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Bilaus B, Turchinski NR, Ahdoot HL, Gavish RE, Shany O, Maayan R, Rosca P, Weizman A, Delayahu Y, Yadid G, Admon R. The Effect of Dehydroepiandrosterone Administration during Rehabilitation on White Matter Integrity Among Individuals With Polysubstance Use Disorder. J Addict Med 2023; 17:551-556. [PMID: 37788608 DOI: 10.1097/adm.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Individuals with polysubstance use disorder (pSUD) exhibit vulnerability to relapse even after prolonged abstinence, with rehabilitation efforts achieving limited success. Previous studies highlighted dehydroepiandrosterone (DHEA) as a putative therapeutic agent that may aid rehabilitation, potentially by impacting white matter (WM) properties. The current study tested, for the first time, the effect of DHEA administration during rehabilitation on WM integrity among pSUD individuals, while assessing its putative association with long-term relapse rates. METHODS Immediately after admission to rehabilitation, 30 pSUD individuals were assigned to receive either placebo or DHEA (100 mg) daily for 3 months, via a randomized double-blind counterbalanced design. Participants also provided blood samples to assess circulating DHEA levels at treatment initiation and completed a diffusion tensor imaging (DTI) scan approximately 1 month after treatment initiation. Clinical status was evaluated 16 months after treatment initiation. Thirty matched healthy controls also underwent a DTI scan without any intervention. RESULTS DHEA administration was not associated with reduced relapse rates compared with placebo. Nevertheless, exploratory analysis revealed that DHEA was associated with successful rehabilitation among pSUD individuals with low circulating DHEA levels at treatment initiation. White matter integrity in the splenium corpus callosum (CC) was reduced in pSUD individuals compared with healthy controls, yet pSUD individuals receiving DHEA exhibited recovery of splenium CC WM integrity. CONCLUSIONS DHEA administration during rehabilitation may restore WM integrity in the CC among pSUD individuals. Although DHEA was not associated with reduced relapse rates in here, its therapeutic efficacy may depend on circulating DHEA levels at treatment initiation.
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Affiliation(s)
- Ben Bilaus
- From the School of Psychological Sciences, University of Haifa, Haifa, Israel (BB, RA); Sagol Department of Neurobiology, University of Haifa, Haifa, Israel (NRT); Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel (HLA, REG, GY); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (OS); Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (OS); The Laboratory of Molecular Psychiatry, Felsenstein Medical Research Center, Petah Tikva, Israel (RM, AW); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (RM, AW, YD); Department for the Treatment of Substance Abuse and Mental Health Services, Israeli Ministry of Health, Jerusalem, Israel (PR); Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel (PR); Research Unit, Geha Mental Health Center, Petah Tikva, Israel (AW); The Dual Diagnosis Ward, Abarbanel Mental Health Center, Bat Yam, Israel (YD); The Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel (RA)
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Gaudreault PO, King SG, Malaker P, Alia-Klein N, Goldstein RZ. Whole-brain white matter abnormalities in human cocaine and heroin use disorders: association with craving, recency, and cumulative use. Mol Psychiatry 2023; 28:780-791. [PMID: 36369361 PMCID: PMC9911401 DOI: 10.1038/s41380-022-01833-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022]
Abstract
Neuroimaging studies in substance use disorder have shown widespread impairments in white matter (WM) microstructure suggesting demyelination and axonal damage. However, substantially fewer studies explored the generalized vs. the acute and/or specific drug effects on WM. Our study assessed whole-brain WM integrity in three subgroups of individuals addicted to drugs, encompassing those with cocaine (CUD) or heroin (HUD) use disorder, compared to healthy controls (CTL). Diffusion MRI was acquired in 58 CTL, 28 current cocaine users/CUD+, 32 abstinent cocaine users/CUD-, and 30 individuals with HUD (urine was positive for cocaine in CUD+ and opiates used for treatment in HUD). Tract-Based Spatial Statistics allowed voxelwise analyses of diffusion metrics [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD)]. Permutation statistics (p-corrected < 0.05) were used for between-group t-tests. Compared to CTL, all individuals with addiction showed widespread decreases in FA, and increases in MD, RD, and AD (19-57% of WM skeleton, p < 0.05). The HUD group showed the most impairments, followed by the CUD+, with only minor FA reductions in CUD- (<0.2% of WM skeleton, p = 0.05). Longer periods of regular use were associated with decreased FA and AD, and higher subjective craving was associated with increased MD, RD, and AD, across all individuals with drug addiction (p < 0.05). These findings demonstrate extensive WM impairments in individuals with drug addiction characterized by decreased anisotropy and increased diffusivity, thought to reflect demyelination and lower axonal packing. Extensive abnormalities in both groups with positive urine status (CUD+ and HUD), and correlations with craving, suggest greater WM impairments with more recent use. Results in CUD-, and correlations with regular use, further imply cumulative and/or persistent WM damage.
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Affiliation(s)
- Pierre-Olivier Gaudreault
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sarah G King
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Pias Malaker
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Nelly Alia-Klein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Rita Z Goldstein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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White matter alterations in chronic MDMA use: Evidence from diffusion tensor imaging and neurofilament light chain blood levels. NEUROIMAGE: CLINICAL 2022; 36:103191. [PMID: 36126513 PMCID: PMC9486575 DOI: 10.1016/j.nicl.2022.103191] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 12/14/2022] Open
Abstract
3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy") is a serotonin- and noradrenaline-releasing substance, currently among the most widely used illicit substances worldwide. In animal studies, repeated exposure to MDMA has been associated with dendritic but also axonal degeneration in the brain. However, translation of the axonal findings, specifically, to humans has been repeatedly questioned and the few existing studies investigating white matter alterations in human chronic MDMA users have yielded conflicting findings. In this study, we combined whole-brain diffusion tensor imaging and neurofilament light chain (NfL) analysis in blood to reveal potential MDMA-induced axonal neuropathology. To this end, we assessed 39 chronic MDMA users and 39 matched MDMA-naïve healthy controls. MDMA users showed increased fractional anisotropy in several white matter tracts, most prominently in the corpus callosum as well as corticospinal tracts, with these findings partly related to MDMA use intensity. However, the NfL levels of MDMA users were not significantly different from those of controls. We conclude that MDMA use is not associated with significant white matter lesions due to the absence of reduced fractional anisotropy and increased NfL levels commonly observed in conditions associated with white matter lesions, including stimulant and ketamine use disorders. Hence, the MDMA-induced axonal degradation demonstrated in animal models was not observed in this human study of chronic MDMA users.
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Agunbiade K, Fonville L, McGonigle J, Elliott R, Ersche KD, Flechais R, Orban C, Murphy A, Smith DG, Suckling J, Taylor EM, Deakin B, Robbins TW, Nutt DJ, Lingford‐Hughes AR, Paterson LM, Nutt D, Lingford‐Hughes A, Paterson L, McGonigle J, Flechais R, Orban C, Deakin B, Elliott R, Murphy A, Taylor E, Robbins T, Ersche K, Suckling J, Smith D, Reed L, Passetti F, Faravelli L, Erritzoe D, Mick I, Kalk N, Waldman A, Nestor L, Kuchibatla S, Boyapati V, Metastasio A, Faluyi Y, Fernandez‐Egea E, Abbott S, Sahakian B, Voon V, Rabiner I. Alterations in white matter microstructure in alcohol and alcohol‐polydrug dependence: Associations with lifetime alcohol and nicotine exposure. Addict Biol 2022. [PMCID: PMC9540248 DOI: 10.1111/adb.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Evidence suggests that alcohol dependence (AD) is associated with microstructural deficits in white matter, but the relationship with lifetime alcohol exposure and the impact of polydrug dependence is not well understood. Using diffusion tensor magnetic resonance (MR) imaging, we examined white matter microstructure in relation to alcohol and polydrug dependence using data from the Imperial College Cambridge Manchester (ICCAM) platform study. Tract‐based spatial statistics were used to examine fractional anisotropy (FA) in a cohort of abstinent AD participants, most of whom had a lifetime history of dependence to nicotine. A further subgroup also had a lifetime history of dependence to cocaine and/or opiates. Individuals with AD had lower FA throughout the corpus callosum, and negative associations with alcohol and nicotine exposure were found. A group‐by‐age interaction effect was found showing greater reductions with age in the alcohol‐dependent group within corpus callosum, overlapping with the group difference. We found no evidence of recovery with abstinence. A comparison of alcohol‐only‐ and alcohol‐polydrug‐dependent groups found no differences in FA. Overall, our findings show that AD is associated with lower FA and suggest that these alterations are primarily driven by lifetime alcohol consumption and cigarette smoking, showing no relationship with exposure to other substances such as cocaine, opiates or cannabis. Reductions in FA across the adult lifespan are more pronounced in AD and offer further support for the notion of accelerated ageing in relation to alcohol dependence. These findings highlight there may be lasting structural differences in white matter in alcohol dependence, despite continued abstinence.
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Affiliation(s)
- Kofoworola Agunbiade
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Leon Fonville
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - John McGonigle
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Karen D. Ersche
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychiatry University of Cambridge Cambridge UK
- Department of Systems Neuroscience University Medical Centre Hamburg‐Eppendorf Hamburg Germany
| | - Remy Flechais
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Csaba Orban
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | - Anna Murphy
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Dana G. Smith
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychology University of Cambridge Cambridge UK
| | - John Suckling
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychiatry University of Cambridge Cambridge UK
| | - Eleanor M. Taylor
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, Institute of Brain, Behaviour and Mental Health University of Manchester Manchester UK
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute University of Cambridge Cambridge UK
- Department of Psychology University of Cambridge Cambridge UK
| | - David J. Nutt
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
| | | | - Louise M. Paterson
- Division of Psychiatry, Department of Brain Sciences Imperial College London London UK
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Lu L, Yang W, Zhang X, Tang F, Du Y, Fan L, Luo J, Yan C, Zhang J, Li J, Liu J, von Deneen KM, Yu D, Liu J, Yuan K. Potential brain recovery of frontostriatal circuits in heroin users after prolonged abstinence: A preliminary study. J Psychiatr Res 2022; 152:326-334. [PMID: 35785575 DOI: 10.1016/j.jpsychires.2022.06.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022]
Abstract
Neuroscientists have devoted efforts to explore potential brain recovery after prolonged abstinence in heroin users (HU). However, not much is known about whether frontostriatal circuits can recover after prolonged abstinence in HU. An eight-month longitudinal study was carried out for HU. Two MRI scans were obtained at baseline (HU1) and 8-month follow-up (HU2). The functional and structural connectivities of dorsal and ventral frontostriatal pathways were measured by resting-state functional connectivity (RSFC) and diffusion tensor imaging (DTI). Correlation analyses were employed to reveal the associations between neuroimaging and behavioral changes. Results suggested that relative to healthy controls (HCs), HU1 showed lower fractional anisotropy (FA) in the right dorsolateral prefrontal cortex (DLPFC)-to-caudate tracts and medial orbitofrontal cortex (mOFC)-to-nucleus accumbens (NAc) tracts as well as decreased RSFC in the left mOFC-NAc circuits. Longitudinal results revealed reduced craving and enhanced cognitive control in HU2 compared with HU1. After prolonged abstinence, HU2 showed increased FA values in the right DLPFC-caudate and mOFC-NAc tracts as well as increased RSFC strength in the bilateral mOFC-NAc circuits compared with HU1. In addition, changes in RSFC and FA values in the right mOFC-NAc circuit were negatively correlated with craving score changes. Similarly, negative correlations were also found between changes of RSFC in the bilateral DLPFC-caudate circuits and TMT-A scores. We provided scientific evidence for brain recovery of the dorsal and ventral frontostriatal circuits in HU after prolonged abstinence, and these circuits may be potential neuroimaging biomarkers for cognition and craving changes.
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Affiliation(s)
- Ling Lu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China; Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Wenhan Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaozi Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China; Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Fei Tang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Yanyao Du
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Li Fan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Luo
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Cui Yan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Zhang
- Hunan Judicial Police Academy, Changsha, China
| | - Jun Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China; Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Jixin Liu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China; Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, Shaanxi, 710071, China
| | - Karen M von Deneen
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Dahua Yu
- International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China.
| | - Kai Yuan
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China; Engineering Research Center of Molecular and Neuroimaging, Ministry of Education, Xi'an, Shaanxi, 710071, China; International Joint Research Center for Advanced Medical Imaging and Intelligent Diagnosis and Treatment & Xi'an Key Laboratory of Intelligent Sensing and Regulation of trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China; Information Processing Laboratory, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, 014010, China.
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Michels L, Moisa M, Stämpfli P, Hirsiger S, Baumgartner MR, Surbeck W, Seifritz E, Quednow BB. The impact of levamisole and alcohol on white matter microstructure in adult chronic cocaine users. Addict Biol 2022; 27:e13149. [PMID: 35394690 PMCID: PMC9287079 DOI: 10.1111/adb.13149] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 11/16/2021] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
Previous brain imaging studies with chronic cocaine users (CU) using diffusion tensor imaging (DTI) mostly focused on fractional anisotropy to investigate white matter (WM) integrity. However, a quantitative interpretation of fractional anisotropy (FA) alterations is often impeded by the inherent limitations of the underlying tensor model. A more fine-grained measure of WM alterations could be achieved by measuring fibre density (FD). This study investigates this novel DTI metric comparing 23 chronic CU and 32 healthy subjects. Quantitative hair analysis was used to determine intensity of cocaine and levamisole exposure-a cocaine adulterant with putative WM neurotoxicity. We first assessed the impact of cocaine use, levamisole exposure and alcohol use on group differences in WM integrity. Compared with healthy controls, all models revealed cortical reductions of FA and FD in CU. At the within-patient group level, we found that alcohol use and levamisole exposure exhibited regionally different FA and FD alterations than cocaine use. We found mostly negative correlations of tract-based WM associated with levamisole and weekly alcohol use. Specifically, levamisole exposure was linked with stronger WM reductions in the corpus callosum than alcohol use. Cocaine use duration correlated negatively with FA and FD in some regions. Yet, most of these correlations did not survive a correction for multiple testing. Our results suggest that chronic cocaine use, levamisole exposure and alcohol use were all linked to significant WM impairments in CU. We conclude that FD could be a sensitive marker to detect the impact of the use of multiple substances on WM integrity in cocaine but also other substance use disorders.
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Affiliation(s)
- Lars Michels
- Department of NeuroradiologyUniversity Hospital ZurichZurichSwitzerland
- Neuroscience Center ZurichUniversity of Zurich and Swiss Federal Institute of Technology ZurichZurichSwitzerland
| | - Marius Moisa
- Zurich Center for Neuroeconomics, Department of NeuroeconomicsUniversity of ZurichZurichSwitzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy, and PsychosomaticsPsychiatric Hospital of the University of ZurichZurichSwitzerland
| | - Sarah Hirsiger
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and PsychosomaticsPsychiatric Hospital of the University of ZurichZurichSwitzerland
| | - Markus R. Baumgartner
- Center of Forensic Hair Analytics, Institute of Forensic MedicineUniversity of ZurichZurichSwitzerland
| | - Werner Surbeck
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and PsychosomaticsPsychiatric Hospital of the University of ZurichZurichSwitzerland
| | - Erich Seifritz
- Neuroscience Center ZurichUniversity of Zurich and Swiss Federal Institute of Technology ZurichZurichSwitzerland
- Department of Psychiatry, Psychotherapy, and PsychosomaticsPsychiatric Hospital of the University of ZurichZurichSwitzerland
| | - Boris B. Quednow
- Neuroscience Center ZurichUniversity of Zurich and Swiss Federal Institute of Technology ZurichZurichSwitzerland
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and PsychosomaticsPsychiatric Hospital of the University of ZurichZurichSwitzerland
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Rasgado-Toledo J, Shah A, Ingalhalikar M, Garza-Villarreal EA. Neurite orientation dispersion and density imaging in cocaine use disorder. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110474. [PMID: 34758367 DOI: 10.1016/j.pnpbp.2021.110474] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/01/2023]
Abstract
Cocaine use disorder (CUD) is characterized by a compulsive search for cocaine. Several studies have shown that cocaine users exhibit cognitive deficits, including lack of inhibition and decision-making as well as brain volume and diffusion-based white-matter alterations in a wide variety of brain regions. However, the non-specificity of standard volumetric and diffusion-tensor methods to detect structural micropathology may lead to wrong conclusions. To better understand microstructural pathology in CUD, we analyzed 60 CUD participants (3 female) and 43 non-CUD controls (HC; 2 female) retrospectively from our cross-sectional Mexican SUD neuroimaging dataset (SUDMEX-CONN), using multi-shell diffusion-weighted imaging and the neurite orientation dispersion and density imaging (NODDI) analysis, which aims to more accurately model microstructural pathology. We used Viso values of NODDI that employ a three-compartment model in white (WM) and gray-matter (GM). These values were also correlated with clinical measures, including psychiatric severity status, impulsive behavior and pattern of cocaine and tobacco use in the CUD group. We found higher whole-brain microstructural pathology in WM and GM in CUD patients than controls. ROI analysis revealed higher Viso-NODDI values in superior longitudinal fasciculus, cingulum, hippocampus cingulum, forceps minor and Uncinate fasciculus, as well as in frontal and parieto-temporal GM structures. We also found correlations between significant ROI and impulsivity, onset age of cocaine use and weekly dosage with Viso-NODDI. However, we did not find correlations with psychopathology measures. Overall, although their clinical relevance remains questionable, microstructural pathology seems to be present in CUD both in gray and white matter.
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Affiliation(s)
- Jalil Rasgado-Toledo
- Instituto de Neurobiología, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, Mexico
| | - Apurva Shah
- Symbiosis Center for Medical Image Analysis, Symbiosis Institute of Technology, Symbiosis International University, Pune, Maharashtra, India
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis, Symbiosis Institute of Technology, Symbiosis International University, Pune, Maharashtra, India
| | - Eduardo A Garza-Villarreal
- Instituto de Neurobiología, Universidad Nacional Autónoma de México campus Juriquilla, Querétaro, Mexico.
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The neurobiology of drug addiction: cross-species insights into the dysfunction and recovery of the prefrontal cortex. Neuropsychopharmacology 2022; 47:276-291. [PMID: 34408275 PMCID: PMC8617203 DOI: 10.1038/s41386-021-01153-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 01/03/2023]
Abstract
A growing preclinical and clinical body of work on the effects of chronic drug use and drug addiction has extended the scope of inquiry from the putative reward-related subcortical mechanisms to higher-order executive functions as regulated by the prefrontal cortex. Here we review the neuroimaging evidence in humans and non-human primates to demonstrate the involvement of the prefrontal cortex in emotional, cognitive, and behavioral alterations in drug addiction, with particular attention to the impaired response inhibition and salience attribution (iRISA) framework. In support of iRISA, functional and structural neuroimaging studies document a role for the prefrontal cortex in assigning excessive salience to drug over non-drug-related processes with concomitant lapses in self-control, and deficits in reward-related decision-making and insight into illness. Importantly, converging insights from human and non-human primate studies suggest a causal relationship between drug addiction and prefrontal insult, indicating that chronic drug use causes the prefrontal cortex damage that underlies iRISA while changes with abstinence and recovery with treatment suggest plasticity of these same brain regions and functions. We further dissect the overlapping and distinct characteristics of drug classes, potential biomarkers that inform vulnerability and resilience, and advancements in cutting-edge psychological and neuromodulatory treatment strategies, providing a comprehensive landscape of the human and non-human primate drug addiction literature as it relates to the prefrontal cortex.
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9
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Ottino-González J, Uhlmann A, Hahn S, Cao Z, Cupertino RB, Schwab N, Allgaier N, Alia-Klein N, Ekhtiari H, Fouche JP, Goldstein RZ, Li CSR, Lochner C, London ED, Luijten M, Masjoodi S, Momenan R, Oghabian MA, Roos A, Stein DJ, Stein EA, Veltman DJ, Verdejo-García A, Zhang S, Zhao M, Zhong N, Jahanshad N, Thompson PM, Conrod P, Mackey S, Garavan H. White matter microstructure differences in individuals with dependence on cocaine, methamphetamine, and nicotine: Findings from the ENIGMA-Addiction working group. Drug Alcohol Depend 2022; 230:109185. [PMID: 34861493 PMCID: PMC8952409 DOI: 10.1016/j.drugalcdep.2021.109185] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/27/2021] [Accepted: 11/14/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nicotine and illicit stimulants are very addictive substances. Although associations between grey matter and dependence on stimulants have been frequently reported, white matter correlates have received less attention. METHODS Eleven international sites ascribed to the ENIGMA-Addiction consortium contributed data from individuals with dependence on cocaine (n = 147), methamphetamine (n = 132) and nicotine (n = 189), as well as non-dependent controls (n = 333). We compared the fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) of 20 bilateral tracts. Also, we compared the performance of various machine learning algorithms in deriving brain-based classifications on stimulant dependence. RESULTS The cocaine and methamphetamine groups had lower regional FA and higher RD in several association, commissural, and projection white matter tracts. The methamphetamine dependent group additionally showed lower regional AD. The nicotine group had lower FA and higher RD limited to the anterior limb of the internal capsule. The best performing machine learning algorithm was the support vector machine (SVM). The SVM successfully classified individuals with dependence on cocaine (AUC = 0.70, p < 0.001) and methamphetamine (AUC = 0.71, p < 0.001) relative to non-dependent controls. Classifications related to nicotine dependence proved modest (AUC = 0.62, p = 0.014). CONCLUSIONS Stimulant dependence was related to FA disturbances within tracts consistent with a role in addiction. The multivariate pattern of white matter differences proved sufficient to identify individuals with stimulant dependence, particularly for cocaine and methamphetamine.
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Affiliation(s)
- Jonatan Ottino-González
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States.
| | - Anne Uhlmann
- Department of Child & Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sage Hahn
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Zhipeng Cao
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Renata B. Cupertino
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Nathan Schwab
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Nicholas Allgaier
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Nelly Alia-Klein
- Department of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York City, New York, United States
| | - Hamed Ekhtiari
- Institute for Cognitive Sciences Studies, University of Tehran, Tehran, Iran,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Jean-Paul Fouche
- SA MRC Genomics and Brain Disorders Unit, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Rita Z. Goldstein
- Department of Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, New York City, New York, United States
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University, New Haven, Connecticut, United States
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Edythe D. London
- Department of Psychiatry and Biobehavioural Sciences, University of California, Los Angeles, California, United States
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Sadegh Masjoodi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Momenan
- Clinical Neuroimaging Research Core, National Institutes on Alcohol Abuse & Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Mohammad Ali Oghabian
- Neuroimaging & Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Annerine Roos
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa,SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Elliot A. Stein
- Neuroimaging Research Branch, Intramural Research Program, National Institute of Drug Abuse, Baltimore, Maryland, United States
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam UMC – location VUMC, Amsterdam, the Netherlands
| | - Antonio Verdejo-García
- School of Psychological Sciences & Turner Institute for Brain & Mental Health, Monash University, Melbourne, Australia
| | - Sheng Zhang
- Department of Psychiatry, Yale University, New Haven, Connecticut, United States
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Neda Jahanshad
- Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, San Diego, California, United States
| | - Paul M. Thompson
- Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, San Diego, California, United States
| | - Patricia Conrod
- Department of Psychiatry, Université de Montreal, Montreal, Quebec, Canada
| | - Scott Mackey
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, Vermont, United States
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10
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Tondo LP, Viola TW, Fries GR, Kluwe-Schiavon B, Rothmann LM, Cupertino R, Ferreira P, Franco AR, Lane SD, Stertz L, Zhao Z, Hu R, Meyer T, Schmitz JM, Walss-Bass C, Grassi-Oliveira R. White matter deficits in cocaine use disorder: convergent evidence from in vivo diffusion tensor imaging and ex vivo proteomic analysis. Transl Psychiatry 2021; 11:252. [PMID: 33911068 PMCID: PMC8081729 DOI: 10.1038/s41398-021-01367-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022] Open
Abstract
White matter (WM) abnormalities in patients with cocaine use disorder (CUD) have been studied; however, the reported effects on the human brain are heterogenous and most results have been obtained from male participants. In addition, biological data supporting the imaging findings and revealing possible mechanisms underlying the neurotoxic effects of chronic cocaine use (CU) on WM are largely restricted to animal studies. To evaluate the neurotoxic effects of CU in the WM, we performed an in vivo diffusion tensor imaging assessment of male and female cocaine users (n = 75) and healthy controls (HC) (n = 58). Moreover, we performed an ex vivo large-scale proteomic analysis using liquid chromatography-tandem mass spectrometry in postmortem brains of patients with CUD (n = 8) and HC (n = 12). Compared with the HC, the CUD group showed significant reductions in global fractional anisotropy (FA) (p < 0.001), and an increase in global mean (MD) and radial diffusion (RD) (both p < 0.001). The results revealed that FA, RD, and MD alterations in the CUD group were widespread along the major WM tracts, after analysis using the tract-based special statistics approach. Global FA was negatively associated with years of CU (p = 0.0421) and female sex (p < 0.001), but not with years of alcohol or nicotine use. Concerning the fibers connecting the left to the right prefrontal cortex, Brodmann area 9 (BA9), the CUD group presented lower FA (p = 0.006) and higher RD (p < 0.001) values compared with the HC group. A negative association between the duration of CU in life and FA values in this tract was also observed (p = 0.019). Proteomics analyses in BA9 found 11 proteins differentially expressed between cocaine users and controls. Among these, were proteins related to myelination and neuroinflammation. In summary, we demonstrate convergent evidence from in vivo diffusion tensor imaging and ex vivo proteomics analysis of WM disruption in CUD.
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Affiliation(s)
- Lucca Pizzato Tondo
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Thiago Wendt Viola
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Gabriel R Fries
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bruno Kluwe-Schiavon
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Leonardo Mello Rothmann
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Renata Cupertino
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Pedro Ferreira
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Scott D Lane
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Laura Stertz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Zhongming Zhao
- Center for Precision Health, School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ruifeng Hu
- Center for Precision Health, School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Thomas Meyer
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joy M Schmitz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Consuelo Walss-Bass
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Brain Institute, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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11
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Suchting R, Beard CL, Schmitz JM, Soder HE, Yoon JH, Hasan KM, Narayana PA, Lane SD. A meta-analysis of tract-based spatial statistics studies examining white matter integrity in cocaine use disorder. Addict Biol 2021; 26:e12902. [PMID: 32267062 DOI: 10.1111/adb.12902] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/18/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Abstract
Tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) studies have consistently shown diminished white matter (WM) integrity for individuals with cocaine use disorder (CUD). The present study used seed-based d mapping (SDM) to determine the extent to which a systematic difference in the WM integrity of cocaine users may exist (as compared with that of healthy controls). Articles from 2006 (when TBSS was first developed) to present were reviewed, with eight selected for inclusion. Meta-analysis found lower fractional anisotropy (FA) in the genu of the corpus callosum for cocaine users, with a small-to-moderate peak effect size (Hedge's g = -0.331). Sensitivity analyses mostly supported the robustness of the obtained difference. Differences detected at exploratory thresholds for significance suggested insult to WM integrity extending beyond the corpus callosum. The present results compliment a previous region-of-interest (ROI)-based meta-analysis of DTI studies in individuals with CUD. These findings have significant implications for the potential role of neuroprotective agents in the treatment of CUD and merit additional iteration as more studies accrue in the literature.
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Affiliation(s)
- Robert Suchting
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
| | | | - Joy M. Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
| | - Heather E. Soder
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
| | - Jin H. Yoon
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
| | - Khader M. Hasan
- Department of Diagnostic and Interventional Imaging, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
| | - Ponnada A. Narayana
- Department of Diagnostic and Interventional Imaging, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
| | - Scott D. Lane
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA
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12
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Prior cocaine self-administration impairs attention signals in anterior cingulate cortex. Neuropsychopharmacology 2020; 45:833-841. [PMID: 31775158 PMCID: PMC7075947 DOI: 10.1038/s41386-019-0578-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/04/2019] [Accepted: 11/15/2019] [Indexed: 01/11/2023]
Abstract
Although maladaptive decision-making is a defining feature of drug abuse and addiction, we have yet to ascertain how cocaine self-administration disrupts neural signals in anterior cingulate cortex (ACC), a brain region thought to contribute to attentional control. To address this issue, rats were trained on a reward-guided decision-making task; reward value was manipulated by independently varying the size of or the delay to reward over several trial blocks. Subsequently, rats self-administered either a cocaine (experimental group) or sucrose (control) during 12 consecutive days, after which they underwent a 1-month withdrawal period. Upon completion of this period, rats performed the previously learned reward-guided decision-making task while we recorded from single neurons in ACC. We demonstrate that prior cocaine self-administration attenuates attention and attention-related ACC signals in an intake-dependent manner, and that changes in attention are decoupled from ACC firing. These effects likely contribute to the impaired decision-making-typified by chronic substance abuse and relapse-observed after drug use.
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13
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A comparison of regional brain volumes and white matter connectivity in subjects with stimulant induced psychosis versus schizophrenia. Psychopharmacology (Berl) 2019; 236:3385-3399. [PMID: 31230145 DOI: 10.1007/s00213-019-05298-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/05/2019] [Indexed: 12/31/2022]
Abstract
RATIONALE Schizophrenia and stimulant-induced psychosis (SIP) represent two different forms of psychotic disorder, with different etiologies. While many of the symptoms of psychosis are common to both disorders, there have been few direct comparisons between these conditions, especially when controlling for stimulant use in individuals with schizophrenia. OBJECTIVES We directly compared both psychotic disorders with a comprehensive battery of clinical, neurocognitive and neuroanatomical measures. This included one group with SIP (and concurrent stimulant dependence) and two groups with schizophrenia (either with or without concurrent stimulant dependence). METHODS Ninety-six participants were recruited from a marginalized urban population, which included 39 with SIP (and concurrent stimulant dependence), 18 with schizophrenia (without stimulant dependence), and 39 with schizophrenia (with concurrent stimulant dependence). All subjects had extensive clinical and neurocognitive evaluations, complemented with structural MRI including diffusion tensor imaging (DTI) sequences to determine regional brain volumes and white matter connectivity. RESULTS Both positive and negative symptoms were greater in the SZ-dependent group than the other two. Neurocognitive function was broadly similar. The structural brain imaging revealed lateralized changes to the left parietal/temporal lobe, in which regional volumes were smaller in the SZ-dependent than the SZ-non-dependent group. DTI analysis indicated extensive decreases in fractional anisotropy, with parallel increases in radial diffusivity, in the SIP group compared to the SZ-dependent group. CONCLUSIONS These findings reveal both similarities and differences between SIP and schizophrenia. Furthermore, schizophrenia with concurrent stimulant dependence may be associated with a different clinical and neuroanatomical profile as compared to schizophrenia alone.
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14
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Stewart JL, May AC, Paulus MP. Bouncing back: Brain rehabilitation amid opioid and stimulant epidemics. NEUROIMAGE-CLINICAL 2019; 24:102068. [PMID: 31795056 PMCID: PMC6978215 DOI: 10.1016/j.nicl.2019.102068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/20/2019] [Accepted: 11/03/2019] [Indexed: 12/18/2022]
Abstract
Frontoparietal event related potentials predict/track recovery. Frontostriatal functional magnetic resonance imaging signals predict/track recovery. Transcranial magnetic left prefrontal stimulation reduces craving and drug use.
Recent methamphetamine and opioid use epidemics are a major public health concern. Chronic stimulant and opioid use are characterized by significant psychosocial, physical and mental health costs, repeated relapse, and heightened risk of early death. Neuroimaging research highlights deficits in brain processes and circuitry that are linked to responsivity to drug cues over natural rewards as well as suboptimal goal-directed decision-making. Despite the need for interventions, little is known about (1) how the brain changes with prolonged abstinence or as a function of various treatments; and (2) how symptoms change as a result of neuromodulation. This review focuses on the question: What do we know about changes in brain function during recovery from opioids and stimulants such as methamphetamine and cocaine? We provide a detailed overview and critique of published research employing a wide array of neuroimaging methods – functional and structural magnetic resonance imaging, electroencephalography, event-related potentials, diffusion tensor imaging, and multiple brain stimulation technologies along with neurofeedback – to track or induce changes in drug craving, abstinence, and treatment success in stimulant and opioid users. Despite the surge of methamphetamine and opioid use in recent years, most of the research on neuroimaging techniques for recovery focuses on cocaine use. This review highlights two main findings: (1) interventions can lead to improvements in brain function, particularly in frontal regions implicated in goal-directed behavior and cognitive control, paired with reduced drug urges/craving; and (2) the targeting of striatal mechanisms implicated in drug reward may not be as cost-effective as prefrontal mechanisms, given that deep brain stimulation methods require surgery and months of intervention to produce effects. Overall, more studies are needed to replicate and confirm findings, particularly for individuals with opioid and methamphetamine use disorders.
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Affiliation(s)
- Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Community Medicine, University of Tulsa, Tulsa, OK, United States.
| | - April C May
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
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15
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Beard CL, Schmitz JM, Soder HE, Suchting R, Yoon JH, Hasan KM, Narayana PA, Moeller FG, Lane SD. Regional differences in white matter integrity in stimulant use disorders: A meta-analysis of diffusion tensor imaging studies. Drug Alcohol Depend 2019; 201:29-37. [PMID: 31176066 PMCID: PMC6660908 DOI: 10.1016/j.drugalcdep.2019.03.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/20/2019] [Accepted: 03/25/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Converging lines of evidence from diffusion tensor imaging (DTI) studies reveal significant alterations in white matter (WM) microstructure in the prefrontal cortex of chronic stimulant users compared to controls, suggesting compromised axonal microstructure and/or myelin. METHODS A meta-analysis of DTI-based WM integrity was conducted for white matter regions across the corpus callosum and association fibers. Articles were sourced and selected using PRISMA guidelines for systematic review and meta-analysis. Inclusion and exclusion criteria were determined by the authors in order to best capture WM integrity among individuals with primary stimulant use in comparison to healthy control subjects. RESULTS Eleven studies that focused on region-of-interest (ROI)-based analysis of WM integrity were extracted from an initial pool of 113 independent studies. Analysis across ROIs indicated significantly lower fractional anisotropy (FA) values in stimulant use groups compared to controls with a small to moderate overall effect (Hedges' g = -0.37, 95% CI [-0.54, -0.20]). Eigenvalues were also analyzed, revealing a significant effect for radial diffusivity (RD; Hedges' g = 0.24, 95% CI [0.01, 0.47]) but not axial diffusivity (AD; Hedges' g = 0.05, 95% CI [-0.20, 0.29]) or mean diffusivity (MD; Hedges' g = 0.20, 95% CI [-0.01, 0.41]). Subgroup analyses based on specific ROIs, primary substance use, poly-substance use, and imaging technology were also explored. CONCLUSION Results of the present study suggest a consistent effect of compromised WM integrity for individuals with stimulant use disorders. Furthermore, no significant differences were found between cocaine and methamphetamine-based groups.
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Affiliation(s)
- Charlotte L Beard
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Rd., Houston, TX, 77054, USA; Department of Psychology, Palo Alto University, Palo Alto, CA, 94304, USA
| | - Joy M Schmitz
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Rd., Houston, TX, 77054, USA.
| | - Heather E Soder
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Rd., Houston, TX, 77054, USA
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Rd., Houston, TX, 77054, USA
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Rd., Houston, TX, 77054, USA
| | - Khader M Hasan
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, 77054, USA
| | - Ponnada A Narayana
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, 77054, USA
| | | | - Scott D Lane
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Rd., Houston, TX, 77054, USA
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16
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Tannous J, Mwangi B, Hasan KM, Narayana PA, Steinberg JL, Walss-Bass C, Moeller FG, Schmitz JM, Lane SD. Measures of possible allostatic load in comorbid cocaine and alcohol use disorder: Brain white matter integrity, telomere length, and anti-saccade performance. PLoS One 2019; 14:e0199729. [PMID: 30625144 PMCID: PMC6326479 DOI: 10.1371/journal.pone.0199729] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 12/07/2018] [Indexed: 12/03/2022] Open
Abstract
Chronic cocaine and alcohol use impart significant stress on biological and cognitive systems, resulting in changes consistent with an allostatic load model of neurocognitive impairment. The present study measured potential markers of allostatic load in individuals with comorbid cocaine/alcohol use disorders (CUD/AUD) and control subjects. Measures of brain white matter (WM), telomere length, and impulsivity/attentional bias were obtained. WM (CUD/AUD only) was indexed by diffusion tensor imaging metrics, including radial diffusivity (RD) and fractional anisotropy (FA). Telomere length was indexed by the telomere to single copy gene (T/S) ratio. Impulsivity and attentional bias to drug cues were measured via eye-tracking, and were also modeled using the Hierarchical Diffusion Drift Model (HDDM). Average whole-brain RD and FA were associated with years of cocaine use (R2 = 0.56 and 0.51, both p < .005) but not years of alcohol use. CUD/AUD subjects showed more anti-saccade errors (p < .01), greater attentional bias scores (p < .001), and higher HDDM drift rates on cocaine-cue trials (Bayesian probability CUD/AUD > control = p > 0.99). Telomere length was shorter in CUD/AUD, but the difference was not statistically significant. Within the CUD/AUD group, exploratory regression using an elastic-net model determined that more years of cocaine use, older age, larger HDDM drift rate differences and shorter telomere length were all predictive of WM as measured by RD (model R2 = 0.79). Collectively, the results provide modest support linking CUD/AUD to putative markers of allostatic load.
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Affiliation(s)
- Jonika Tannous
- Program in Neuroscience, UTHealth Graduate School of Biomedical Sciences, Houston, Texas, United States of America
| | - Benson Mwangi
- Department of Psychiatry & Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, United States of America
| | - Khader M. Hasan
- Department of Diagnostic and Interventional Imaging, UTHealth McGovern Medical School, Houston, Texas, United States of America
| | - Ponnada A. Narayana
- Program in Neuroscience, UTHealth Graduate School of Biomedical Sciences, Houston, Texas, United States of America
- Department of Diagnostic and Interventional Imaging, UTHealth McGovern Medical School, Houston, Texas, United States of America
| | - Joel L. Steinberg
- Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Consuelo Walss-Bass
- Program in Neuroscience, UTHealth Graduate School of Biomedical Sciences, Houston, Texas, United States of America
- Department of Psychiatry & Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, United States of America
| | - F. Gerard Moeller
- Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Joy M. Schmitz
- Department of Psychiatry & Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, United States of America
| | - Scott D. Lane
- Program in Neuroscience, UTHealth Graduate School of Biomedical Sciences, Houston, Texas, United States of America
- Department of Psychiatry & Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, United States of America
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17
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Unterrainer HF, Hiebler-Ragger M, Koschutnig K, Fuchshuber J, Ragger K, Perchtold CM, Papousek I, Weiss EM, Fink A. Brain Structure Alterations in Poly-Drug Use: Reduced Cortical Thickness and White Matter Impairments in Regions Associated With Affective, Cognitive, and Motor Functions. Front Psychiatry 2019; 10:667. [PMID: 31616326 PMCID: PMC6763614 DOI: 10.3389/fpsyt.2019.00667] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/19/2019] [Indexed: 12/21/2022] Open
Abstract
Substance use disorders (SUDs) are defined by obsessive and uncontrolled consumption, which is related to neurobiological changes. Based on previous work, this study investigated potential alterations in brain structure in poly-drug use disordered (PUD) patients in comparison to controls from the normal population. This study involved a sample of 153 right-handed men aged between 18 and 41 years, comprising a clinical group of 78 PUD and a group of 75 healthy controls. Group differences in gray matter (GM) and white matter (WM), as well as cortical thickness (CT), were investigated by means of diffusion tensor imaging using automated fiber quantification (AFQ) and voxel-based morphometry. We observed significant WM impairments in PUD, especially in the bilateral corticospinal tracts and the inferior longitudinal fasciculi. Furthermore, we found reduced CT in the PUD group especially in the left insular and left lateral orbitofrontal cortex. There were no group differences in GM. In addition, PUD exhibited a higher amount of psychiatric symptoms (Brief Symptom Inventory) and impairments in cognitive functions (Wonderlic Personnel Test). In line with previous research, this study revealed substantial impairments in brain structure in the PUD group in areas linked with affective, cognitive, and motor functions. We therefore hypothesize a neurologically informed treatment approach for SUD. Future studies should consequently explore a potential positive neuroplasticity in relation to a better therapeutic outcome.
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Affiliation(s)
- Human F Unterrainer
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria.,Institute for Religious Studies, University of Vienna, Vienna, Austria
| | - Michaela Hiebler-Ragger
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Klemens Ragger
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Ilona Papousek
- Institute of Psychology, University of Graz, Graz, Austria
| | | | - Andreas Fink
- Institute of Psychology, University of Graz, Graz, Austria
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