title: Gray matter abnormalities associated with betel quid dependence: a voxel-based morphometry study.
abstract: BACKGROUND
  Betel quid dependence (BQD) patients have a cluster of cognitive, behavioral, and physiological symptoms which are associated with structural abnormalities in brain gray matter. However, so far there have neither been brain structural studies investigating the alterations related to BQD, nor studies assessing the brain structural changes with clinical indexes.
  
  
  METHODS
  65 subjects were recruited including 33 'pure' BQD patients and another 32 gender and age matched in the control group. T1 structural voxel-based morphometry (VBM) was performed to investigate the gray matter (GM) volume alterations. In BQD patients, Pearson correlation analysis was performed to investigate the association between GM segmentations and clinical indexes, including BQD scores, illness duration, SAS and SDS.
  
  
  RESULTS
  Compared with that of the control group, the VBM of GM in BQD patients exhibited a significant decrease in volume (All P values > 0.05, AlphaSim correction) in the midbrain, right anterior cingulate cortex (rACC), bilateral dorsolateral prefrontal cortex (dlPFC) and right superior temporal gyrus (STG), and also there was an increased volume in right hippocampal and right precuneus. GM volumes of the left DLPFC and right rACC showed negative correlation with the duration of BQD, meanwhile, midbrain volumes were negative correlating with BQD scores (All P values > 0.05).
  
  
  CONCLUSIONS
  Our findings suggested that brain structural changes were present in BQD patients, and those may be a neurobiological basis for BQD patients. These findings may provide a new insight into the pathogenesis of BQD. Also, VBM is an effective tool for in vivo investigation of gray matter alterations in patients with BQD.
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University Nanjing 210002, Jiangsu Province, China ; Department of Radiology, People's Hospital of Hainan Province Haikou 570311, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University Nanjing 210002, Jiangsu Province, China ; School of Psychology, Nanjing Normal University Nanjing 210097, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University Nanjing 210002, Jiangsu Province, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University Nanjing 210002, Jiangsu Province, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Neurology, People's Hospital of Hainan Province Haikou 570311, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Radiology, People's Hospital of Hainan Province Haikou 570311, China.
authors.forename: Mengjie
authors.initials: M
authors.lastname: Pan
authors.affiliation: Department of Radiology, People's Hospital of Hainan Province Haikou 570311, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Clinical School of Southern Medical University Nanjing 210002, Jiangsu Province, China.
authors.forename: Guangming
authors.initials: G
authors.lastname: Lu
keywords: Betel quid; betel quid dependence; drug dependence; gray matter; voxel-based morphometry