Metabolism Of γ-Aminobutyric Acid And Glutamate In The Anterior Cingulate Gyrus Of Betel Quid Dependence Based On Magnetic Resonance Spectroscopy

Objective:Betel quid dependence（BQD）is a chronic recurrent brain disease.Long-term chewing of betel quid is harmful to health and can lead to diseases such as oral cancer.Betel quid dependence can lead to brain changes in structure and function,but only few studies have been done on cerebral biochemical metabolic changes.The purpose of this study is to use proton magnetic resonance spectroscopy（MRS）to investigate the concerntration of gamma-aminobutyric acid（GABA）in the anterior cingulate gyrus in patients with BQD,which may provide a favorable imaging evidence for the treatment and intervention of betel quid dependence.Methods:48 patients in the BQD group and 37 in the HC group were initially recruited in Hainan province.After excluding the combined smoking or alcohol dependence,motion artifacts and poor quality imaging,Fourty-nine individuals（BQD,n=27;HC,n=22）were enrolled in this research.We use J-difference edited point-resolved spectroscopy（MEGA-PRESS）to analyze the changes of GABA and Glu levels in the brain region of anterior cingulate cortex（ACC）,and use Gannet software to analyze the spectroscopy for processing.Since the signals detected at 3.0 ppm by using MEGA-PRESS technology contain macromolecular substances（MM）and GABA,we use GABA+to represent them.In addicton,The chemical structure and spectral peaks of Glu and glutamine（Glutamine,Gln）are very similar and overlapped,so they are collectively referred to as Glutamate-glutamine complex（Glx）.Using creatine as a reference,non-parametric tests were used to analyze the changes of GABA+/Cr and Glx/Cr between the two groups,and the correlation analysis with the clinical characteristics assessment scale was performed.Result:Compared with the healthy control group,the level of GABA+/Cr in the ACC area of BQD patients was decreased,which was statistically different（z=-2.294,P=0.013）.There was no significant statistical difference in GABA+/H₂O（z=-1.186,P=0.236）,also Glx/Cr and Glx/H₂O did not reach statistical significant difference between the two groups（z=-0.171,P=0.864;z=-0.342,P=0.733）.GABA+/Cr was positively correlated with the duration of the disease（r=0.406,P=0.035）and the daily dose（r=0.408,P=0.034）,was negatively co-rrelated score of HAMA-14（r=-0.427,P=0.026）,while there is no statistical correlation with the score of HAMD-24,Mo CA,BIS-11（r=-0.007,P=0.960;r=0.195,P=0.179;r=0.119,P=0.415）.Conclusion:The brain biochemical metabolism of betel quid dependence patients has changed in the present study and this alterations was associated with affective disorders.Magnetic resonance spectroscopy provides a non-invasive method for exploring the cerebral metabolism alterations in betel quid dependence,suggesting that the biochemical changes in the brain play an important role in betel quid dependence and provides a new basis for the cell-specific drugs treatment.