.57 ± 0.27	N/A
戒断前海洛因用量/月(g)	17.03 ± 8.21	N/A
用药时长(月)	207.34 ± 45.65	N/A
使用总量(g)	3614.67 ± 2095.69	N/A
戒断时长(月)	43.55 ± 6.59	N/A

基本信息	戒断组(35)	对照组(26)	t	p	Cohen'sd
年龄(岁)	40.69 ± 3.61	42.31 ± 8.45	-0.90	0.37	0.25
受教育程度(年)	9.17 ± 1.30	10.50 ± 1.55	-3.48	0.00	0.93
香烟用量/天(根)	13.81 ± 8.27	11.43 ± 9.72	0.99	0.33	0.26
酒精用量/天(ml)	19.74 ± 13.93	8.84 ± 8.70	3.45	0.00	0.94
戒断前海洛因用量/天(g)	0.57 ± 0.27	N/A
戒断前海洛因用量/月(g)	17.03 ± 8.21	N/A
用药时长(月)	207.34 ± 45.65	N/A
使用总量(g)	3614.67 ± 2095.69	N/A
戒断时长(月)	43.55 ± 6.59	N/A

基本信息	戒断组(35)	对照组(26)	t	p	Cohen'sd
灰质总量(mm³)	625.41 ± 36.41	654.26 ± 63.43	-2.23	0.03	0.56
白质总量(mm³)	523.02 ± 51.08	540.36 ± 9.03	-1.28	0.21	0.47
脑脊液总量(mm³)	231.95 ± 18.98	234.16 ± 30.49	-0.34	0.73	0.09
脑实质占比(%)	0.83 ± 0.01	0.84 ± 0.02	-1.24	0.22	0.63
颅内总体积(mm³)	1380.38 ± 84.65	1428.79 ± 132.81	-1.74	0.09	0.43