Hai-Kang Zhao

Publications (2)2.63 Total impact

• Article: Nucleus Accumbens Surgery for Addiction.

  Nan Li, Jing Wang, Xue-Lien Wang, Chong-Wang Chang, Shun-Nan Ge, Li Gao, He-Ming Wu, Hai-Kang Zhao, Ning Geng, Guo-Dong Gao
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  ABSTRACT: Opiate addiction remains intractable in a large percentage of patients, and relapse is biggest hurdles to recovery because of the psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. Based on animal experiment, our institute started the clinical trial for the treatment of drug addicts' psychological dependence by making lesions in the bilateral NAc with stereotactic surgery from July 2000.The short-term outcomes were encourage and triggered rapid application of this treatment in China from 2003 to 2004. However, lack of long-term outcomes and controversy eventually lead to halting the surgery for addiction by Ministry of Health of China in November 2004 and a nationwide survey about it later. Our institute had performed this surgery in 272 patients with severe heroin addiction. The follow up study showed the 5 years non-relapse rate was 58% and the quality of life was significantly improved. The patients had several kinds of side effects, but the incidence rate is relatively low. The patients gradually recovered in more than 5 years after the surgery. The side effects would not severely influence individual life and work. Nationwide surgery showed the non-relapse rate was 50% in the sample of 150 cases，from 1167 patients in all who underwent stereotactic surgery in China. Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has significantly impacts on treatment efficacy and need further studies. Since ablation is irreversible, the NAc Surgery for addiction should be performed with cautiousness and the deep brain stimulation（DBS）is ideal alternative.
  World Neurosurgery 10/2012; · 0.68 Impact Factor
• Article: Associations between personality changes and nucleus accumbens ablation in opioid addicts.

  Hai-kang Zhao, Chong-wang Chang, Ning Geng, Li Gao, Jing Wang, Xin Wang, Ya-rong Wang, Xue-lian Wang, Guo-dong Gao
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  ABSTRACT: It has been reported that nucleus accumbens (NAc) lesions can help to prevent relapse in opioid addicts. This article aimed to investigate associations between personality changes and NAc lesions. The surgery group consisted of 78 patients who had received bilateral stereotactic lesions of the NAc to treat opioid addiction. Seventy two non-surgery opioid addicts were appropriately paired with the patients of the surgery group as the non-surgery group. All participants were interviewed in person and received urine tests, naloxone provocative tests and hair tests to determine the prevalence of relapse. Eysenck personality questionnaire (EPQ) and the health survey questionnaire (SF-36) were employed to assess personality and functional health, respectively. In the surgery group, 30 participants relapsed, and the non-relapse rate was 61.5% (48/78). Compared with the Chinese normative data, the neuroticism (N) and psychoticism (P) dimensions of the EPQ in the non-surgery group were significantly higher, whereas the lie (L) dimension was significantly lower. There was no significant difference in all dimensions of the EPQ between the surgery group and the Chinese normative data. The N dimension in the relapse group and the L dimension in the surgery group were significantly lower than those of the non-surgery group. The P dimension in the relapse group was significantly higher than that of the non-relapse group. The extraversion (E) dimension was relatively stable between these groups. Although the influence of other factors cannot be excluded, it is apparent that surgically induced NAc lesions are associated with lower P and N dimensions for opioid addicts, and a higher P dimension is associated with a tendency to relapse.
  Acta Pharmacologica Sinica 04/2012; 33(5):588-93. · 1.95 Impact Factor