1
|
Zhang M, Chen L, Ren Z, Wang Z, Luo W. Applications of TMS in individuals with methamphetamine use disorder: A review. Heliyon 2024; 10:e25565. [PMID: 38420394 PMCID: PMC10900420 DOI: 10.1016/j.heliyon.2024.e25565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/25/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Methamphetamine abuse results in a host of social and medical issues. Methamphetamine use disorder (MUD) can hinder the brain and impair cognitive functions and mental health. Transcranial magnetic stimulation (TMS) is a non-invasive approach in the treatment of MUD. Recent studies have demonstrated encouraging and positive effects of TMS on the craving, affective symptoms, sleep quality, and cognitive functions in individuals with MUD. The regulation of specific brain activities through TMS has also been found to be a contributing factor to these positive outcomes. It is essential to employ more techniques, participants, and stimulation parameters and targets in the future.
Collapse
Affiliation(s)
- Mingming Zhang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, 116029, China
| | - Lei Chen
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, 116029, China
| | - Ziwei Ren
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, 116029, China
| | - Zhiyan Wang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, 116029, China
| | - Wenbo Luo
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China
- Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, 116029, China
| |
Collapse
|
2
|
Tian W, Zhao D, Ding J, Zhan S, Zhang Y, Etkin A, Wu W, Yuan TF. An electroencephalographic signature predicts craving for methamphetamine. Cell Rep Med 2024; 5:101347. [PMID: 38151021 PMCID: PMC10829728 DOI: 10.1016/j.xcrm.2023.101347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/17/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
Craving is central to methamphetamine use disorder (MUD) and both characterizes the disease and predicts relapse. However, there is currently a lack of robust and reliable biomarkers for monitoring craving and diagnosing MUD. Here, we seek to identify a neurobiological signature of craving based on individual-level functional connectivity pattern differences between healthy control and MUD subjects. We train high-density electroencephalography (EEG)-based models using data recorded during the resting state and then calculate imaginary coherence features between the band-limited time series across different brain regions of interest. Our prediction model demonstrates that eyes-open beta functional connectivity networks have significant predictive value for craving at the individual level and can also identify individuals with MUD. These findings advance the neurobiological understanding of craving through an EEG-tailored computational model of the brain connectome. Dissecting neurophysiological features provides a clinical avenue for personalized treatment of MUD.
Collapse
Affiliation(s)
- Weiwen Tian
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Di Zhao
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Jinjun Ding
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Shulu Zhan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Yi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
| | - Amit Etkin
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA 94305, USA; Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA 94305, USA; Alto Neuroscience, Inc., Los Altos, CA 94022, USA
| | - Wei Wu
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA 94305, USA; Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA 94305, USA; Alto Neuroscience, Inc., Los Altos, CA 94022, USA.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China; Institute of Mental Health and Drug Discovery, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang 325000, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226019, China.
| |
Collapse
|
3
|
Yang L, Zhang L, Yang W, Tang F, Du Y, Liu J. Exploring the potential of the metaverse medical paradigm in drug addiction treatment: a preliminary discussion and future prospects. Gen Psychiatr 2023; 36:e101258. [PMID: 38116459 PMCID: PMC10728956 DOI: 10.1136/gpsych-2023-101258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- Longtao Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lijie Zhang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenhan Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fei Tang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanyao Du
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Medical Imaging in Hunan Province, Changsha, Hunan, China
- Department of Radiology Quality Control Center in Hunan Province, Changsha, Hunan, China
| |
Collapse
|
4
|
Lütt A, Tsamitros N, Wolbers T, Rosenthal A, Bröcker AL, Schöneck R, Bermpohl F, Heinz A, Beck A, Gutwinski S. An explorative single-arm clinical study to assess craving in patients with alcohol use disorder using Virtual Reality exposure (CRAVE)-study protocol. BMC Psychiatry 2023; 23:839. [PMID: 37964300 PMCID: PMC10647047 DOI: 10.1186/s12888-023-05346-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) belongs to the most burdensome clinical disorders worldwide. Current treatment approaches yield unsatisfactory long-term effects with relapse rates up to 85%. Craving for alcohol is a major predictor for relapse and can be intentionally induced via cue exposure in real life as well as in Virtual Reality (VR). The induction and habituation of craving via conditioned cues as well as extinction learning is used in Cue Exposure Therapy (CET), a long-known but rarely used strategy in Cognitive Behavioral Therapy (CBT) of AUD. VR scenarios with alcohol related cues offer several advantages over real life scenarios and are within the focus of current efforts to develop new treatment options. As a first step, we aim to analyze if the VR scenarios elicit a transient change in craving levels and if this is measurable via subjective and psychophysiological parameters. METHODS A single-arm clinical study will be conducted including n = 60 patients with AUD. Data on severity of AUD and craving, comorbidities, demographics, side effects and the feeling of presence in VR will be assessed. Patients will use a head-mounted display (HMD) to immerse themselves into three different scenarios (neutral vs. two target situations: a living room and a bar) while heart rate, heart rate variability, pupillometry and electrodermal activity will be measured continuously. Subjective craving levels will be assessed before, during and after the VR session. DISCUSSION Results of this study will yield insight into the induction of alcohol craving in VR cue exposure paradigms and its measurement via subjective and psychophysiological parameters. This might be an important step in the development of innovative therapeutic approaches in the treatment of patients with AUD. TRIAL REGISTRATION This study was approved by the Charité-Universitätsmedizin Berlin Institutional Review Board (EA1/190/22, 23.05.2023). It was registered on ClinicalTrials.gov (NCT05861843).
Collapse
Affiliation(s)
- A Lütt
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany.
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany.
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany.
| | - N Tsamitros
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - T Wolbers
- German Center for Neurodegenerative Diseases (DZNE), 39120, Magdeburg, Germany
| | - A Rosenthal
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - A L Bröcker
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - R Schöneck
- Salus Clinic Lindow, 16835, Lindow, Germany
| | - F Bermpohl
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - A Heinz
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
| | - A Beck
- Faculty of Health, Health and Medical University, 14471, Potsdam, Germany
| | - S Gutwinski
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| |
Collapse
|
5
|
Castellano P, Gigli V, Ghezzi V, Ang YS, Schettino M, Pizzagalli DA, Ottaviani C. Momentary gustative-olfactory sensitivity and tonic heart rate variability are independently associated with motivational behavior. Int J Psychophysiol 2023; 186:1-9. [PMID: 36738932 DOI: 10.1016/j.ijpsycho.2023.01.010] [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: 11/05/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023]
Abstract
Deficits in motivational functioning including impairments in reward learning or reward sensitivity are common in psychiatric disorders characterized by anhedonia. Recently, anhedonic symptoms have been exacerbated by the pandemic caused by the Coronavirus disease 2019 (COVID-19) in the general population. The present study examined the putative associations between loss of smell (anosmia) and taste (ageusia) sensitivity, irrespective of COVID-19 infection, and anhedonia, measured by a signal-detection task probing the ability to modify behavior as a function of rewards (Probabilistic Reward Task; PRT). Tonic heart rate variability (HRV) was included in the model, due to its association with both smell and taste sensitivity as well as motivational functioning. The sample included 114 healthy individuals (81 females; mean age 22.2 years), who underwent a laboratory session in which dispositional traits, resting HRV and PRT performance were assessed, followed by a 4-days ecological momentary assessment to obtain daily measures of anosmia and ageusia. Lower levels of tonic HRV and lower momentary levels of smell and taste sensitivity were associated with impaired reward responsiveness and ability to shape future behavioral choices based on prior reinforcement experiences. Overall, the current results provide initial correlational evidence that could be fruitfully used to inform future experimental investigations aimed at elucidating the disruptive worldwide mental health consequences triggered by the pandemic.
Collapse
Affiliation(s)
- Paola Castellano
- Department of Psychology, Sapienza University of Rome, Rome, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Valeria Gigli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Valerio Ghezzi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Yuen-Siang Ang
- Department of Social and Cognitive Computing, Institute of High Performance Computing, Agency for Science, Technology and Research, Singapore
| | - Martino Schettino
- Department of Psychology, Sapienza University of Rome, Rome, Italy; Neuroimaging Laboratory, IRCCS, Santa Lucia Foundation, Rome, Italy
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy; Neuroimaging Laboratory, IRCCS, Santa Lucia Foundation, Rome, Italy.
| |
Collapse
|
6
|
Chen YH, Yang J, Wu H, Beier KT, Sawan M. Challenges and future trends in wearable closed-loop neuromodulation to efficiently treat methamphetamine addiction. Front Psychiatry 2023; 14:1085036. [PMID: 36911117 PMCID: PMC9995819 DOI: 10.3389/fpsyt.2023.1085036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Achieving abstinence from drugs is a long journey and can be particularly challenging in the case of methamphetamine, which has a higher relapse rate than other drugs. Therefore, real-time monitoring of patients' physiological conditions before and when cravings arise to reduce the chance of relapse might help to improve clinical outcomes. Conventional treatments, such as behavior therapy and peer support, often cannot provide timely intervention, reducing the efficiency of these therapies. To more effectively treat methamphetamine addiction in real-time, we propose an intelligent closed-loop transcranial magnetic stimulation (TMS) neuromodulation system based on multimodal electroencephalogram-functional near-infrared spectroscopy (EEG-fNIRS) measurements. This review summarizes the essential modules required for a wearable system to treat addiction efficiently. First, the advantages of neuroimaging over conventional techniques such as analysis of sweat, saliva, or urine for addiction detection are discussed. The knowledge to implement wearable, compact, and user-friendly closed-loop systems with EEG and fNIRS are reviewed. The features of EEG and fNIRS signals in patients with methamphetamine use disorder are summarized. EEG biomarkers are categorized into frequency and time domain and topography-related parameters, whereas for fNIRS, hemoglobin concentration variation and functional connectivity of cortices are described. Following this, the applications of two commonly used neuromodulation technologies, transcranial direct current stimulation and TMS, in patients with methamphetamine use disorder are introduced. The challenges of implementing intelligent closed-loop TMS modulation based on multimodal EEG-fNIRS are summarized, followed by a discussion of potential research directions and the promising future of this approach, including potential applications to other substance use disorders.
Collapse
Affiliation(s)
- Yun-Hsuan Chen
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| | - Jie Yang
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| | - Hemmings Wu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kevin T Beier
- Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA, United States.,Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States.,Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States.,Department of Pharmaceutical Sciences, University of California, Irvine, Irvine, CA, United States.,Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Mohamad Sawan
- CenBRAIN Neurotech Center of Excellence, School of Engineering, Westlake University, Hangzhou, China.,Institute of Advanced Technology, Westlake Institute for Advanced Study, Hangzhou, China
| |
Collapse
|
7
|
Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clin Psychol Rev 2022; 98:102213. [PMID: 36356351 DOI: 10.1016/j.cpr.2022.102213] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION PROSPERO register CRD42020188436. FUNDING The review was funded by budgets from the University of Bonn. No third party funding was involved.
Collapse
Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pramme
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nike Blumenthal
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Asché
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Maria Steffens
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Max Christian Pensel
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Matthias Guth
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Felicia Rohlfsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mogda Ekhlas
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Lügering
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Fileccia
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Julian Pakos
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
| |
Collapse
|
8
|
Zhou Y, Tang J, Sun Y, Yang WFZ, Ma Y, Wu Q, Chen S, Wang Q, Hao Y, Wang Y, Li M, Liu T, Liao Y. A brainnetome atlas-based methamphetamine dependence identification using neighborhood component analysis and machine learning on functional MRI data. Front Cell Neurosci 2022; 16:958437. [PMID: 36238830 PMCID: PMC9550874 DOI: 10.3389/fncel.2022.958437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Addiction to methamphetamine (MA) is a major public health concern. Developing a predictive model that can classify and characterize the brain-based biomarkers predicting MA addicts may directly lead to improved treatment outcomes. In the current study, we applied the support vector machine (SVM)-based classification method to resting-state functional magnetic resonance imaging (rs-fMRI) data obtained from individuals with methamphetamine use disorder (MUD) and healthy controls (HCs) to identify brain-based features predictive of MUD. Brain connectivity analyses were conducted for 36 individuals with MUD as well as 37 HCs based on the brainnetome atlas, and the neighborhood component analysis was applied for feature selection. Eighteen most relevant features were screened out and fed into the SVM to classify the data. The classifier was able to differentiate individuals with MUD from HCs with a high prediction accuracy, sensitivity, specificity, and AUC of 88.00, 86.84, 89.19, and 0.94, respectively. The top six discriminative features associated with changes in the functional activity of key nodes in the default mode network (DMN), all the remaining discriminative features are related to the thalamic connections within the cortico-striato-thalamo-cortical (CSTC) loop. In addition, the functional connectivity (FC) between the bilateral inferior parietal lobule (IPL) and right cingulate gyrus (CG) was significantly correlated with the duration of methamphetamine use. The results of this study not only indicated that MUD-related FC alterations were predictive of group membership, but also suggested that machine learning techniques could be used for the identification of MUD-related imaging biomarkers.
Collapse
Affiliation(s)
- Yanan Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Jingsong Tang
- Department of Psychiatry, School of Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Yunkai Sun
- Department of Psychiatry, School of Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, College of Arts and Sciences, Texas Tech University, Lubbock, TX, United States
| | - Yuejiao Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yunfei Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Manyun Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu
| | - Yanhui Liao
- Department of Psychiatry, School of Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China
- Yanhui Liao
| |
Collapse
|
9
|
Chen CC, Chung CR, Tsai MC, Wu EHK, Chiu PR, Tsai PY, Yeh SC. Impaired Brain-Heart Relation in Patients With Methamphetamine Use Disorder During VR Induction of Drug Cue Reactivity. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2022; 12:1-9. [PMID: 38059128 PMCID: PMC10697298 DOI: 10.1109/jtehm.2022.3206333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/12/2022] [Accepted: 09/08/2022] [Indexed: 12/08/2023]
Abstract
Methamphetamine use disorder (MUD) is an illness associated with severe health consequences. Virtual reality (VR) is used to induce the drug-cue reactivity and significant EEG and ECG abnormalities were found in MUD patients. However, whether a link exists between EEG and ECG abnormalities in patients with MUD during exposure to drug cues remains unknown. This is important from the therapeutic viewpoint because different treatment strategies may be applied when EEG abnormalities and ECG irregularities are complications of MUD. We designed a VR system with drug cues and EEG and ECG were recorded during VR exposure. Sixteen patients with MUD and sixteen healthy subjects were recruited. Statistical tests and Pearson correlation were employed to analyze the EEG and ECG. The results showed that, during VR induction, the patients with MUD but not healthy controls showed significant [Formula: see text] and [Formula: see text] power increases when the stimulus materials were most intense. This finding indicated that the stimuli are indiscriminate to healthy controls but meaningful to patients with MUD. Five heart rate variability (HRV) indexes significantly differed between patients and controls, suggesting abnormalities in the reaction of patient's autonomic nervous system. Importantly, significant relations between EEG and HRV indexes changes were only identified in the controls, but not in MUD patients, signifying a disruption of brain-heart relations in patients. Our findings of stimulus-specific EEG changes and the impaired brain-heart relations in patients with MUD shed light on the understanding of drug-cue reactivity and may be used to design diagnostic and/or therapeutic strategies for MUD.
Collapse
Affiliation(s)
- Chun-Chuan Chen
- Department of Biomedical Sciences and EngineeringNational Central UniversityTaoyuan City320317Taiwan
| | - Chia-Ru Chung
- Computer Science and Information Engineering DepartmentNational Central UniversityTaoyuan City320317Taiwan
| | - Meng-Chang Tsai
- Department of PsychiatryKaohsiung Chang Gung Memorial HospitalKaohsiung City83301Taiwan
- Department of PsychiatryChang Gung University College of MedicineKaohsiung City83301Taiwan
| | - Eric Hsiao-Kuang Wu
- Computer Science and Information Engineering DepartmentNational Central UniversityTaoyuan City320317Taiwan
| | - Po-Ru Chiu
- Department of Biomedical Sciences and EngineeringNational Central UniversityTaoyuan City320317Taiwan
| | - Po-Yi Tsai
- Department of Physical Medicine and RehabilitationTaipei Veterans General HospitalTaipei112201Taiwan
| | - Shih-Ching Yeh
- Computer Science and Information Engineering DepartmentNational Central UniversityTaoyuan City320317Taiwan
| |
Collapse
|
10
|
Wen Y, Hao X, Chen X, Qiao S, Li Q, Winkler MH, Wang F, Yan X, Wang F, Wang L, Jiang F, Pauli P, Dong X, Li Y. Theta-Burst Stimulation Combined With Virtual-Reality Reconsolidation Intervention for Methamphetamine Use Disorder: Study Protocol for a Randomized-Controlled Trial. Front Psychiatry 2022; 13:903242. [PMID: 35865301 PMCID: PMC9294395 DOI: 10.3389/fpsyt.2022.903242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/13/2022] [Indexed: 12/05/2022] Open
Abstract
Background Craving associated with drug-related memory is one of the key factors that induce the relapse of methamphetamine (MA). Disruption or modulation of the reconsolidation of drug-related memory may serve as an option for clinical treatment of MA addiction. This protocol proposes to use virtual reality (VR) to retrieve drug-associated memory and then use transcranial magnetic stimulation (TMS) at the neural circuit that encodes the reward value of drug cues to provide a non-invasive intervention during reconsolidation. We aim to evaluate the effectiveness of TMS treatment after VR retrieval on the reduction of cue reactivity and craving of MA. Methods This is a randomized, double-blind, sham-controlled, parallel group trial, targeting participants with MA use disorder aged from 18 to 45 years old. Forty-five eligible volunteers in Shanxi Drug Rehabilitation Center will be recruited and be randomly allocated into three parallel groups, receiving either 1) MA-related cues retrieval in VR combined with active TMS (MA VR scene + TBS) or 2) sham TMS (MA VR scene + sham TBS), or 3) neutral cues retrieval in VR combined with active TMS (neutral VR scene + TBS). Two sessions of post-VR-retrieval TBS will be scheduled on two separate days within 1 week. The primary outcome will detect the memory-related activity by the electroencephalography (EEG) reactivity to drug cues in VR scenes. Secondary outcomes are the self-reported MA craving in VR scene, the physiological parameter (cue-induced heart rate) and the scores of psychological questionnaires including anxiety, depression, and mood. All primary and secondary outcomes will be assessed at baseline, 1-week, and 1-month post-intervention. Assessments will be compared between the groups of 1) MA VR scene + TBS, 2) MA VR scene + sham TBS and 3) neutral VR scene + TBS. Discussion This will be the first study to examine whether the TMS modulation after VR retrieval can reduce self-reported craving and drug-related cue reactivity. It will promote the understanding of the neural circuit mechanism of the reconsolidation-based intervention and provide an effective treatment for MA use disorder patients. Clinical Trial Registration [Chinese Clinical Trial Registry], identifier [ChiCTR1900026902]. Registered on 26 October 2019.
Collapse
Affiliation(s)
- Yatong Wen
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xuemin Hao
- School of Education, Shaanxi Normal University, Xi'an, China
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
| | - Xijing Chen
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Siyue Qiao
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - Qianling Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Markus H. Winkler
- Department of Psychology I, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Wurzburg, Wurzburg, Germany
| | - Fenglan Wang
- Shanxi Women's Drug Rehabilitation Center, Taiyuan, China
| | - Xiaoli Yan
- Shanxi Women's Drug Rehabilitation Center, Taiyuan, China
| | - Fang Wang
- Shanxi Women's Drug Rehabilitation Center, Taiyuan, China
| | - Liang Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Feng Jiang
- Library, Shanxi Medical University, Taiyuan, China
| | - Paul Pauli
- Department of Psychology I, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Wurzburg, Wurzburg, Germany
| | - Xinwen Dong
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yonghui Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
11
|
Parisi A, Landicho HL, Hudak J, Leknes S, Froeliger B, Garland EL. Emotional distress and pain catastrophizing predict cue-elicited opioid craving among chronic pain patients on long-term opioid therapy. Drug Alcohol Depend 2022; 233:109361. [PMID: 35278786 PMCID: PMC9466292 DOI: 10.1016/j.drugalcdep.2022.109361] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Individuals who use illicit substances exhibit cue-elicited craving and autonomic cue-reactivity when exposed to cues associated with past drug use. However, little is known about this phenomenon among chronic pain patients on long-term opioid therapy (LTOT). Negative cognitive-emotional reactivity in general (e.g., distress) and cognitive-emotional reactivity specific to pain (e.g., pain catastrophizing) might drive cue-reactivity independent of pain severity. Here we examined emotional distress and pain catastrophizing as predictors of cue-reactivity among a sample of chronic pain patients receiving LTOT. We also tested whether associations between distress, catastrophizing, and cue-reactivity differed as a function of opioid misuse status. MATERIALS AND METHODS Patients receiving LTOT (N = 243) were classified as exhibiting aberrant behavior consistent with opioid misuse (MISUSE+, n = 145) or as using opioids as prescribed (MISUSE-, n = 97). Participants completed assessments of pain catastrophizing and emotional distress and then participated in an opioid cue-reactivity task one week later. Cue-elicited opioid craving and autonomic cue-reactivity were measured with craving ratings and high-frequency heart rate variability (HRV), respectively. RESULTS Distress and catastrophizing predicted cue-elicited craving and HRV, whereas pain severity did not. Misuser status moderated the relationship between emotional distress and self-reported craving, such that higher levels of distress predicted craving among the MISUSE+ group, but not among the MISUSE- group. No moderating effects were found for catastrophizing. CONCLUSIONS Findings suggest that although opioids are prescribed for analgesia, the exacerbating influence of negative cognitive-emotional reactivity, both in general and specific to pain, on cue-elicited opioid craving extends beyond the effects of pain severity alone.
Collapse
Affiliation(s)
- Anna Parisi
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, USA; College of Social Work, University of Utah, USA
| | - Hannah Louise Landicho
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, USA; College of Social Work, University of Utah, USA
| | - Justin Hudak
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, USA; College of Social Work, University of Utah, USA
| | - Siri Leknes
- Department of Psychology, University of Oslo, USA
| | - Brett Froeliger
- Department of Psychiatry; Department of Psychological Sciences, University of Missouri, USA
| | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, USA; College of Social Work, University of Utah, USA
| |
Collapse
|
12
|
Lin Q, Li D, Hu C, Shen Z, Wang Y. Altered EEG Microstates Dynamics During Cue-Induced Methamphetamine Craving in Virtual Reality Environments. Front Psychiatry 2022; 13:891719. [PMID: 35599773 PMCID: PMC9114476 DOI: 10.3389/fpsyt.2022.891719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/06/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cue-induced craving is widely considered to be the most important risk factor for relapse during abstinence from methamphetamine (Meth). There is limited research regarding electroencephalography (EEG) microstates of Meth-dependent patients under exposure to drug-related cues. Our objective was to investigate whether EEG microstate temporal characteristics could capture neural correlates of cue-induced Meth craving in virtual reality (VR) environments. METHODS EEG recordings of 35 Meth-dependent patients and 30 healthy controls (HCs) were collected during eyes-open state and cue-induced state, respectively. Group differences and condition differences in temporal parameters of four microstate classes were compared. RESULTS The results demonstrated the greater presence of microstate B in both Meth-dependent patients and HCs during the cue-induced condition, compared to resting state. In addition, for Meth-dependent patients, microstate C occurred significantly less frequently, along with a tendency of increased occurrence for class D during the cue-induced condition, compared to resting state. However, the change direction of class C and class D in HCs was completely opposite to that of Meth-dependent patients. The cue-induced condition also elicited different changes in transition probability between Meth-dependent patients and HCs. CONCLUSION This study explored the features of EEG microstates in Meth-dependent patients during the cue-induced condition, which can improve our understanding of Meth addiction and contribute to the development of effective assessments and intervention tools.
Collapse
Affiliation(s)
- Qianqian Lin
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dongxu Li
- Anhui Psychiatric Medical Center, Anhui Medical University, Hefei, China
| | - Cheng Hu
- Shiliping Compulsory Rehabilitation Center, Zhejiang, China
| | - Zhihua Shen
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yongguang Wang
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Anhui Psychiatric Medical Center, Anhui Medical University, Hefei, China.,Zhejiang Provincial Institute of Drug Abuse Research, Hangzhou, China
| |
Collapse
|
13
|
Geraets CNW, Wallinius M, Sygel K. Use of Virtual Reality in Psychiatric Diagnostic Assessments: A Systematic Review. Front Psychiatry 2022; 13:828410. [PMID: 35295778 PMCID: PMC8918631 DOI: 10.3389/fpsyt.2022.828410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Technological developments such as Virtual reality (VR) provide new opportunities to extend and innovate mental healthcare. VR as a tool for clinical assessment has been described as promising, as it can enable real-time assessment within real-like environments or contexts as opposed to self-report and behavioral tasks in laboratory settings. OBJECTIVE With this systematic review we aimed to provide an overview of recent studies using VR in the assessment of psychiatric disorders. METHODS A systematic search was performed using Pubmed, Embase, PsycInfo, and Web of Science between 2016 and 2020. Studies were included if they used immersive VR, concerned assessment of psychiatric symptoms/disorders, and included adult patients with psychiatric disorders. RESULTS The search resulted in 3,163 potentially eligible articles, from which a total of 27 studies fulfilled inclusion criteria. Most studies considered anxiety (n = 7), addictive, (n = 7), or psychotic disorders (n = 5). Regarding ADHD (n = 3), PTSD (n = 3), and pedophilic disorder (n = 1), a few studies had been performed since 2016. The majority of the included studies compared patient groups to healthy control groups. DISCUSSION Recent studies on VR-assisted psychiatric assessments have been conducted to validate VR environments, to assess symptoms for diagnostics or therapy goals, search for biomarkers, and to gain knowledge on psychiatric disorders. VR tasks were able to detect some difference between patient and healthy control groups, mainly with regard to self-report measures. Despite previous, promising prospects, the use of VR as a tool in clinical assessments must still be considered as a field in need of continued developments and evaluations. SYSTEMATIC REVIEW REGISTRATION www.crd.york.ac.uk/prospero, identifier: CRD42021233772.
Collapse
Affiliation(s)
- Chris N W Geraets
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.,Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - Märta Wallinius
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.,Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kristina Sygel
- Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.,Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Forensic Psychiatry, National Board of Forensic Medicine, Stockholm, Sweden
| |
Collapse
|
14
|
From skinner box to daily life: Sign-tracker phenotype co-segregates with impulsivity, compulsivity, and addiction tendencies in humans. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:1358-1369. [PMID: 35672650 PMCID: PMC9622514 DOI: 10.3758/s13415-022-01014-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 01/27/2023]
Abstract
Pavlovian conditioning holds the potential to incentivize environmental cues, leading to approach behavior toward them, even outside our awareness. Animal models suggest that this is particularly true for the so-called sign-tracker (ST) phenotype, which is considered to reflect a predisposition toward developing addiction-related behaviours. Despite its potential clinical relevance, few studies have demonstrated the translational validity of this model, likely due to difficulties in studying Pavlovian processes in humans. To fill this gap, we combined an ecological momentary assessment with ambulatory peripheral autonomic monitoring to test the hypothesis that traits associated with ST in preclinical studies would be associated with attribution of high incentive salience to reward-related cues. Several times for 2 days, participants were asked to rate the attractiveness of several preselected ecological rewards (e.g., coffee) and the preceding cues (the smell of coffee) while their electrocardiogram was recorded. While no absolute difference in subjective and physiological measures of motivational approach to daily cues compared with rewards emerged, individuals with high levels of impulsivity, obsessive-compulsive, and addiction-prone behaviors rated as more attractive and showed a greater increase in sympathetic arousal to cues versus rewards. The opposite pattern emerged for those with low levels in those dispositional traits, who responded more (both subjectively and physiologically) to rewards compared with their preceding cues. This study represents an attempt to answer the call to parcel complex behaviors into smaller constructs, improving the early detection of those who are vulnerable to develop psychopathological disorders, particularly in the domain of impulse control such as addiction.
Collapse
|
15
|
Virtual reality: a powerful technology to provide novel insight into treatment mechanisms of addiction. Transl Psychiatry 2021; 11:617. [PMID: 34873146 PMCID: PMC8648903 DOI: 10.1038/s41398-021-01739-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/20/2021] [Accepted: 11/01/2021] [Indexed: 12/31/2022] Open
Abstract
Due to its high ecological validity, virtual reality (VR) technology has emerged as a powerful tool for mental health research. Despite the wide use of VR simulations in research on mental illnesses, the study of addictive processes through the use of VR environments is still at its dawn. In a systematic literature search, we identified 38 reports of research projects using highly immersive head-mounted displays, goggles, or CAVE technologies to provide insight into treatment mechanisms of addictive behaviors. So far, VR research has mainly addressed the roles of craving, psychophysiology, affective states, cognition, and brain activity in addiction. The computer-generated VR environments offer very realistic, dynamic, interactive, and complex real-life simulations requesting active participation. They create a high sense of immersion in users by combining stereoscopic three-dimensional visual, auditory, olfactory, and tactile perceptions, tracking systems responding to user movements, and social interactions. VR is an emerging tool to study how proximal multi-sensorial cues, contextual environmental cues, as well as their interaction (complex cues) modulate addictive behaviors. VR allows for experimental designs under highly standardized, strictly controlled, predictable, and repeatable conditions. Moreover, VR simulations can be personalized. They are currently refined for psychotherapeutic interventions. Embodiment, eye-tracking, and neurobiological factors represent novel future directions. The progress of VR applications has bred auspicious ways to advance the understanding of treatment mechanisms underlying addictions, which researchers have only recently begun to exploit. VR methods promise to yield significant achievements to the addiction field. These are necessary to develop more efficacious and efficient preventive and therapeutic strategies.
Collapse
|
16
|
Assessing methamphetamine-related cue reactivity in people with methamphetamine use disorder relative to controls. Addict Behav 2021; 123:107075. [PMID: 34385074 DOI: 10.1016/j.addbeh.2021.107075] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/15/2021] [Accepted: 07/29/2021] [Indexed: 12/30/2022]
Abstract
Methamphetamine use disorder involves methamphetamine-related cues invoking intense craving leading to relapse. Such cue reactivity is thought to arise from Pavlovian conditioning that occurs during the drug-taking experience. Cue reactivity then should be selective to methamphetamine cues (and not other cues), and not observed in people who have never experienced methamphetamine. However, these premises have never been tested and reported using objective measures such as skin conductance response (SCR). The primary aim of this study was to test these premises using a cue reactivity paradigm we developed using control cues. The secondary aim was to explore the relationship between cue reactivity, drug use characteristics, and cognition. Thirty people with a current diagnosis of methamphetamine use disorder and 30 matched controls with no history of substance use disorder were recruited. We observed higher overall subjective reactivity (F = 62.810; p < 0.001) and cue-selective physiological reactivity (F = 5.160; p = 0.026) in people with methamphetamine use disorder but not in controls. Co-morbid sedative use was associated with higher subjective craving (r = 0.521; p = 0.003). People who use methamphetamine intravenously had higher cue-selective SCR than smokers (t = 3.750; p < 0.001). Low inhibitory control measured by the Stroop task was associated with increased craving across the cue paradigm (r = -0.494; p = 0.006). Overall, these results support that cue reactivity in people with methamphetamine use disorder is due to Pavlovian conditioning. Its association with drug use and cognition highlights cue reactivity paradigm's utility in understanding methamphetamine use disorder to develop new treatments targeting cue-induced craving.
Collapse
|
17
|
Langener S, Van Der Nagel J, van Manen J, Markus W, Dijkstra B, De Fuentes-Merillas L, Klaassen R, Heitmann J, Heylen D, Schellekens A. Clinical Relevance of Immersive Virtual Reality in the Assessment and Treatment of Addictive Disorders: A Systematic Review and Future Perspective. J Clin Med 2021; 10:3658. [PMID: 34441953 PMCID: PMC8396890 DOI: 10.3390/jcm10163658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 02/02/2023] Open
Abstract
(1) Background: Virtual reality (VR) has been investigated in a variety of psychiatric disorders, including addictive disorders (ADs); (2) Objective: This systematic review evaluates the current evidence of immersive VR (using head-mounted displays) in the clinical assessment and treatment of ADs; (3) Method: PubMed and PsycINFO were queried for publications up to November 2020; (4) Results: We screened 4519 titles, 114 abstracts and 85 full-texts, and analyzed 36 articles regarding the clinical assessment (i.e., diagnostic and prognostic value; n = 19) and treatment (i.e., interventions; n = 17) of ADs. Though most VR assessment studies (n = 15/19) showed associations between VR-induced cue-reactivity and clinical parameters, only two studies specified diagnostic value. VR treatment studies based on exposure therapy showed no or negative effects. However, other VR interventions like embodied and aversive learning paradigms demonstrated positive findings. The overall study quality was rather poor; (5) Conclusion: Though VR in ADs provides ecologically valid environments to induce cue-reactivity and provide new treatment paradigms, the added clinical value in assessment and therapy remains to be elucidated before VR can be applied in clinical care. Therefore, future work should investigate VR efficacy in randomized clinical trials using well-defined clinical endpoints.
Collapse
Affiliation(s)
- Simon Langener
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Joanne Van Der Nagel
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Jeannette van Manen
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Wiebren Markus
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- IrisZorg Addiction Care, 6835 HZ Arnhem, The Netherlands
| | - Boukje Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Radboud University Medical Centre, 6525 GC Nijmegen, The Netherlands
- Novadic-Kentron, Network for Addiction Treatment Service, 5261 LX Vught, The Netherlands
| | - Laura De Fuentes-Merillas
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Novadic-Kentron, Network for Addiction Treatment Service, 5261 LX Vught, The Netherlands
| | - Randy Klaassen
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
| | - Janika Heitmann
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 CP Groningen, The Netherlands
| | - Dirk Heylen
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
| | - Arnt Schellekens
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Radboud University Medical Centre, 6525 GC Nijmegen, The Netherlands
| |
Collapse
|
18
|
Tsamitros N, Sebold M, Gutwinski S, Beck A. Virtual Reality-Based Treatment Approaches in the Field of Substance Use Disorders. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00377-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Purpose
Substance use disorders (SUD) are burdening chronic conditions characterized by high relapse rates despite severe negative consequences. Substance-related cues that elicit craving by means of automatic physiological and behavioural responses have long been suggested to predict relapse. One major mechanism contributing to relapse behaviour are cue-induced behavioural approach tendencies towards the addictive agent. Recently, there has been an emerging interest in virtual reality (VR)-based approaches to assess and modify craving and its related responses. This review aims at elucidating (1) VR techniques applied in the field of SUD, (2) VR as an induction/assessment tool for biopsychological correlates of craving and (3) VR-based therapeutic approaches.
Findings
There is an emerging number of studies focusing on different substances of abuse incorporating VR in craving induction/assessment as well as therapy. Despite some limitations as missing of randomized controlled clinical trials with large samples and missing data on the long-term effects of VR treatment, the VR approach showed consistent results in eliciting and reducing craving across different substances.
Summary
This review suggests virtual reality as a promising tool for the assessment and treatment of craving among individuals with substance use disorders. Because of its ecological validity, VR unifies the benefits of a laboratory setting with the advantages of a realistic environment. Further studies with large samples and randomized controlled clinical trials using more homogenous VR techniques as well as assessment of objective biophysiological craving markers are required.
Collapse
|
19
|
Tsai MC, Chung CR, Chen CC, Chen JY, Yeh SC, Lin CH, Chen YJ, Tsai MC, Wang YL, Lin CJ, Wu EHK. An Intelligent Virtual-Reality System With Multi-Model Sensing for Cue-Elicited Craving in Patients With Methamphetamine Use Disorder. IEEE Trans Biomed Eng 2021; 68:2270-2280. [PMID: 33571085 DOI: 10.1109/tbme.2021.3058805] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Methamphetamine abuse is getting worse amongst the younger population. While there is methadone or buprenorphine harm-reduction treatment for heroin addicts, there is no drug treatment for addicts with methamphetamine use disorder (MUD). Recently, non-medication treatment, such as the cue-elicited craving method integrated with biofeedback, has been widely used. Further, virtual reality (VR) is proposed to simulate an immersive virtual environment for cue-elicited craving in therapy. In this study, we developed a VR system equipped with flavor simulation for the purpose of inducing cravings for MUD patients in therapy. The VR system was integrated with multi-model sensors, such as an electrocardiogram (ECG), galvanic skin response (GSR) and eye tracking to measure various physiological responses from MUD patients in the virtual environment. The goal of the study was to validate the effectiveness of the proposed VR system in inducing the craving of MUD patients via the physiological data. Clinical trials were performed with 20 MUD patients and 11 healthy subjects. VR stimulation was applied to each subject and the physiological data was measured at the time of pre-VR stimulation and post-VR stimulation. A variety of features were extracted from the raw data of heart rate variability (HRV), GSR and eye tracking. The results of statistical analysis found that quite a few features of HRV, GSR and eye tracking had significant differences between pre-VR stimulation and post-VR stimulation in MUD patients but not in healthy subjects. Also, the data of post-VR stimulation showed a significant difference between MUD patients and healthy subjects. Correlation analysis was made and several features between HRV and GSR were found to be correlated. Further, several machine learning methods were applied and showed that the classification accuracy between MUD and healthy subjects at post-VR stimulation attained to 89.8%. In conclusion, the proposed VR system was validated to effectively induce the drug craving in MUD patients.
Collapse
|
20
|
Yan C, Yang X, Yang R, Yang W, Luo J, Tang F, Huang S, Liu J. Treatment Response Prediction and Individualized Identification of Short-Term Abstinence Methamphetamine Dependence Using Brain Graph Metrics. Front Psychiatry 2021; 12:583950. [PMID: 33746790 PMCID: PMC7965948 DOI: 10.3389/fpsyt.2021.583950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background: The abuse of methamphetamine (MA) worldwide has gained international attention as the most rapidly growing illicit drug problem. The classification and treatment response prediction of MA addicts are thereby paramount, in order for effective treatments to be more targeted to individuals. However, there has been limited progress. Methods: In the present study, 43 MA-dependent participants and 38 age- and gender-matched healthy controls were enrolled, and their resting-state functional magnetic resonance imaging data were collected. MA-dependent participants who showed 50% reduction in craving were defined as responders to treatment. The present study used the machine learning method, which is a support vector machine (SVM), to detect the most relevant features for discriminating and predicting the treatment response for MA-dependent participants based on the features extracted from the functional graph metrics. Results: A classifier was able to differentiate MA-dependent subjects from normal controls, with a cross-validated prediction accuracy, sensitivity, and specificity of 73.2% [95% confidence interval (CI) = 71.23-74.17%), 66.05% (95% CI = 63.06-69.04%), and 80.35% (95% CI = 77.77-82.93%), respectively, at the individual level. The most accurate combination of classifier features included the nodal efficiency in the right middle temporal gyrus and the community index in the left precentral gyrus and cuneus. Between these two, the community index in the left precentral gyrus had the highest importance. In addition, the classification performance of the other classifier used to predict the treatment response of MA-dependent subjects had an accuracy, sensitivity, and specificity of 71.2% (95% CI = 69.28-73.12%), 86.75% (95% CI = 84.48-88.92%), and 55.65% (95% CI = 52.61-58.79%), respectively, at the individual level. Furthermore, the most accurate combination of classifier features included the nodal clustering coefficient in the right orbital part of the superior frontal gyrus, the nodal local efficiency in the right orbital part of the superior frontal gyrus, and the right triangular part of the inferior frontal gyrus and right temporal pole of middle temporal gyrus. Among these, the nodal local efficiency in the right temporal pole of the middle temporal gyrus had the highest feature importance. Conclusion: The present study identified the most relevant features of MA addiction and treatment based on SVMs and the features extracted from the graph metrics and provided possible biomarkers to differentiate and predict the treatment response for MA-dependent patients. The brain regions involved in the best combinations should be given close attention during the treatment of MA.
Collapse
Affiliation(s)
- Cui Yan
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xuefei Yang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Ru Yang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenhan Yang
- 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
| | - Fei Tang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Sihong Huang
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Liu
- Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
21
|
Seow LSE, Ong WJ, Hombali A, AshaRani PV, Subramaniam M. A Scoping Review on Cue Reactivity in Methamphetamine Use Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6504. [PMID: 32906716 PMCID: PMC7558044 DOI: 10.3390/ijerph17186504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 01/25/2023]
Abstract
The experience of craving via exposure to drug-related cues often leads to relapse in drug users. This study consolidated existing empirical evidences of cue reactivity to methamphetamine to provide an overview of current literature and to inform the directions for future research. The best practice methodological framework for conducting scoping review by Arkey and O'Malley was adopted. Studies that have used a cue paradigm or reported on cue reactivity in persons with a history of methamphetamine use were included. Databases such as Medline, EMBASE, PsycINFO and CINAHL were searched using key terms, in addition to citation check and hand search. The search resulted in a total of 32 original research articles published between 2006 to 2020. Three main themes with regard to cue reactivity were identified and synthesized: (1) effects of cue exposure, (2) individual factors associated with cue reactivity, and (3) strategies that modulate craving or reactivity to cues. Exposure to methamphetamine-associated cues elicits significant craving and other autonomic reactivity. Evidence suggests that drug cue reactivity is strongly associated with indices of drug use and other individual-specific factors. Future studies should focus on high quality studies to support evidence-based interventions for reducing cue reactivity and to examine cue reactivity as an outcome measure.
Collapse
|
22
|
Wang YG, Liu MH, Shen ZH. A virtual reality counterconditioning procedure to reduce methamphetamine cue-induced craving. J Psychiatr Res 2019; 116:88-94. [PMID: 31226580 DOI: 10.1016/j.jpsychires.2019.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/29/2019] [Accepted: 06/13/2019] [Indexed: 01/19/2023]
Abstract
The present work developed a virtual reality (VR) counterconditioning procedure (VRCP), and investigated its efficacy in treatment of cue-induced craving in individuals with methamphetamine (METH) dependence. In study 1, thirty-one patients diagnosed with METH dependence received VRCP, while twenty-nine METH-dependent patients in waiting-list group did not. In study 2, the VRCP was computerized as a VR treatment system. Six-hundred and twelve abstinent individuals with a history of METH dependence received the computerized VRCP, while two-hundred seventy-six abstinent individuals with a history of METH dependence in waiting-list group did not. Patients with METH dependence who received VRCP showed a significantly larger decrease on the score of METH-craving and METH-liking from baseline to follow-up assessments, compared to those who did not received VRCP. Participants received VRCP showed a significantly larger decrease in HRV indexes on time domain and non-linear domain from baseline to follow-up assessments during exposure to VR cues, compared to those in waiting-list group. These findings indicate that the counterconditioning procedure under VR environment may be a useful strategy in suppressing cue-induced reactivity for patients with METH dependence.
Collapse
Affiliation(s)
- Yong-Guang Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China; Anhui Psychiatric Medical Center, Anhui Medical University, Hefei, Anhui Province, China; Zhejiang Provincial Institute of Drug Abuse Research, Hangzhou, Zhejiang Province, China.
| | - Meng-Hui Liu
- Anhui Psychiatric Medical Center, Anhui Medical University, Hefei, Anhui Province, China
| | - Zhi-Hua Shen
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China
| |
Collapse
|