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Vol. 81, No. 1-4, 2003
Issue release date: January 2004
Meet Am Soc Stereotact Funct Neurosurg, New York, N.Y., 2003. Stereotact Funct Neurosurg 2003;81:96–104
(DOI:10.1159/000075111)

Clinical Study for Alleviating Opiate Drug Psychological Dependence by a Method of Ablating the Nucleus accumbens with Stereotactic Surgery

Gao G. · Wang X. · He S. · Li W. · Wang Q. · Liang Q. · Zhao Y. · Hou F. · Chen L. · Li A.
Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xian, China

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Abstract

The aim of this study was to explore a new way of treating drug addiction by ablating the nucleus accumbens (NAC), which has a close relationship with drug-induced psychological dependence, using stereotactic surgery, blocking the mesocorticolimbic dopamine circuit, alleviating craving for drugs and lowering the relapse rate after detoxification. On the basis of animal experiments, stereotactic surgery was performed in 28 patients by making a lesion in the NAC bilaterally to treat opiate drug dependence. Indications, the criterion of therapeutic effect, treatment process and the therapeutic and safety evaluation index of the surgery were formulated particularly. The mean follow-up period was 15 months. Relapse has not occurred in 11 cases up till now. Drug-free time in these patients has been more than half a year in 4 cases (more than a year in 3 cases), and less than half a year in 7 cases. Relapse occurred in 15 cases after surgery. Drug-free time in these patients was more than half a year in 3 cases, between 1 month and half a year in 10 cases and less than 1 month in 2 cases. The therapeutic effect was excellent in 7 cases (26.9%), good in 10 cases (38.5%) and poor in 2 cases (7.7%). Another 7 cases were still under investigation at the time of writing. Relapse rates after surgery were 7.7, 38.5 and 57.5% within 1 month, between 1 month and half a year and after more than half a year, respectively. There were no common complications of surgery such as intracranial hematoma or infection in these patients after operation. Character type was changed slightly in 2 cases, and 4 cases suffered temporary memory loss, which did not affect their daily lives and learning function. They all recovered within 1 month. There were different degrees of effectiveness of treating drug addicts’ psychological dependence by making lesions in the NAC bilaterally with stereotactic surgery. No particular complications occurred. The operation is safe and feasible. The mean follow-up time in this study was 15 months. The effectiveness was satisfactory. The relapse rate of drug addicts after detoxification was clearly reduced.



Copyright / Drug Dosage

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Wang TY, Chen JR, Chen CG, et al: Treatment of drug addiction with gamma knife radiosurgery. J China Med Univ 1997;26:641–643.
  2. Qing BY: The present state of drug abuse and therapy in China. Chin J Drug Depend 1999;8:81–85.
  3. Li B, Zhang JW, Liu CH, et al: Clinical study on treatment of drug addiction with gamma knife radiosurgery. J Harbin Med Univ 2000;34:73–74.
  4. Hutcheson DI, Parkinson JA, Robbins TW, Everitt BJ: The effects of nucleus accumbens core and shell lesions on intravenous heroin self-administration and the acquisition of drug-seeking behaviour under a second-order schedule of heroin reinforcement. Psychopharmacology (Berl) 2000;153:464–472.

    External Resources

  5. Alderson HL, Parkinson JA, Robbins TW, Everitt BJ: The effects of excitotoxic lesions of the nucleus accumbens core or shell regions on intravenous heroin self-administration in rats. Psychopharmacology (Berl) 2001;153:455–463.
  6. Shi JG: Addiction Medicine, ed 1. Beijing, Science Press, 2002.
  7. He SHM, Gao GD, Wang XL, et al: The effect of the nucleus accumbens and ventral pallidum lesions on seeking behavior in rats. Mod Rehabil 2001;5:62–63.
  8. He SHM, Gao GD, Wang XL, et al: Effect of ventral pallidum lesions on drug seeking behavior in rats. Chin J Drug Depend 2001;10:182–184.


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