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Ye J, Mehta S, Peterson H, Ibrahim A, Saeed G, Linsky S, Kreinin I, Tsang S, Nwanaji-Enwerem U, Raso A, Arora J, Tokoglu F, Yip SW, Hahn CA, Lacadie C, Greene AS, Constable RT, Barry DT, Redeker NS, Yaggi HK, Scheinost D. Neural Variability and Cognitive Control in Individuals With Opioid Use Disorder. JAMA Netw Open 2025; 8:e2455165. [PMID: 39821393 PMCID: PMC11742521 DOI: 10.1001/jamanetworkopen.2024.55165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 11/11/2024] [Indexed: 01/19/2025] Open
Abstract
Importance Opioid use disorder (OUD) impacts millions of people worldwide. Prior studies investigating its underpinning neural mechanisms have not often considered how brain signals evolve over time, so it remains unclear whether brain dynamics are altered in OUD and have subsequent behavioral implications. Objective To characterize brain dynamic alterations and their association with cognitive control in individuals with OUD. Design, Setting, and Participants This case-control study collected functional magnetic resonance imaging (fMRI) data from individuals with OUD and healthy control (HC) participants. The study was performed at an academic research center and an outpatient clinic from August 2019 to May 2024. Exposure Individuals with OUD were all recently stabilized on medications for OUD (<24 weeks). Main Outcomes and Measures Recurring brain states supporting different cognitive processes were first identified in an independent sample with 390 participants. A multivariate computational framework extended these brain states to the current dataset to assess their moment-to-moment engagement within each individual. Resting-state and naturalistic fMRI investigated whether brain dynamic alterations were consistently observed in OUD. Using a drug cue paradigm in participants with OUD, the association between cognitive control and brain dynamics during exposure to opioid-related information was studied. Variations in continuous brain state engagement (ie, state engagement variability [SEV]) were extracted during resting-state, naturalistic, and drug-cue paradigms. Stroop assessed cognitive control. Results Overall, 99 HC participants (54 [54.5%] female; mean [SD] age, 31.71 [12.16] years) and 76 individuals with OUD (31 [40.8%] female; mean [SD] age, 39.37 [10.47] years) were included. Compared with HC participants, individuals with OUD demonstrated consistent SEV alterations during resting-state (99 HC participants; 71 individuals with OUD; F4,161 = 6.83; P < .001) and naturalistic (96 HC participants; 76 individuals with OUD; F4,163 = 9.93; P < .001) fMRI. Decreased cognitive control was associated with lower SEV during the rest period of a drug cue paradigm among 70 participants with OUD. For example, lower incongruent accuracy scores were associated with decreased transition SEV (ρ58 = 0.34; P = .008). Conclusions and Relevance In this case-control study of brain dynamics in OUD, individuals with OUD experienced greater difficulty in effectively engaging various brain states to meet changing demands. Decreased cognitive control during the rest period of a drug cue paradigm suggests that these individuals had an impaired ability to disengage from opioid-related information. The current study introduces novel information that may serve as groundwork to strengthen cognitive control and reduce opioid-related preoccupation in OUD.
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Affiliation(s)
- Jean Ye
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Saloni Mehta
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Hannah Peterson
- Department of Health Policy, Vanderbilt University, Nashville, Tennessee
| | - Ahmad Ibrahim
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Gul Saeed
- Department of Internal Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | | | - Iouri Kreinin
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Sui Tsang
- Program of Aging, Yale University, New Haven, Connecticut
| | | | - Anthony Raso
- Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, Connecticut
| | - Jagriti Arora
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Fuyuze Tokoglu
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Sarah W. Yip
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - C. Alice Hahn
- Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, Connecticut
| | - Cheryl Lacadie
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Abigail S. Greene
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | - R. Todd Constable
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, Connecticut
- Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut
| | - Declan T. Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
- Department of Research, APT Foundation, New Haven, Connecticut
| | | | - H. Klar Yaggi
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Clinical Epidemiology Research Center, VA CT Healthcare System, West Haven, Connecticut
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, Connecticut
- Department of Statistics & Data Science, Yale School of Medicine, New Haven, Connecticut
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Ye J, Mehta S, Peterson H, Ibrahim A, Saeed G, Linsky S, Kreinin I, Tsang S, Nwanaji-Enwerem U, Raso A, Arora J, Tokoglu F, Yip SW, Alice Hahn C, Lacadie C, Greene AS, Constable RT, Barry DT, Redeker NS, Yaggi H, Scheinost D. Investigating brain dynamics and their association with cognitive control in opioid use disorder using naturalistic and drug cue paradigms. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.25.24303340. [PMID: 38464297 PMCID: PMC10925365 DOI: 10.1101/2024.02.25.24303340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Objectives Opioid use disorder (OUD) impacts millions of people worldwide. The prevalence and debilitating effects of OUD present a pressing need to understand its neural mechanisms to provide more targeted interventions. Prior studies have linked altered functioning in large-scale brain networks with clinical symptoms and outcomes in OUD. However, these investigations often do not consider how brain responses change over time. Time-varying brain network engagement can convey clinically relevant information not captured by static brain measures. Methods We investigated brain dynamic alterations in individuals with OUD by applying a new multivariate computational framework to movie-watching (i.e., naturalistic; N=76) and task-based (N=70) fMRI. We further probed the associations between cognitive control and brain dynamics during a separate drug cue paradigm in individuals with OUD. Results Compared to healthy controls (N=97), individuals with OUD showed decreased variability in the engagement of recurring brain states during movie-watching. We also found that worse cognitive control was linked to decreased variability during the rest period when no opioid-related stimuli were present. Conclusions These findings suggest that individuals with OUD may experience greater difficulty in effectively engaging brain networks in response to evolving internal or external demands. Such inflexibility may contribute to aberrant response inhibition and biased attention toward opioid-related stimuli, two hallmark characteristics of OUD. By incorporating temporal information, the current study introduces novel information about how brain dynamics are altered in individuals with OUD and their behavioral implications.
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Affiliation(s)
- Jean Ye
- Interdepartmental Neuroscience Program, Yale University
| | - Saloni Mehta
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | | | - Ahmad Ibrahim
- Department of Internal Medicine, Yale School of Medicine
| | - Gul Saeed
- Department of Internal Medicine, Roger Williams Medical Center
| | | | - Iouri Kreinin
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine
| | | | | | - Anthony Raso
- Frank H. Netter M.D. School of Medicine, Quinnipiac University
| | - Jagriti Arora
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | - Fuyuze Tokoglu
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | - Sarah W Yip
- Interdepartmental Neuroscience Program, Yale University
- Department of Psychiatry, Yale School of Medicine
- Child Study Center, Yale School of Medicine
| | - C Alice Hahn
- Yale Center for Clinical Investigation, Yale School of Medicine
| | - Cheryl Lacadie
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
| | | | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale University
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science
- Department of Neurosurgery, Yale School of Medicine
| | - Declan T Barry
- Department of Psychiatry, Yale School of Medicine
- Child Study Center, Yale School of Medicine
- Department of Research, APT foundation
| | | | - Henry Yaggi
- Department of Internal Medicine, Yale School of Medicine
- Clinical Epidemiology Research Center, VA CT Healthcare System
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale University
- Department of Radiology & Biomedical Imaging, Yale School of Medicine
- Child Study Center, Yale School of Medicine
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science
- Department of Statistics & Data Science, Yale School of Medicine
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Rudroff T. Revealing the Complexity of Fatigue: A Review of the Persistent Challenges and Promises of Artificial Intelligence. Brain Sci 2024; 14:186. [PMID: 38391760 PMCID: PMC10886506 DOI: 10.3390/brainsci14020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/31/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
Part I reviews persistent challenges obstructing progress in understanding complex fatigue's biology. Difficulties quantifying subjective symptoms, mapping multi-factorial mechanisms, accounting for individual variation, enabling invasive sensing, overcoming research/funding insularity, and more are discussed. Part II explores how emerging artificial intelligence and machine and deep learning techniques can help address limitations through pattern recognition of complex physiological signatures as more objective biomarkers, predictive modeling to capture individual differences, consolidation of disjointed findings via data mining, and simulation to explore interventions. Conversational agents like Claude and ChatGPT also have potential to accelerate human fatigue research, but they currently lack capacities for robust autonomous contributions. Envisioned is an innovation timeline where synergistic application of enhanced neuroimaging, biosensors, closed-loop systems, and other advances combined with AI analytics could catalyze transformative progress in elucidating fatigue neural circuitry and treating associated conditions over the coming decades.
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Affiliation(s)
- Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
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