论文部分内容阅读
目的：探索重复经颅磁刺激（ repetitive transcranial magnetic stimulation，rTMS）治疗氯胺酮心理渴求的疗效，以及产生疗效的神经学机制。方法：10名有氯胺酮心理渴求者采用视觉模拟渴求评分（ visual Analogue Scale，vAS）评估心理渴求后进行rTMS治疗，治疗位点为右侧前额叶背外侧皮质，刺激频率15Hz，共10次。治疗结束后对比分析治疗前后患者脑功能活动的静息态功能磁共振（ resting-state fMRI）局部一致性（ Regional Homogeneity，ReHo）变化情况。结果：与治疗前相比，治疗后氯胺酮心理渴求者视觉模拟渴求评分（ vAS）显著下降（ P=0.002）；静息态功能分析发现左额叶中上回ReHo信号减低，右内侧额上回和右扣带回的ReHo增强（ P<0.05，AlphaSim校正，cluster size=85）。结论：本研究提示rTMS治疗氯胺酮渴求具有潜在疗效，涉及的神经学机制可能与额叶-边缘系统的相关回路有关。“,”ObjEctivE:To explore the effects of repetitive transcranial magnetic stimulation( rTMS)for the treatment of ketamine craving and the neural mechanism. MEthods:Ketamine dependent patients(n=10)were treated with rTMS directed to right dorsolat-eral frontal cortex. Drug craving scores were evaluated by a visual analogue scale. Resting-state fMRI was scanned before and after the treatment,then regional homogeneity( ReHo)was employed to analyze alterations of the functional brain activities. REsuIts:After 10 sessions of rTMS treatment,the ketamine craving scores decreased significantly(P=0. 002);ReHo signal decreased statistically in left superior middle frontal gyrus and increased in right medial frontal gyrus and cingulated gyrus.( P<0. 05,AlphaSim correction, cluster size=85). ConcIusion:This study suggested the potential effectiveness of rTMS on ketamine craving and the frontal-limbic cir-cuit might be involved in the neural mechanism.