The Quality Of Life And Health Survey For Patients With Alcohol Dependence Ablating The Nucleus Accumbens Using Stereotactic Surgery

Alcohol dependence is chronic central nervous system disorder caused by alcoholsubstance, mainly expression as a craving for alcohol and compulsive drinking. Afterwithdrawal there would be a serious psychological and physical symptoms, and restoringdrinking these symptoms quickly disappear, which is called the withdrawal syndrome.Long-term alcohol consumption as a substance abuse caused by alcohol dependence that isalso considered to be closely related with the Mesolimbic dopamine system(rewardcircuit). The acute effect of alcohol can induce alternation glutamate and GABAtransmission in the nucleus accumbens, but also to change the membrane electricalproperties of the medium spiny neurons.Long-term chronic alcohol exposure can affect therelease and the basal level of dopamine, glutamate and GABA,and induce long-lastneuroadaptations，so that the homeostasis of neuron changed. Long-last neuroadaptationsincrease the tolerance of alcohol, cause psychological and physiological signs ofwithdrawal, and then expand the formation of craving,dependence and compulsive drinking behavior. Stereotactic ablating in the bilateral nucleus accumbens is a good targetfor addiction treatment of severe psychological dependence and mitigation the withdrawalsymptoms. And through the post-operative follow-up report,fewer complicationshappened, the surgery is relatively safe. Thirty-three patients alcohol dependence (treatedsystematically with medication for detoxification over3times before, but had relapsedafter withdrawal) were treated by ablating the nucleus accumbens (NAC) bilaterally usingstereotactic surgery.12months later,to find out the change of the quality-of-life andhealth，all patients take the quality-of-life and health survey.The treatment effect andsafety of the surgery were analyzed. Relapse has only occurred in4cases. The prevalenceof relapse was12.2%within12months. And through statistics analyze the dataof theSF-36and WHOQOL-BREF（before surgery and12months later）,The quality-of-life andhealth of the patients improve markedly,and their subjective feeling make better.Ablatingnucleus accumbens (NAC) using stereotactic surgery is a effective and safe method toalleviate alcohol craving, reduce relapse rates and improve quality-of-life and health inpatients with alcohol dependence.