口服吗啡一个月可减少腰痛患者右侧杏仁核灰质体积:证实先前报道的磁共振成像结果

Joanne C Lin, L. Chu, E. Stringer, Katharine S. Baker, Zahra N. Sayyid, John Sun, Kelsey A. Campbell, J. Younger
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引用次数: 31

摘要

目标。已知长期暴露于阿片类药物会在动物中产生神经可塑性改变;然而,很少有研究调查了人类短期处方阿片类药物使用的影响。我们实验室之前的一项研究表明,每天口服吗啡1个月的参与者右侧杏仁核的体积减少与剂量相关。本研究的目的是复制和扩展最初的研究结果。方法。21名慢性腰痛患者参加了这项双盲、安慰剂对照研究。参与者被随机分配接受1个月的每日吗啡(n = 11)或匹配的安慰剂(n = 10)。在给药前后立即获得高分辨率解剖图像。形态学上的灰质变化采用基于张量的形态测量法进行研究,并随后测试显著区域与吗啡剂量的相关性。结果。吗啡组在几个与奖励和疼痛相关的区域观察到灰质体积减少,包括双侧杏仁核、左下眶额皮质和双侧辅助前运动区。吗啡也与扣带区灰质显著增加有关,包括扣带中部、扣带前部背侧和扣带后部腹侧。结论。许多体积的增加和减少在空间上与先前报道的变化重叠。服用安慰剂1个月的人,灰质既没有增加也没有减少。结果证实了先前的报道,即短期处方阿片类药物使用后,奖励相关网络会发生快速变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
One Month of Oral Morphine Decreases Gray Matter Volume in the Right Amygdala of Individuals with Low Back Pain: Confirmation of Previously Reported Magnetic Resonance Imaging Results
Objective. Prolonged exposure to opioids is known to produce neuroplastic changes in animals; however, few studies have investigated the effects of short-term prescription opioid use in humans. A previous study from our laboratory demonstrated a dosage-correlated volumetric decrease in the right amygdala of participants administered oral morphine daily for 1 month. The purpose of this current study was to replicate and extend the initial findings. Methods. Twenty-one participants with chronic low back pain were enrolled in this double-blind, placebo-controlled study. Participants were randomized to receive daily morphine (n = 11) or a matched placebo (n = 10) for 1 month. High-resolution anatomical images were acquired immediately before and after the treatment administration period. Morphological gray matter changes were investigated using tensor-based morphometry, and significant regions were subsequently tested for correlation with morphine dosage. Results. Decreased gray matter volume was observed in several reward- and pain-related regions in the morphine group, including the bilateral amygdala, left inferior orbitofrontal cortex, and bilateral pre-supplementary motor areas. Morphine administration was also associated with significant gray matter increases in cingulate regions, including the mid cingulate, dorsal anterior cingulate, and ventral posterior cingulate. Conclusions. Many of the volumetric increases and decreases overlapped spatially with the previously reported changes. Individuals taking placebo for 1 month showed neither gray matter increases nor decreases. The results corroborate previous reports that rapid alterations occur in reward-related networks following short-term prescription opioid use.
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