摘要目的:探讨青少年网络游戏障碍（IGD）患者中缝核功能连接特征及其与神经递质受体/转运体系统的关系。方法:回顾性纳入2022年9月至2023年12月在郑州大学第一附属医院就诊的青少年IGD患者（IGD组），同期招募年龄、性别、受教育年限匹配的健康志愿者（对照组）。采用网络成瘾测试（IAT）、24项汉密尔顿抑郁量表（HAMD-24）和14项汉密尔顿焦虑量表（HAMA-14）分别评估IGD组的IGD、抑郁和焦虑的严重程度。采集两组的全脑静息态功能MRI数据，选取背侧中缝核（DR）和中缝中央核（MR）作为种子点，以年龄、性别、受教育年限为协变量，分析比较IGD组和对照组DR和MR与全脑功能连接的差异。基于跨模态数据分析工具包JuSpace，分析IGD组差异功能连接与不同神经递质受体/转运体系统的PET和单光子发射计算机断层扫描衍生图之间的空间相关性。结果:IGD组52例，男43例，女9例，年龄（14.6±2.0）岁，受教育年限（8.7±1.9）年；对照组46名，男34名，女12名，年龄（16.1±5.9）岁，受教育年限（9.5±4.4）年。IGD组的IAT为（62.5±10.8）分，HAMD-24为（22.5±12.7）分，HAMA-14为（14.6±9.6）分。以DR为种子点，IGD组左侧额中回（ t=4.43）、左侧顶下小叶（ t=4.25）、左侧辅助运动区（ t=4.60）、左侧中央前回（ t=4.12）、左侧额上回（ t=4.00）的功能连接水平高于对照组［高斯随机场（GRF）校正，体素水平均 P<0.005，团块水平均 P<0.05］。以MR为种子点，IGD组右侧小脑Crus I功能连接水平高于对照组（ t=5.66，GRF校正，体素水平 P<0.005，团块水平 P<0.05）。IGD组与对照组存在差异的DR功能连接与多巴胺系统（D1、D2）、5-羟色胺（5-HT）系统（5-HT1a、5-HT1b、5-HT2a）和μ-阿片受体系统相关（Bonferroni校正， P<0.05/24）。 结论:青少年IGD患者存在中缝核全脑功能连接异常，且与多种神经递质系统有关。

abstractsObjective:To investigate the functional connectivity (FC) characteristics of the raphe nucleus in adolescents with internet gaming disorder (IGD) and its relationship with the neurotransmitter receptor/transporter system.Method:This retrospective study enrolled adolescent IGD patients (IGD group) at the First Affiliated Hospital of Zhengzhou University between September 2022 and December 2023, and age-, sex-, and education-matched healthy volunteers (control group) were recruited concurrently. The severity of IGD, depression, and anxiety in the IGD group was assessed using the Internet Addiction Test (IAT), 24-item Hamilton Depression Rating Scale (HAMD-24), and 14-item Hamilton Anxiety Rating Scale (HAMA-14), respectively. Whole-brain resting-state functional MRI (rs-fMRI) data were collected for both groups. The dorsal raphe nucleus (DR) and median raphe nucleus (MR) were selected as seed points, with age, sex, and education years included as covariates for comparing FC differences between the IGD and control groups. The cross-modal JuSpace toolbox was used to analyze spatial correlations between altered FC in the IGD group and PET/SPECT-derived maps of various neurotransmitter receptor/transporter systems.Results:The IGD group comprised 52 participants [43 males, 9 females, age (14.6±2.0) years, years of education (8.7±1.9) years], while the control group consisted of 46 participants [34 males, 12 females, age (16.1±5.9) years, years of education (9.5±4.4) years]. The IAT, HAMD-24, and HAMA-14 of the IGD group were (62.5±10.8) points, (22.5±12.7) points, and (14.6±9.6) points. With the DR as the seed point, the IGD group showed higher FC in the left middle frontal gyrus ( t=4.43), left inferior parietal lobule ( t=4.25), left supplementary motor area ( t=4.60), left precentral gyrus ( t=4.12), and left superior frontal gyrus ( t=4.00) compared to the control group [Gaussian random field (GRF) corrected, voxel level P<0.005, mass level P<0.05]. With the MR as the seed point, the IGD group showed higher FC in the right cerebellum Crus I compared with the control group [ t=5.66, GRF corrected, voxel level P<0.005, mass level P<0.05]. The altered DR-related FC in the IGD group was spatially correlated with the dopamine (D1, D2), serotonin (5-HT1a, 5-HT1b, 5-HT2a), and μ-opioid receptor systems (Bonferroni correction, P<0.05/24). Conclusion:Adolescent IGD patients displayed abnormal whole-brain FC of raphe nucleus, which is associated with multiple neurotransmitter systems.