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Zheng H, Zhai T, Lin X, Dong G, Yang Y, Yuan TF. The resting-state brain activity signatures for addictive disorders. MED 2024; 5:201-223.e6. [PMID: 38359839 PMCID: PMC10939772 DOI: 10.1016/j.medj.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/20/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Addiction is a chronic and relapsing brain disorder. Despite numerous neuroimaging and neurophysiological studies on individuals with substance use disorder (SUD) or behavioral addiction (BEA), currently a clear neural activity signature for the addicted brain is lacking. METHODS We first performed systemic coordinate-based meta-analysis and partial least-squares regression to identify shared or distinct brain regions across multiple addictive disorders, with abnormal resting-state activity in SUD and BEA based on 46 studies (55 contrasts), including regional homogeneity (ReHo) and low-frequency fluctuation amplitude (ALFF) or fractional ALFF. We then combined Neurosynth, postmortem gene expression, and receptor/transporter distribution data to uncover the potential molecular mechanisms underlying these neural activity signatures. FINDINGS The overall comparison between addiction cohorts and healthy subjects indicated significantly increased ReHo and ALFF in the right striatum (putamen) and bilateral supplementary motor area, as well as decreased ReHo and ALFF in the bilateral anterior cingulate cortex and ventral medial prefrontal cortex, in the addiction group. On the other hand, neural activity in cingulate cortex, ventral medial prefrontal cortex, and orbitofrontal cortex differed between SUD and BEA subjects. Using molecular analyses, the altered resting activity recapitulated the spatial distribution of dopaminergic, GABAergic, and acetylcholine system in SUD, while this also includes the serotonergic system in BEA. CONCLUSIONS These results indicate both common and distinctive neural substrates underlying SUD and BEA, which validates and supports targeted neuromodulation against addiction. FUNDING This work was supported by the National Natural Science Foundation of China and Intramural Research Program of the National Institute on Drug Abuse, National Institutes of Health.
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Affiliation(s)
- Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China
| | - Tianye Zhai
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Guangheng Dong
- Department of Psychology, Yunnan Normal University, Kunming 650092, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China; Institute of Mental Health and Drug Discovery, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang 325000, China.
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2
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Lv Q, Zhang M, Jiang H, Liu Y, Zhao S, Xu X, Zhang W, Chen T, Su H, Zhang J, Wang H, Zhang J, Feng Y, Li Y, Li B, Zhao M, Wang Z. Metabolic and functional substrates of impulsive decision-making in individuals with heroin addiction after prolonged methadone maintenance treatment. Neuroimage 2023; 283:120421. [PMID: 37879424 DOI: 10.1016/j.neuroimage.2023.120421] [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: 04/20/2023] [Revised: 10/08/2023] [Accepted: 10/23/2023] [Indexed: 10/27/2023] Open
Abstract
Elevated impulsivity has been frequently reported in individuals with opioid addiction receiving methadone maintenance therapy (MMT), but the underlying neural mechanisms and cognitive subprocesses are not fully understood. We acquired functional magnetic resonance imaging (fMRI) data from 37 subjects with heroin addiction receiving long-term MMT and 33 healthy controls who performed a probabilistic reversal learning task, and measured their resting-state brain glucose using fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Subjects receiving MMT exhibited significantly elevated self-reported impulsivity, and computational modeling revealed a marked impulsive decision bias manifested as switching more frequently without available evidence. Moreover, this impulsive decision bias was associated with the dose and duration of methadone use, irrelevant to the duration of heroin use. During the task, the switch-related hypoactivation in the left rostral middle frontal gyrus was correlated with the impulsive decision bias while the function of reward sensitivity was intact in subjects receiving MMT. Using prior brain-wide receptor density data, we found that the highest variance of regional metabolic abnormalities was explained by the spatial distribution of μ-opioid receptors among 10 types of neurotransmitter receptors. Heightened impulsivity in individuals receiving prolonged MMT is manifested as atypical choice bias and noise in decision-making processes, which is further driven by deficits in top-down cognitive control, other than reward sensitivity. Our findings uncover multifaceted mechanisms underlying elevated impulsivity in subjects receiving MMT, which might provide insights for developing complementary therapies to improve retention during MMT.
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Affiliation(s)
- Qian Lv
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Miao Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yilin Liu
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, China
| | - Shaoling Zhao
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, China
| | - Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenlei Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiangtao Zhang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, China
| | - Heqiu Wang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, China
| | - Jianmin Zhang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, China
| | - Yuanjing Feng
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Yongqiang Li
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Zheng Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China.
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3
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Kwon M, Kim H, Yang J, Lee Y, Hur JK, Lee TH, Bjork JM, Ahn WY. Caffeinated Soda Intake in Children Is Associated with Neurobehavioral Risk Factors for Substance Misuse. Subst Use Misuse 2023; 59:79-89. [PMID: 37936270 DOI: 10.1080/10826084.2023.2259471] [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] [Indexed: 11/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Use of psychotropic substances in childhood has been associated with both impulsivity and other manifestations of poor executive function as well as escalation over time to use of progressively stronger substances. However, how this relationship may start in earlier childhood has not been well explored. Here, we investigated the neurobehavioral correlates of daily caffeinated soda consumption in preadolescent children and examined whether caffeinated soda intake is associated with a higher risk of subsequent alcohol initiation. METHODS Using Adolescent Brain Cognitive Development study data (N = 2,092), we first investigated cross-sectional relationships between frequent caffeinated soda intake and well-known risk factors of substance misuse: impaired working memory, high impulsivity, and aberrant reward processing. We then examined whether caffeinated soda intake at baseline predicts more alcohol sipping at 12 months follow-up using a machine learning algorithm. RESULTS Daily consumption of caffeinated soda was cross-sectionally associated with neurobehavioral risk factors for substance misuse such as higher impulsivity scores and lower working memory performance. Furthermore, caffeinated soda intake predicted a 2.04 times greater likelihood of alcohol sipping after 12 months, even after controlling for rates of baseline alcohol sipping rates. CONCLUSIONS These findings suggest that previous linkages between caffeine and substance use in adolescence also extend to younger initiation, and may stem from core neurocognitive features thought conducive to substance initiation.
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Affiliation(s)
- Mina Kwon
- Department of Psychology, Seoul National University, Seoul, Korea
| | - Hyeonjin Kim
- Department of Psychology, Seoul National University, Seoul, Korea
| | - Jaeyeong Yang
- Department of Psychology, Seoul National University, Seoul, Korea
| | - Yoseph Lee
- Department of Psychology, Seoul National University, Seoul, Korea
| | - Jihyun K Hur
- Department of Psychology, Seoul National University, Seoul, Korea
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Tae-Ho Lee
- Department of Psychology, Virginia Tech, Blacksburg, Virginia, USA
| | - James M Bjork
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, Korea
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Korea
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4
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Liang X, Li X, Jin Y, Wang Y, Wei C, Zhu Z. Effect of Aerobic Exercise on Intestinal Microbiota with Amino Acids and Short-Chain Fatty Acids in Methamphetamine-Induced Mice. Metabolites 2023; 13:metabo13030361. [PMID: 36984800 PMCID: PMC10055719 DOI: 10.3390/metabo13030361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
This study aimed to investigate the changes in intestinal homeostasis and metabolism in mice after methamphetamine (MA) administration and exercise intervention. In this study, male C57BL/B6J mice were selected to establish a model of methamphetamine-induced addiction, and the gut microbiota composition, short-chain fatty acids (SCFAs), and amino acid levels were assessed by 16S rRNA, liquid chromatography–tandem mass spectrometry, and gas chromatography–tandem mass spectrometry, respectively. The results showed that 23 dominant microbiota, 12 amino acids, and 1 SCFA were remarkably higher and 9 amino acids and 6 SCFAs were remarkably lower in the exercise model group than in the control group. Among the top 10 markers with opposite trends between the exercise intervention group and model group, the differential microbiomes included Oscillibacter, Alloprevotella, Colidextribacter, Faecalibaculum, Uncultured, Muribaculaceae, and Negativibacillus; amino acids included proline; and SCFAs included isovaleric acid and pentanoic acid. Proline was negatively correlated with Negativibacillus and positively correlated with pentanoic acid. The results suggested that moderate-intensity aerobic exercise may modulate changes in the composition of the gut microbiota and the levels of amino acids and SCFAs induced by MA administration.
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Affiliation(s)
- Xin Liang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Xue Li
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
- Correspondence: ; Tel.: +86-135-5014-6822
| | - Yu Jin
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Yi Wang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Changling Wei
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Zhicheng Zhu
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
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5
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Zhao Y, Skandali N, Bethlehem RAI, Voon V. Mesial Prefrontal Cortex and Alcohol Misuse: Dissociating Cross-sectional and Longitudinal Relationships in UK Biobank. Biol Psychiatry 2022; 92:907-916. [PMID: 35589437 DOI: 10.1016/j.biopsych.2022.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/24/2022] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Alcohol misuse is a major global public health issue. The disorder is characterized by aberrant neural networks interacting with environment and genetics. Dissecting the neural substrates and functional networks that relate to longitudinal changes in alcohol use from those that relate to alcohol misuse cross-sectionally is important to elucidate therapeutic approaches. METHODS To assess how neuroimaging data, including T1, resting-state functional magnetic resonance imaging, and diffusion-weighted imaging, relate to alcohol misuse cross-sectionally and longitudinally in the UK Biobank, this study analyzed range of alcohol misuse in a population-based normative sample of 24,784 participants, ages 45 to 81 years old, in a cross-sectional analysis and a sample of 3070 participants in a longitudinal analysis 2 years later. RESULTS Cross-sectional analysis showed that alcohol use is associated with a reduction in dorsal anterior cingulate cortex and dorsomedial prefrontal cortex gray matter concentration and functional resting-state connectivity (nodal degree: t24,422 = -12.99, p < 1 × 10-17). Reduced dorsal anterior cingulate cortex/dorsomedial prefrontal cortex functional connections to the ventrolateral prefrontal cortex, amygdala, and striatum relate to greater alcohol use. In a longitudinal analysis, higher resting-state nodal degree (t3036 = -3.27, p = .0011) and T1 gray matter concentration in the ventromedial prefrontal cortex relate to reduced alcohol intake frequency 2 years later. Higher ventromedial prefrontal cortex and frontoparietal executive network functional connectivity is associated with lower subsequent drinking longitudinally. CONCLUSIONS Dorsal versus ventromedial prefrontal regions are differentially related to alcohol misuse cross-sectionally or longitudinally in a large UK Biobank normative dataset. Our study provides a comprehensive understanding of the neurobiological substrates of alcohol use as a state or prospectively, thereby providing potential targets for clinical treatment.
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Affiliation(s)
- Ying Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
| | - Nikolina Skandali
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Valerie Voon
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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6
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Mattavelli G, Lo Presti S, Tornaghi D, Canessa N. High-definition transcranial direct current stimulation of the dorsal anterior cingulate cortex modulates decision-making and executive control. Brain Struct Funct 2022; 227:1565-1576. [PMID: 35102442 DOI: 10.1007/s00429-022-02456-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/13/2022] [Indexed: 11/02/2022]
Abstract
Previous neuroimaging evidence highlights the translational implications of targeting the dorsal anterior cingulate cortex (dACC), i.e. a key node of the networks underlying conflict monitoring and decision-making, in brain stimulation treatments with clinical or rehabilitative purposes. While the optimized modelling of "high-definition" current flows between multiple anode-cathode pairs might, in principle, allow to stimulate an otherwise challenging target, sensitive benchmark metrics of dACC neuromodulation are required to assess the effectiveness of this approach. On this basis, we aimed to assess the modulatory effect of anodal and cathodal high-definition tDCS (HD-tDCS) of the dACC on different facets of executive control and decision-making in healthy young individuals. A combined modelling/targeting procedure provided the optimal montage for the maximum intensity of dACC stimulation with six small "high-definition" electrodes delivering anodal, cathodal or sham HD-tDCS for 20 min in a within-subject design with three separate sessions. Following stimulation, participants performed Flanker and gambling tasks unveiling individual differences in executive control and both loss- and risk-aversion in decision-making, respectively. Compared to both anodal and sham conditions, cathodal dACC stimulation significantly affected task performance by increasing control over the Flanker conflict effect, and both loss and risk-aversion in decision-making. By confirming the feasibility and effectiveness of dACC stimulation with HD-tDCS, these findings highlight the implications of modelling and targeting procedures for neuromodulation in clinical research, whereby innovative protocols might serve as treatment addressing dysfunctional dACC activity, or combined with cognitive training, to enhance higher-order executive functioning in different neuropsychiatric conditions.
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Affiliation(s)
- Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, 27100, Pavia, Italy.,Cognitive Neuroscience Laboratory of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 4, 27100, Pavia, Italy
| | - Sara Lo Presti
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, 27100, Pavia, Italy
| | - Diana Tornaghi
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, 27100, Pavia, Italy
| | - Nicola Canessa
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, 27100, Pavia, Italy. .,Cognitive Neuroscience Laboratory of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 4, 27100, Pavia, Italy.
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7
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Morgello S, Buyukturkoglu K, Murray J, Veenstra M, Berman JW, Byrd D, Inglese M. MR spectroscopy and diffusion imaging in people with human immunodeficiency virus: Relationships to clinical and immunologic findings. J Neuroimaging 2022; 32:158-170. [PMID: 34520593 PMCID: PMC8752497 DOI: 10.1111/jon.12931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND PURPOSE People with human immunodeficiency virus (HIV; PWH) present a complex array of immunologic and medical disorders that impact brain structure and metabolism, complicating the interpretation of neuroimaging. This pilot study of well-characterized multi-morbid PWH examined how medical and immunologic factors predicted brain characteristics on proton MR spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI). METHODS Eighteen individuals on combination antiretroviral therapy (cART), with mean age of 56 years, underwent medical history review, neuroimaging, and on the day of imaging, blood draw for assay of 20 plasma cytokines and flow cytometric characterization of peripheral blood mononuclear cell subsets. Predictors of n-acetyl aspartate, choline, myoinositol, glutamate/glutamine, fractional anisotropy and mean diffusivity were identified through bivariate correlation; those significant at p < .1000 were advanced to multivariate analysis, with models created for each neuroimaging outcome. RESULTS Monocyte subsets and diverse cytokines accounted for 16 of 25 (64%) variables predicting 1H-MRS spectra in frontal gray and white matter and basal ganglia; monocyte subsets did not predict any DWI characteristic. In contrast, age, presence of hypertension, and duration of HIV infection accounted for 13 of 25 (52%) variables predicting diffusion characteristics in the corpus callosum, thalamic radiations, and basal ganglia but only 3 of 25 (12%) predictors of 1H-MRS features. CONCLUSIONS 1H-MRS neurometabolites were most often predicted by immunologic factors sensitive to temporal variation, whereas DWI metrics were more often related to longer-term disease state. In multi-morbid cART-era populations, selection and interpretation of neuroimaging modalities should account for complex temporal and pathogenetic influences of immunologic abnormality, disease state, and aging.
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Affiliation(s)
- Susan Morgello
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, New York,Departments of Neuroscience and Pathology, The Icahn School of Medicine at Mount Sinai, New York City, New York
| | | | - Jacinta Murray
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Mike Veenstra
- Departments of Pathology, Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York
| | - Joan W. Berman
- Departments of Pathology, Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York
| | - Desiree Byrd
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, New York,Department of Psychology, Queens College and the Graduate Center, City University of New York, Queens, New York
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
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8
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Chen T, Tan H, Lei H, Li X, Wu Q, Xu X, Ye Y, Zhong N, Du J, Jiang H, Su H, Zhao M. Nature of glutamate alterations in substance dependence: A systematic review and meta-analysis of proton magnetic resonance spectroscopy studies. Psychiatry Res Neuroimaging 2021; 315:111329. [PMID: 34271295 DOI: 10.1016/j.pscychresns.2021.111329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/19/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Animal studies have reported the brain glutamatergic dysfunction in substance dependence. However, proton magnetic resonance spectroscopy (1H-MRS) studies of glutamate in substance-dependent patients published contradicting results. In order to investigate the characteristics of brain glutamatergic alterations in substance-dependent patients, we conducted systematic reviews and meta-analyses of 1H-MRS studies that have investigated the glutamate, glutamine, and Glx (glutamate + glutamine) concentration in substance-dependent patients. Multiple databases were searched until Sep 10, 2020. Twenty-nine studies comprising 982 patients and 787 controls were included. There was significantly decreased glutamate level in dorsolateral prefrontal cortex in patients compared with controls. Higher glutamate levels in medial prefrontal cortex and basal ganglia region were also demonstrated in patients compared with controls. Subgroup analyses based on the substance type and abstinence period (short vs medium-term abstinence period) were performed. The results revealed Glx and glutamate concentrations in all investigated brain regions were not different in patients with any types of substance dependence compared with controls. The abstinence period had no effect on the glutamate levels. In summary, substance dependence is associated with glutamatergic dysfunction of prefrontal cortex and basal ganglia. Present findings partially support the hypothesis that addiction is associated with abnormal brain glutamatergic neurotransmission.
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Affiliation(s)
- Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Haoye Tan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Huiting Lei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Xiaotong Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Qianying Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Yujian Ye
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China.
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9
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Yang C, Fu X, Hao W, Xiang X, Liu T, Yang B, Zhang X. Gut dysbiosis associated with the rats' responses in methamphetamine-induced conditioned place preference. Addict Biol 2021; 26:e12975. [PMID: 33094505 DOI: 10.1111/adb.12975] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/11/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023]
Abstract
Methamphetamine (MA) is a potent stimulant and notoriously addictive. Individuals respond to MA effects differently and thus have a varying susceptible risk of developing MA use disorder. Cumulative evidence has indicated that gut dysbiosis contributes to behavioral response to drug effects. However, the role of gut microbiota in the susceptible risk of developing MA use disorder has remained elusive. Using an MA-induced conditioned place preference (CPP) rat model, we administrated the same dose of MA to rats, which then showed distinct preferences in drug-related place, indicating their different responses to MA. From all of the MA-exposed rats, the eight with the highest CPP scores were labeled as group high CPP (H-CPP), and the eight with the lowest were labeled as group low CPP (L-CPP). By 16S ribosomal RNA (rRNA) sequencing, we found that the gut microbiota compositions differed between H-CPP and L-CPP. Specifically, Akkermansia was significantly higher in H-CPP and positively correlated with the CPP scores. Notably, H-CPP and L-CPP differed in the gut microbiota composition prior to the CPP training; Ruminococcus was the dominant phylotype in H-CPP at baseline. More importantly, rats pretreated by antibiotics showed a significantly stronger MA-induced CPP than did the controls. Our study demonstrates that the gut dysbiosis was associated with the MA-induced CPP, indicating that the gut microbiota might be important modulators for MA-induced behavior and vulnerability to MA use disorder.
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Affiliation(s)
- Cheng Yang
- Department of Psychiatry, The Second Xiangya Hospital Central South University Changsha China
- National Clinical Research Center on Mental Disorders (Xiangya) Changsha China
- National Technology Institute on Mental Disorders Changsha China
- Hunan Key Laboratory of Psychiatry and Mental Health Changsha China
- Mental Health Institute of Central South University Changsha China
| | - Xiaoya Fu
- Department of Psychiatry, The Second Xiangya Hospital Central South University Changsha China
- National Clinical Research Center on Mental Disorders (Xiangya) Changsha China
- National Technology Institute on Mental Disorders Changsha China
- Hunan Key Laboratory of Psychiatry and Mental Health Changsha China
- Mental Health Institute of Central South University Changsha China
| | - Wei Hao
- Department of Psychiatry, The Second Xiangya Hospital Central South University Changsha China
- National Clinical Research Center on Mental Disorders (Xiangya) Changsha China
- National Technology Institute on Mental Disorders Changsha China
- Hunan Key Laboratory of Psychiatry and Mental Health Changsha China
- Mental Health Institute of Central South University Changsha China
| | - Xiaojun Xiang
- Department of Psychiatry, The Second Xiangya Hospital Central South University Changsha China
- National Clinical Research Center on Mental Disorders (Xiangya) Changsha China
- National Technology Institute on Mental Disorders Changsha China
- Hunan Key Laboratory of Psychiatry and Mental Health Changsha China
- Mental Health Institute of Central South University Changsha China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya Hospital Central South University Changsha China
- National Clinical Research Center on Mental Disorders (Xiangya) Changsha China
- National Technology Institute on Mental Disorders Changsha China
- Hunan Key Laboratory of Psychiatry and Mental Health Changsha China
- Mental Health Institute of Central South University Changsha China
| | - Bao‐Zhu Yang
- Department of Psychiatry Yale University School of Medicine New Haven CT USA
| | - Xiaojie Zhang
- Department of Psychiatry, The Second Xiangya Hospital Central South University Changsha China
- National Clinical Research Center on Mental Disorders (Xiangya) Changsha China
- National Technology Institute on Mental Disorders Changsha China
- Hunan Key Laboratory of Psychiatry and Mental Health Changsha China
- Mental Health Institute of Central South University Changsha China
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Distinct patterns of prefrontal cortical disengagement during inhibitory control in addiction: A meta-analysis based on population characteristics. Neurosci Biobehav Rev 2021; 127:255-269. [PMID: 33933507 DOI: 10.1016/j.neubiorev.2021.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/22/2021] [Accepted: 04/25/2021] [Indexed: 11/21/2022]
Abstract
Prefrontal cortical dysfunctions underlying inhibitory control deficits in addiction are complex and likely dependent on population characteristics. Here, we conducted a meta-analysis to examine alterations in brain activations during response inhibition in addicted individuals. We characterized imaging findings based on substance use status, diagnosis, substance classes, and task performance. Results revealed in those with active drug addiction hypoactivation of the left dorsal anterior cingulate cortex (dACC) and right middle frontal gyrus (MFG), compared with healthy controls. Weakening of the dACC and MFG activations was particularly pronounced in nicotine users, respectively. Impaired task performance was also associated with diminished MFG activation. In contrast, abstinent users did not exhibit any significant differences compared with healthy controls. Those with behavioral addictions were characterized by higher midcingulate cortical activation. Thus, the neural disengagement during response inhibition in active drug addiction was limited to a small number of prefrontal cortical regions and dependent on population characteristics. Finally, the evidence for potential normalization of hypofrontality following substance use cessation highlights the benefits of abstinence in restoring cerebral functions.
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11
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Kiemes A, Davies C, Kempton MJ, Lukow PB, Bennallick C, Stone JM, Modinos G. GABA, Glutamate and Neural Activity: A Systematic Review With Meta-Analysis of Multimodal 1H-MRS-fMRI Studies. Front Psychiatry 2021; 12:644315. [PMID: 33762983 PMCID: PMC7982484 DOI: 10.3389/fpsyt.2021.644315] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Multimodal neuroimaging studies combining proton magnetic resonance spectroscopy (1H-MRS) to quantify GABA and/or glutamate concentrations and functional magnetic resonance imaging (fMRI) to measure brain activity non-invasively have advanced understanding of how neurochemistry and neurophysiology may be related at a macroscopic level. The present study aimed to perform a systematic review and meta-analysis of available studies examining the relationship between 1H-MRS glutamate and/or GABA levels and task-related fMRI signal in the healthy brain. Ovid (Medline, Embase, and PsycINFO) and Pubmed databases were systematically searched to identify articles published until December 2019. The primary outcome of interest was the association between resting levels of glutamate or GABA and task-related fMRI. Fifty-five papers were identified for inclusion in the systematic review. A further 22 studies were entered into four separate meta-analyses. These meta-analyses found evidence of significant negative associations between local GABA levels and (a) fMRI activation to visual tasks in the occipital lobe, and (b) activation to emotion processing in the medial prefrontal cortex (mPFC)/anterior cingulate cortex (ACC). However, there was no significant association between mPFC/ACC glutamate levels and fMRI activation to cognitive control tasks or to emotional processing, with the relationship to emotion processing related neural activity narrowly missing significance. Moreover, our systematic review also found converging evidence of negative associations between GABA levels and local brain activity, and positive associations between glutamate levels and distal brain activity, outside of the 1H-MRS sampling region. Albeit less consistently, additional relationships between GABA levels and distal brain activity and between glutamate levels and local brain activity were found. It remains unclear if the absence of effects for other brain regions and other cognitive-emotional domains reflects study heterogeneity or potential confounding effects of age, sex, or other unknown factors. Advances in 1H-MRS methodology as well as in the integration of 1H-MRS readouts with other imaging modalities for indexing neural activity hold great potential to reveal key aspects of the pathophysiology of mental health disorders involving aberrant interactions between neurochemistry and neurophysiology such as schizophrenia.
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Affiliation(s)
- Amanda Kiemes
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Cathy Davies
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew J Kempton
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Paulina B Lukow
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Carly Bennallick
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - James M Stone
- Brighton and Sussex Medical School, University of Sussex & University of Brighton, Brighton, United Kingdom
| | - Gemma Modinos
- Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Medical Research Centre Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
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12
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Effects of long-term cocaine self-administration on brain resting-state functional connectivity in nonhuman primates. Transl Psychiatry 2020; 10:420. [PMID: 33268770 PMCID: PMC7710734 DOI: 10.1038/s41398-020-01101-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/02/2020] [Accepted: 11/10/2020] [Indexed: 12/21/2022] Open
Abstract
Long-term cocaine use is associated with a variety of neural and behavioral deficits that impact daily function. This study was conducted to examine the effects of chronic cocaine self-administration on resting-state functional connectivity of the dorsal anterior cingulate (dACC) and putamen-two brain regions involved in cognitive function and motoric behavior-identified in a whole brain analysis. Six adult male squirrel monkeys self-administered cocaine (0.32 mg/kg/inj) over 140 sessions. Six additional monkeys that had not received any drug treatment for ~1.5 years served as drug-free controls. Resting-state fMRI imaging sessions at 9.4 Tesla were conducted under isoflurane anesthesia. Functional connectivity maps were derived using seed regions placed in the left dACC or putamen. Results show that cocaine maintained robust self-administration with an average total intake of 367 mg/kg (range: 299-424 mg/kg). In the cocaine group, functional connectivity between the dACC seed and regions primarily involved in motoric behavior was weaker, whereas connectivity between the dACC seed and areas implicated in reward and cognitive processing was stronger. In the putamen seed, weaker widespread connectivity was found between the putamen and other motor regions as well as with prefrontal areas that regulate higher-order executive function; stronger connectivity was found with reward-related regions. dACC connectivity was associated with total cocaine intake. These data indicate that functional connectivity between regions involved in motor, reward, and cognitive processing differed between subjects with recent histories of cocaine self-administration and controls; in dACC, connectivity appears to be related to cumulative cocaine dosage during chronic exposure.
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13
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Alemu WG, Zeleke TA, Takele WW, Mekonnen SS. Prevalence and risk factors for khat use among youth students in Ethiopia: systematic review and meta-analysis, 2018. Ann Gen Psychiatry 2020; 19:16. [PMID: 32165908 PMCID: PMC7061479 DOI: 10.1186/s12991-020-00265-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/21/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Khat use is a widely spreading public health problem affecting the most economically productive population areas in Ethiopia. Khat use among students has been linked with mental, physical, social, and psychological problems. Reliable prevalence has not been recognized because of varying published rates. The objective of this systematic review and meta-analysis is to synthesize evidence on the prevalence and potential risk factors of khat use in Ethiopia. METHODS We found 284 studies of which 266 were removed due to duplication, irrelevant topics, and other reasons, respectively. All studies conducted in Ethiopia on khat chewing among students irrespective of time frame were included. Subsequently, 18 studies were used for synthesis of prevalence. Figures were extracted from published reports, and any lost information was requested from investigators. The quality of the included literature was evaluated by using the Newcastle-Ottawa Scale (NOS). Prevalence was pooled using random-effects meta-analyses. The presence of association was declared using P-values and an odds ratio with a corresponding 95% CI. RESULTS The pooled prevalence of khat use among students was 16.7% (13.7-19.7%). In the subgroup analysis, the highest prevalence was observed in the Oromia region, at 21.1% (15.5%, 26.7%), and an almost equal prevalence of 14.8% (10.6, 18.9) and 14.3% (10.3, 18.3) was observed in Amhara and the Southern Nation, Nationalities, and People's Region of Ethiopia, respectively. Being male (OR: 2.43 (1.73, 3.13)), being a Muslim religion follower (OR: 2.22 (1.6, 2.8)), being an alcohol user (OR: 2.3 (1.5, 3.0)), khat use by a family member (OR: 1.8 (1.4, 2.2)), peer pressure (OR: 4.4 (3.1, 5.6)), and being a cigarette smoker (OR: 8.5 (5.3, 11.7)) were found to be risk factors for khat chewing. CONCLUSIONS Khat use is a common problem among students. Health promotion, awareness on effect of khat, set policy on khat and substance use on the male sex, Muslim religion, alcohol user, having a family-member khat user, peer pressure, and being a cigarette smoker as possible risk factors for khat use among students. LIMITATIONS Irrespective of time restriction, all studies conducted in Ethiopia are included and cross-sectional in nature. Protocol no. CRD-42017081886.
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Affiliation(s)
- Wondale Getinet Alemu
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare Zeleke
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shegaye Shumet Mekonnen
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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14
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No evidence of abnormal metabolic or inflammatory activity in the brains of patients with rheumatoid arthritis: results from a preliminary study using whole-brain magnetic resonance spectroscopic imaging (MRSI). Clin Rheumatol 2020; 39:1765-1774. [PMID: 32002761 PMCID: PMC7237391 DOI: 10.1007/s10067-019-04923-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/21/2019] [Accepted: 12/29/2019] [Indexed: 01/15/2023]
Abstract
Introduction/objectives Many individuals with rheumatoid arthritis (RA) report persistent fatigue even after management of peripheral disease activity. This study used whole-brain magnetic resonance spectroscopic imaging (MRSI) to investigate whether abnormal inflammatory activity in the central nervous system may be associated with such symptoms. We hypothesized that RA patients would show higher brain choline (CHO), myo-inositol (MI), and lactate (LAC), and higher brain temperature than healthy controls. We further hypothesized that the metabolite levels would be positively correlated with self-reported fatigue. Method Thirteen women with RA provided fatigue severity ratings and underwent whole-brain MRSI and a joint examination. Thirteen healthy controls (HC) provided comparison imaging and fatigue data. CHO, MI, LAC, and brain temperature in 47 brain regions were contrasted between groups using independent-samples t tests. Significant differences were determined using a false discovery rate (FDR)-adjusted p value threshold of ≤ 0.0023. Secondary analyses obtained correlations between imaging and clinical outcomes in the RA group. Results No brain metabolic differences were identified between the groups. In the RA group, fatigue severity was positively correlated with CHO in several brain regions—most strongly the right frontal lobe (rs = 0.823, p < 0.001). MI was similarly correlated with fatigue, particularly in the right calcarine fissure (rs = 0.829, p < 0.001). CHO in several regions was positively correlated with joint swelling and tenderness. Conclusions We conclude that abnormal brain metabolites are not a common feature of RA, but may been seen in patients with persistent fatigue or disease activity after conventional treatment.Key Points • Whole-brain magnetic resonance spectroscopy revealed no metabolic abnormalities in the brain in patients with rheumatoid arthritis. • Brain choline levels were correlated with fatigue severity reported by RA patients and with peripheral joint swelling and tenderness. • Brain myo-inositol levels were similarly correlated with fatigue severity in RA patients. |
Electronic supplementary material The online version of this article (10.1007/s10067-019-04923-5) contains supplementary material, which is available to authorized users.
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15
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Kriegler J, Wegener S, Richter F, Scherbaum N, Brand M, Wegmann E. Decision making of individuals with heroin addiction receiving opioid maintenance treatment compared to early abstinent users. Drug Alcohol Depend 2019; 205:107593. [PMID: 31634665 DOI: 10.1016/j.drugalcdep.2019.107593] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/18/2019] [Accepted: 07/27/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Individuals with heroin addiction are prone to dysfunctional decision-making. They frequently choose the short-term rewarding option of drug intake despite experiencing long-term negative consequences. Opioid maintenance treatment (OMT) is the most common treatment of heroin addiction. METHODS In this study, 38 individuals in an early stage of abstinence from heroin addiction (ESA-HA individuals) at the end of inpatient detoxification treatment and 41 individuals in long-term OMT were examined. Decision-making was assessed by (I) a modified version of the Iowa Gambling Task (IGT) with drug-related stimuli focusing on decision-making under ambiguity and (II) the Game of Dice Task (GDT) assessing decision-making under objective risk. RESULTS OMT-individuals showed significantly better performance in the IGT than the ESA-HA-individuals. They also showed significantly less craving under exposure of drug-related pictures. In the GDT, OMT-individuals showed significantly less risky decision-making than ESA-HA-individuals. CONCLUSION The results suggest that patients receiving OMT show better functional decision-making and lower craving reactions. It could be assumed that the effectiveness of OMT in preventing relapse is linked to better decision-making and lower craving among these patients.
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Affiliation(s)
- Julia Kriegler
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany.
| | - Sophia Wegener
- Berufsförderungswerk Stralsund GmbH, Große Parower Straße 133, 18435 Stralsund, Germany.
| | - Francois Richter
- Suchthilfe direkt Essen GmbH, Hoffnungstraße 24, 45127 Essen, Germany.
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany.
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany.
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16
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Huhn AS, Brooner RK, Sweeney MM, Yip SW, Ayaz H, Dunn KE. Increased neural activity in the right dorsolateral prefrontal cortex during a risky decision-making task is associated with cocaine use in methadone-maintained patients. Drug Alcohol Depend 2019; 205:107650. [PMID: 31669801 PMCID: PMC6905637 DOI: 10.1016/j.drugalcdep.2019.107650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/28/2019] [Accepted: 09/10/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Methadone maintenance is an effective treatment for opioid use disorder (OUD), yet many methadone-maintained patients (MMPs) struggle with cocaine use during OUD recovery. The current study aimed to identify whether prefrontal cortex (PFC) activity during a risky decision-making task was associated with cocaine use during a 90-day follow-up in MMPs. METHODS MMPs (N = 28) attended a single neuroimaging session wherein PFC activity was measured using functional near-infrared spectroscopy (fNIRS) during the Balloon Analogue Risk Task (BART). Trait impulsivity was assessed via the Barratt Impulsiveness Scale version 11 (BIS-11). Following the neuroimaging session, MMPs were tracked via electronic health records for 90 days to determine treatment outcomes including cocaine use verified by urine drug screens. RESULTS During the BART, MMPs who used cocaine displayed increased neural activity in the right PFC during active decision-making (F1, 22 = 14.75, p = 0.001) and the right dorsolateral PFC during active minus passive decision-making (F1, 22 = 5.56, p = 0.028) compared to participants who did not use cocaine. Receiver operating characteristic curves confirmed that neural activity in the right PFC during active decision-making (AUC = 0.841, 95% CI, 0.697-0.985, p = 002), and in the right dorsolateral PFC during active minus passive decision-making (AUC = 0.805, 95% CI, 0.643-0.968, p = 0.006) was associated with continued cocaine use. MMPs who used cocaine versus those who did not reported increased trait impulsivity on the BIS-11 Total Score (t=-2.28, p = 0.031). CONCLUSIONS The fNIRS device is portable, relatively easy to use, and potentially feasible for use in methadone outpatient programs to assess propensity for negative treatment outcomes such as continued cocaine use.
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Affiliation(s)
- Andrew S. Huhn
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA
| | - Robert K Brooner
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA
| | - Mary M. Sweeney
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA
| | - Sarah W. Yip
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, USA
| | - Hasan Ayaz
- Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, PA 19104, USA,University of Pennsylvania, Department of Family and Community Health, Philadelphia, PA 19104, USA,Children’s Hospital of Philadelphia, Division of General Pediatrics, Philadelphia, PA 19104, USA
| | - Kelly E. Dunn
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA
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17
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Berihu BA, Asfeha GG, Welderufael AL, Debeb YG, Zelelow YB, Beyene HA. Toxic effect of khat ( Catha edulis) on memory: Systematic review and meta-analysis. J Neurosci Rural Pract 2019; 8:30-37. [PMID: 28149078 PMCID: PMC5225718 DOI: 10.4103/0976-3147.193524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND People use khat (Catha edulis) for its pleasant stimulant effect of physical activity, consciousness, motor, and mental functions. Although there are reports assessing the effect of khat on memory, there was no study based on formal systematic review and meta-analysis. OBJECTIVE We have therefore conducted this meta-analysis to determine the level of evidence for the effect of khat (C. edulis Forsk) on memory discrepancy. METHODS MEDLINE, Cochrane Library, PubMed, Academic Search Complete, SPORTDiscus, ScienceDirect, Scopus, Web of Science, and Google Scholar were searched to retrieve the papers for this review. Keywords utilized across database search were khat, cat, chat, long-term memory, short-term memory, memory deficit, randomized control trial, and cross-sectional survey. The search was limited to studies in humans and rodents; published in English language. RESULT Finding of various studies included in our meta-analysis showed that the effect of acute, and subchronic exposure to khat showed that short-term memory appears to be affected depending on the duration of exposure. However, does not have any effect on long-term memory. CONCLUSION Although a number of studies regarding the current topic are limited, the evidenced showed that khat (C. edulis) induced memory discrepancy.
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Affiliation(s)
- Birhane Alem Berihu
- Department of Anatomy and Histology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gebrekidan Gebregzabher Asfeha
- Department of Biochemistry and Molecular Biology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abadi Leul Welderufael
- Department of Pediatrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yared Godefa Debeb
- Department of Physiology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yibrah Berhe Zelelow
- Department of Pediatrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Hafte Assefa Beyene
- Department of Anatomy and Histology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Woodcock EA, Hillmer AT, Mason GF, Cosgrove KP. Imaging Biomarkers of the Neuroimmune System among Substance Use Disorders: A Systematic Review. MOLECULAR NEUROPSYCHIATRY 2019; 5:125-146. [PMID: 31312635 DOI: 10.1159/000499621] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/13/2019] [Indexed: 12/14/2022]
Abstract
There is tremendous interest in the role of the neuroimmune system and inflammatory processes in substance use disorders (SUDs). Imaging biomarkers of the neuroimmune system in vivo provide a vital translational bridge between preclinical and clinical research. Herein, we examine two imaging techniques that measure putative indices of the neuroimmune system and review their application among SUDs. Positron emission tomography (PET) imaging of 18 kDa translocator protein availability is a marker associated with microglia. Proton magnetic resonance spectroscopy quantification of myo-inositol levels is a putative glial marker found in astrocytes. Neuroinflammatory responses are initiated and maintained by microglia and astrocytes, and thus represent important imaging markers. The goal of this review is to summarize neuroimaging findings from the substance use literature that report data using these markers and discuss possible mechanisms of action. The extant literature indicates abused substances exert diverse and complex neuroimmune effects. Moreover, drug effects may change across addiction stages, i.e. the neuroimmune effects of acute drug administration may differ from chronic use. This burgeoning field has considerable potential to improve our understanding and treatment of SUDs. Future research is needed to determine how targeting the neuroimmune system may improve treatment outcomes.
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Affiliation(s)
- Eric A Woodcock
- Departments of Psychiatry, and of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ansel T Hillmer
- Departments of Psychiatry, and of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Graeme F Mason
- Departments of Psychiatry, and of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kelly P Cosgrove
- Departments of Psychiatry, and of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
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Moningka H, Lichenstein S, Yip SW. Current understanding of the neurobiology of opioid use disorder: An overview. Curr Behav Neurosci Rep 2019; 6:1-11. [PMID: 34485022 PMCID: PMC8412234 DOI: 10.1007/s40473-019-0170-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW This review provides an overview of the neurobiological mechanisms underlying opioid use disorder (OUD) drawing from genetic, functional and structural magnetic resonance imaging (MRI) research. RECENT FINDINGS Preliminary evidence suggests an association between OUD and specific variants of the DRD2, δ-opioid receptor 1 (OPRD1) and μ-opioid receptor 1 (OPRM1) genes. Additionally, MRI research indicates functional and structural alterations in striatal and corticolimbic brain regions and pathways underlying reward, emotion/stress and cognitive control processes among individuals with OUD. SUMMARY Individual differences in genetic and functional and structural brain-based features are correlated with differences in OUD severity and treatment outcomes, and therefore may potentially one day be used to inform OUD treatment selection. However, given the heterogeneous findings reported, further longitudinal research across different stages of opioid addiction is needed to yield a convergent characterization of OUD and improve treatment and prevention.
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Affiliation(s)
- Hestia Moningka
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510
- University College London, Division of Psychology and Language Sciences, London WC1H 0AP
| | - Sarah Lichenstein
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510
| | - Sarah W. Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510
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20
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Morgenroth E, Orlov N, Lythgoe DJ, Stone JM, Barker H, Munro J, Eysenck M, Allen P. Altered relationship between prefrontal glutamate and activation during cognitive control in people with high trait anxiety. Cortex 2019; 117:53-63. [PMID: 30928721 DOI: 10.1016/j.cortex.2019.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/06/2018] [Accepted: 02/22/2019] [Indexed: 01/08/2023]
Abstract
Trait anxiety can affect cognitive control resulting in ineffective and/or inefficient task performance. Moreover, previous functional Magnetic Resonance Imaging (fMRI) studies have reported altered dorsolateral prefrontal cortex (DLPFC) activity in anxious cohorts, particularly when executive control is required. Recently, it has been demonstrated that cortical glutamate levels can predict both functional activation during cognitive control, and anxiety levels. In the present study we sought to investigate the relationship between trait anxiety, prefrontal glutamate levels and functional activation in DLPFC during a cognitive control task. Thirty-nine participants assigned to either low trait anxiety (LTA) or high trait anxiety (HTA) groups underwent 1H-Magnetic Resonance Spectroscopy (1H-MRS) to measure levels of resting glutamate in the prefrontal cortex (PFC). Participants also completed fMRI during a Stroop task comprising congruent and incongruent colour word trials. The HTA group showed reduced task performance relative to the LTA group. In the LTA group, there was a positive association between PFC Glu levels and DLPFC activation during incongruent trials. This association was absent in the HTA group. Individual differences in trait anxiety affect the relationship between PFC glutamate levels and DLPFC activation, possibly contributing to ineffective task performance when cognitive control is required.
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Affiliation(s)
| | - Natasza Orlov
- Department of Psychology, University of Roehampton, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - David J Lythgoe
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - James M Stone
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Holly Barker
- Department of Psychology, University of Roehampton, London, UK
| | - James Munro
- Department of Psychology, University of Roehampton, London, UK; Department of Psychology, Edinburgh Napier University, Edinburgh, UK
| | - Michael Eysenck
- Department of Psychology, University of Roehampton, London, UK; Department of Psychology, Royal Holloway University of London, London, UK
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Combined Universities Brain Imaging Centre, London, UK
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Sariah A, Liu Z, Pu W, Liu H, Xue Z, Huang X. Structural and Functional Alterations in Betel-Quid Chewers: A Systematic Review of Neuroimaging Findings. Front Psychiatry 2019; 10:16. [PMID: 30761025 PMCID: PMC6361845 DOI: 10.3389/fpsyt.2019.00016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/11/2019] [Indexed: 12/21/2022] Open
Abstract
Background: A number of neuroimaging studies have investigated structural, metabolic, and functional connectivity changes in betel quid (BQ) chewers. We present a systematic review of neuroimaging studies with emphasis on key brain systems affected by BQ chewing to bring a better understanding on the neuro mechanisms involved in BQD. Methods: All BQ neuroimaging studies were identified by searching PubMed, EMBASE, and Google scholar for English articles published until March 2018 using the key words: Betel-quid, resting state, functional MRI, structural MRI, diffusion tensor imaging (DTI), and betel quid dependence basing on the PRISMA criteria. We also sought unpublished studies, and the rest were obtained from reference lists of the retrieved articles. All neuroimaging studies investigating brain structural, and functional alterations related to BQ chewing and BQ dependence were included. Our systematic review registration number is CRD42018092669. Results: A review of 12 studies showed that several systems in the brain of BQ chewers exhibited structural, metabolic, and functional alterations. BQ chewing was associated with alterations in the reward [areas in the midbrain, and prefrontal cortex (PFC)], impulsivity (anterior cingulate cortex, PFC) and cognitive (PFC, the default mode, frontotemporal, frontoparietal, occipital/temporal, occipital/parietal, temporal/limbic networks, hippocampal/hypothalamus, and the cerebellum) systems in the brain. BQ duration and severity of betel quid dependence were associated with majority of alterations in BQ chewers. Conclusion: Betel quid chewing is associated with brain alterations in structure, metabolism and function in the cognitive, reward, and impulsivity circuits which are greatly influenced by duration and severity of betel quid dependence.
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Affiliation(s)
- Adellah Sariah
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.,Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Weidan Pu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Haihong Liu
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, China
| | - Zhimin Xue
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojun Huang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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22
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Stewart JL, May AC, Aupperle RL, Bodurka J. Forging Neuroimaging Targets for Recovery in Opioid Use Disorder. Front Psychiatry 2019; 10:117. [PMID: 30899231 PMCID: PMC6417368 DOI: 10.3389/fpsyt.2019.00117] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/15/2019] [Indexed: 01/01/2023] Open
Abstract
The United States is in the midst of an opioid epidemic and lacks a range of successful interventions to reduce this public health burden. Many individuals with opioid use disorder (OUD) consume drugs to relieve physical and/or emotional pain, a pattern that may increasingly result in death. The field of addiction research lacks a comprehensive understanding of physiological and neural mechanisms instantiating this cycle of Negative Reinforcement in OUD, resulting in limited interventions that successfully promote abstinence and recovery. Given the urgency of the opioid crisis, the present review highlights faulty brain circuitry and processes associated with OUD within the context of the Three-Stage Model of Addiction (1). This model underscores Negative Reinforcement processes as crucial to the maintenance and exacerbation of chronic substance use together with Binge/Intoxication and Preoccupation/Anticipation processes. This review focuses on cross-sectional as well as longitudinal studies of relapse and treatment outcome that employ magnetic resonance imaging (MRI), functional near-infrared spectroscopy (fNIRs), brain stimulation methods, and/or electroencephalography (EEG) explored in frequency and time domains (the latter measured by event-related potentials, or ERPs). We discuss strengths and limitations of this neuroimaging work with respect to study design and individual differences that may influence interpretation of findings (e.g., opioid use chronicity/recency, comorbid symptoms, and biological sex). Lastly, we translate gaps in the OUD literature, particularly with respect to Negative Reinforcement processes, into future research directions involving operant and classical conditioning involving aversion/stress. Overall, opioid-related stimuli may lessen their hold on frontocingulate mechanisms implicated in Preoccupation/Anticipation as a function of prolonged abstinence and that degree of frontocingulate impairment may predict treatment outcome. In addition, longitudinal studies suggest that brain stimulation/drug treatments and prolonged abstinence can change brain responses during Negative Reinforcement and Preoccupation/Anticipation to reduce salience of drug cues, which may attenuate further craving and relapse. Incorporating this neuroscience-derived knowledge with the Three-Stage Model of Addiction may offer a useful plan for delineating specific neurobiological targets for OUD treatment.
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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
- Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, San Diego, CA, United States
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States.,Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States
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23
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Moningka H, Lichenstein S, Worhunsky PD, DeVito EE, Scheinost D, Yip SW. Can neuroimaging help combat the opioid epidemic? A systematic review of clinical and pharmacological challenge fMRI studies with recommendations for future research. Neuropsychopharmacology 2019; 44:259-273. [PMID: 30283002 PMCID: PMC6300537 DOI: 10.1038/s41386-018-0232-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 02/04/2023]
Abstract
The current opioid epidemic is an urgent public health problem, with enormous individual, societal, and healthcare costs. Despite effective, evidence-based treatments, there is significant individual variability in treatment responses and relapse rates are high. In addition, the neurobiology of opioid-use disorder (OUD) and its treatment is not well understood. This review synthesizes published fMRI literature relevant to OUD, with an emphasis on findings related to opioid medications and treatment, and proposes areas for further research. We conducted a systematic literature review of Medline and Psychinfo to identify (i) fMRI studies comparing OUD and control participants; (ii) studies related to medication, treatment, abstinence or withdrawal effects in OUD; and (iii) studies involving manipulation of the opioid system in healthy individuals. Following application of exclusionary criteria (e.g., insufficient sample size), 45 studies were retained comprising data from ~1400 individuals. We found convergent evidence that individuals with OUD display widespread heightened neural activation to heroin cues. This pattern is potentiated by heroin, attenuated by medication-assisted treatments for opioids, predicts treatment response, and is reduced following extended abstinence. Nonetheless, there is a paucity of literature examining neural characteristics of OUD and its treatment. We discuss limitations of extant research and identify critical areas for future neuroimaging studies, including the urgent need for studies examining prescription opioid users, assessing sex differences and utilizing a wider range of clinically relevant task-based fMRI paradigms across different stages of addiction.
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Affiliation(s)
- Hestia Moningka
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Sarah Lichenstein
- Yale School of Medicine, Radiology and Bioimaging Sciences, New Haven, CT, 06510, USA
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Dustin Scheinost
- Yale School of Medicine, Radiology and Bioimaging Sciences, New Haven, CT, 06510, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA.
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24
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Alemu WG, Amare Zeleke T, Takele WW. Prevalence and associated factors of khat chewing among students in Ethiopia: a protocol for systematic review and meta-analysis. BMJ Open 2018; 8:e021157. [PMID: 30478104 PMCID: PMC6254418 DOI: 10.1136/bmjopen-2017-021157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION These days, in Ethiopia, khat chewing is one of the widely spreading public health problems affecting the most productive segment of the population. The health implications of khat chewing among students are strongly linked with poor mental, physical and social performances. However, the national magnitude of khat chewing and the associated factors among Ethiopian students are unknown. Therefore, this systematic review and meta-analysis will answer the national prevalence of khat chewing and the associated factors among students in Ethiopia. METHODS Published primary relevant articles will be accessed using various databases, such as Medline, PubMed, EMBASE and Scopus. Other electronic search engines, for instance, Google Scholar and Google, will be used. Furthermore, additional studies will be collected by communicating with the author(s) and following the references of relevant articles. To select eligible studies, the Joanna Briggs Institute quality appraisal checklist will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed to keep the scientific rigour of the study. Heterogeneity between studies will be examined through forest plot and I2 heterogeneity tests. To identify influential studies, sensitivity analysis will be done. For substantial heterogeneity (I2>50%), the DerSimonian and Laird random-effects model will be employed. Subgroup analyses will be conducted using the random-effect model. Moreover, small studies' publication bias will be checked by funnel plots and objectively by Egger's regression test. If in case Egger's test was found to be statistically significant (p<0.05), trim and fill (Duval and Tweedie) analysis will be performed. The presence of association will be declared using p≤0.05 and OR with corresponding 95% CI. ETHICS AND DISSEMINATION Since the intention of the study is to describe earlier primary studies qualitatively and pool the results of those articles, ethical clearance will not be a concern. The results of the study will be published in a reputable peer-reviewed journal and presented at different scientific research conferences. It will also be disseminated to academic as well as other concerned institutions. PROSPERO REGISTRATION NUMBER CRD-42,017,081,886.
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Affiliation(s)
- Wondale Getinet Alemu
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare Zeleke
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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25
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Mullins PG. Towards a theory of functional magnetic resonance spectroscopy (fMRS): A meta-analysis and discussion of using MRS to measure changes in neurotransmitters in real time. Scand J Psychol 2018; 59:91-103. [PMID: 29356002 DOI: 10.1111/sjop.12411] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/01/2017] [Indexed: 02/06/2023]
Abstract
Proton magnetic resonance spectroscopy is a powerful tool to investigate neurochemistry and physiology in vivo. Recently researchers have started to use MRS to measure neurotransmitter changes related to neural activity, so called functional MRS (fMRS). Particular interest has been placed on measuring glutamate changes associated with neural function, but differences are reported in the size of changes seen. This review discusses fMRS, and includes meta-analyses of the relative size of glutamate changes seen in fMRS, and the impact experimental design and stimulus paradigm may have. On average glutamate was found to increase by 6.97% (±1.739%) in response to neural activation. However, factors of experimental design may have a large impact on the size of these changes. For example an increase of 4.749% (±1.45%) is seen in block studies compared to an increase of 13.429% (±3.59) in studies using event related paradigms. The stimulus being investigated also seems to play a role with prolonged visual stimuli showing a small mean increase in glutamate of 2.318% (±1.227%) while at the other extreme, pain stimuli show a mean stimulation effect of 14.458% (±3.736%). These differences are discussed with regards to possible physiologic interpretations, as well experimental design implications.
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26
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Murphy A, Lubman DI, McKie S, Bijral PS, Peters LA, Faiz Q, Holmes SE, Anderson IM, Deakin B, Elliott R. Time-dependent neuronal changes associated with craving in opioid dependence: an fMRI study. Addict Biol 2018; 23:1168-1178. [PMID: 28940758 PMCID: PMC6120475 DOI: 10.1111/adb.12554] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/03/2017] [Accepted: 08/08/2017] [Indexed: 12/11/2022]
Abstract
Relapse after initially successful treatment is a significant problem facing the treatment of opioid dependence. Evidence suggests craving elicited by re‐exposure to drug cues may precipitate relapse. Attempts to identify neural biomarkers of cue‐elicited craving have yielded inconsistent findings. We aimed to apply a novel continuous functional magnetic resonance imaging technique to follow the minute‐to‐minute evolution of brain responses, which correlate with the waxing and waning of craving. Newly detoxified male opioid‐dependent patients and healthy control participants attended two separate, counterbalanced, functional magnetic resonance imaging scanning sessions during which they viewed a 10‐minute video (drug cue or neutral cue) followed by 5 minutes of fixation. Participants rated the intensity of their craving throughout each session. We hypothesized that subcortical/ventral prefrontal cortex (PFC) regions and dorsal PFC regions would show different associations with craving reflecting their putative roles in appetitive processing versus cognitive control. Compared with controls, drug cue (minus neutral cue) video recruited the left amygdala and was temporally correlated with craving. In contrast, dorsal anterior cingulate blood‐oxygen‐level‐dependent signal time course was higher than controls only during a period after cue exposure when craving levels were declining. Against expectations, neither the ventral striatum nor ventral PFC was significantly recruited by drug cue exposure. Findings suggest that the amygdala has a central role in craving, whereas the dorsal anterior cingulate may control craving in treatment‐seeking patients. Time course analysis yielded new insights into the neural substrates of craving that could objectively validate development of psychological and pharmacological approaches to sustained abstinence.
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Affiliation(s)
- Anna Murphy
- Neuroscience and Psychiatry Unit, Faculty of Biology, Medicine and Health; University of Manchester; UK
- Department of Biological Sciences; University of Huddersfield; UK
| | - Dan I. Lubman
- Turning Point; Eastern Health; Australia
- Eastern Health Clinical School; Monash University; Australia
| | - Shane McKie
- Neuroscience and Psychiatry Unit, Faculty of Biology, Medicine and Health; University of Manchester; UK
| | - Prun S. Bijral
- Chapman-Barker Unit; Greater Manchester West NHS Foundation Trust; UK
- Change, Grow, Live; UK
| | - Lesley A. Peters
- Pennine Care NHS Foundation Trust; UK
- DISC, My Recovery Tameside; UK
| | - Qasim Faiz
- Chapman-Barker Unit; Greater Manchester West NHS Foundation Trust; UK
- Pennine Care NHS Foundation Trust; UK
| | - Sophie E. Holmes
- Neuroscience and Psychiatry Unit, Faculty of Biology, Medicine and Health; University of Manchester; UK
- Department of Psychiatry; Yale University School of Medicine; West Haven CT USA
| | - Ian M. Anderson
- Neuroscience and Psychiatry Unit, Faculty of Biology, Medicine and Health; University of Manchester; UK
| | - Bill Deakin
- Neuroscience and Psychiatry Unit, Faculty of Biology, Medicine and Health; University of Manchester; UK
- Greater Manchester Mental Health NHS Foundation Trust; UK
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, Faculty of Biology, Medicine and Health; University of Manchester; UK
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27
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Deng Y, Wang X, Wang Y, Zhou C. Neural correlates of interference resolution in the multi-source interference task: a meta-analysis of functional neuroimaging studies. Behav Brain Funct 2018; 14:8. [PMID: 29636070 PMCID: PMC5891971 DOI: 10.1186/s12993-018-0140-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/17/2018] [Indexed: 01/01/2023] Open
Abstract
Background Interference resolution refers to cognitive control processes enabling one to focus on task-related information while filtering out unrelated information. But the exact neural areas, which underlie a specific cognitive task on interference resolution, are still equivocal. The multi-source interference task (MSIT), as a particular cognitive task, is a well-established experimental paradigm used to evaluate interference resolution. Studies combining the MSIT with functional magnetic resonance imaging (fMRI) have shown that the MSIT evokes the dorsal anterior cingulate cortex (dACC) and cingulate–frontal–parietal cognitive-attentional networks. However, these brain areas have not been evaluated quantitatively and these findings have not been replicated. Methods In the current study, we firstly report a voxel-based meta-analysis of functional brain activation associated with the MSIT so as to identify the localization of interference resolution in such a specific cognitive task. Articles on MSIT-related fMRI published between 2003 and July 2017 were eligible. The electronic databases searched included PubMed, Web of Knowledge, and Google Scholar. Differential BOLD activation patterns between the incongruent and congruent condition were meta-analyzed in anisotropic effect-size signed differential mapping software. Results Robustness meta-analysis indicated that two significant activation clusters were shown to have reliable functional activity in comparisons between incongruent and congruent conditions. The first reliable activation cluster, which included the dACC, medial prefrontal cortex, supplementary motor area, replicated the previous MSIT-related fMRI study results. Furthermore, we found another reliable activation cluster comprising areas of the right insula, right inferior frontal gyrus, and right lenticular nucleus-putamen, which were not typically discussed in previous MSIT-related fMRI studies. Conclusions The current meta-analysis study presents the reliable brain activation patterns on MSIT. These findings suggest that the cingulate-frontal-striatum network and right insula may allow control demands to resolve interference on MSIT. These results provide new insights into the neural mechanisms underlying interference resolution.
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Affiliation(s)
- Yuqin Deng
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, People's Republic of China
| | - Xiaochun Wang
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, People's Republic of China
| | - Yan Wang
- Interdisciplinary Center for Social and Behavioral Studies, Dongbei University of Finance and Economics, Dalian, 116025, Liaoning Province, People's Republic of China
| | - Chenglin Zhou
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, 399 Chang Hai Road, Shanghai, 200438, People's Republic of China.
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28
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Gruber SA, Sagar KA, Dahlgren MK, Gonenc A, Smith RT, Lambros AM, Cabrera KB, Lukas SE. The Grass Might Be Greener: Medical Marijuana Patients Exhibit Altered Brain Activity and Improved Executive Function after 3 Months of Treatment. Front Pharmacol 2018; 8:983. [PMID: 29387010 PMCID: PMC5776082 DOI: 10.3389/fphar.2017.00983] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/22/2017] [Indexed: 11/22/2022] Open
Abstract
The vast majority of states have enacted full or partial medical marijuana (MMJ) programs, causing the number of patients seeking certification for MMJ use to increase dramatically in recent years. Despite increased use of MMJ across the nation, no studies thus far have examined the specific impact of MMJ on cognitive function and related brain activation. In the present study, MMJ patients seeking treatment for a variety of documented medical conditions were assessed prior to initiating MMJ treatment and after 3 months of treatment as part of a larger longitudinal study. In order to examine the effect of MMJ treatment on task-related brain activation, MMJ patients completed the Multi-Source Interference Test (MSIT) while undergoing functional magnetic resonance imaging (fMRI). We also collected data regarding conventional medication use, clinical state, and health-related measures at each visit. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pre-treatment, suggestive of a potential normalization of brain function relative to baseline. These findings suggest that MMJ use may result in different effects relative to recreational marijuana (MJ) use, as recreational consumers have been shown to exhibit decrements in task performance accompanied by altered brain activation. Moreover, patients in the current study also reported improvements in clinical state and health-related measures as well as notable decreases in prescription medication use, particularly opioids and benzodiapezines after 3 months of treatment. Further research is needed to clarify the specific neurobiologic impact, clinical efficacy, and unique effects of MMJ for a range of indications and how it compares to recreational MJ use.
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Affiliation(s)
- Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Mary K Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychology, Tufts University, Medford, MA, United States
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Rosemary T Smith
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Ashley M Lambros
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Korine B Cabrera
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Marijuana Investigations for Neuroscientific Discovery Program, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Scott E Lukas
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States.,Behavioral Psychopharmacology Research Laboratory, McLean Imaging Center, McLean Hospital, Belmont, MA, United States
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Online effects of transcranial direct current stimulation on prefrontal metabolites in gambling disorder. Neuropharmacology 2017; 131:51-57. [PMID: 29221791 DOI: 10.1016/j.neuropharm.2017.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 02/07/2023]
Abstract
Gambling disorder is characterized by persistent maladaptive gambling behaviors and is now considered among substance-related and addictive disorders. There is still unmet therapeutic need for these clinical populations, however recent advances indicate that interventions targeting the Glutamatergic/GABAergic system hold promise in reducing symptoms in substance-related and addictive disorders, including gambling disorder. There is some data indicating that transcranial direct current stimulation may hold clinical benefits in substance use disorders and modulate levels of brain metabolites including glutamate and GABA. The goal of the present work was to test whether this non-invasive neurostimulation method modulates key metabolites in gambling disorder. We conducted a sham-controlled, crossover, randomized study, blinded at two levels in order to characterize the effects of transcranial direct current stimulation over the dorsolateral prefrontal cortex on neural metabolites levels in sixteen patients with gambling disorder. Metabolite levels were measured with magnetic resonance spectroscopy from the right dorsolateral prefrontal cortex and the right striatum during active and sham stimulation. Active as compared to sham stimulation elevated prefrontal GABA levels. There were no significant changes between stimulation conditions in prefrontal glutamate + glutamine and N-acetyl Aspartate, or in striatal metabolite levels. Results also indicated positive correlations between metabolite levels during active, but not sham, stimulation and levels of risk taking, impulsivity and craving. Our findings suggest that transcranial direct current stimulation can modulate GABA levels in patients with gambling disorder which may represent an interesting future therapeutic avenue.
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30
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Liu XL, Li L, Li JN, Tang JH, Rong JH, Liu B, Hu ZX. Quantifying absolute glutamate concentrations in nucleus accumbens of prescription opioid addicts by using 1H MRS. Brain Behav 2017; 7:e00769. [PMID: 28828225 PMCID: PMC5561325 DOI: 10.1002/brb3.769] [Citation(s) in RCA: 16] [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: 02/23/2017] [Revised: 06/07/2017] [Accepted: 06/13/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The diagnosis of psychoactive substance use disorders has been based primarily on descriptive, symptomatic checklist criteria. In opioid addiction, there are no objective biological indicators specific enough to guide diagnosis, monitor disease status, and evaluate efficacy of therapeutic interventions. Proton magnetic resonance spectroscopy (1H MRS) of the brain has potential to identify and quantify biomarkers for the diagnosis of opioid dependence. The purpose of this study was to detect the absolute glutamate concentration in the nucleus accumbens (NAc) of patients with prescription opioid dependence using 1H MRS, and to analyze its clinical associations. METHODS Twenty patients with clinically diagnosed definitive prescription opioid dependent (mean age = 26.5 ± 4.3 years) and 20 matched healthy controls (mean age = 26.1 ± 3.8 years) participated in this study. Patients were evaluated with the Barratt Impulsiveness Scale (BIS-11), the Self-Rating Anxiety Scale (SAS), and the opiate Addiction Severity Inventory (ASI). We used point-resolved spectroscopy to quantify the absolute concentrations of metabolites (glutamate, choline, N-acetylaspartate, glutamine, creatine) within the NAc. The difference between metabolite levels of groups and Pearson's correlation between glutamate levels and psychometric scores in patients were analyzed statistically. RESULTS Glutamate concentrations in the NAc were significantly higher in prescription opiate addicts than in controls (t = 3.84, p = .001). None of the other metabolites differed significantly between the two groups (all ps > .05). The glutamate concentrations correlated positively with BIS-11 scores in prescription opiate addicts (r = .671, p = .001), but not with SAS score and ASI index. CONCLUSIONS Glutamate levels in the NAc measured quantitatively with in vivo 1H MRS could be used as a biomarker to evaluate disease condition in opioid-dependent patients.
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Affiliation(s)
- Xi-Long Liu
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Long Li
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Jian-Neng Li
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Ji-Hua Tang
- Department of Psychology and Addiction Medicine Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Jia-Hui Rong
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Bo Liu
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
| | - Ze-Xuan Hu
- Department of Radiology Guangdong Provincial Corps Hospital of Chinese People's Armed Police Forces Guangzhou Medical University Guangzhou China
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31
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Gruber SA, Dahlgren MK, Sagar KA, Gonenc A, Norris L, Cohen BM, Ongur D, Lewandowski KE. Decreased Cingulate Cortex activation during cognitive control processing in bipolar disorder. J Affect Disord 2017; 213:86-95. [PMID: 28199893 DOI: 10.1016/j.jad.2017.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/05/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive deficits are well-documented in patients with bipolar disorder (BPD) and may impact the efficacy of psychotherapy. Cognitive control, a form of executive functioning, is often used therapeutically to shift patients' thoughts and behaviors from automatic, maladaptive responses to adaptive coping strategies. This study examined cognitive control processing in patients with BPD using the Multi-Source Interference Task (MSIT). METHOD Twenty-nine patients diagnosed with BPD and 21 healthy control (HC) subjects completed the MSIT with concurrent functional magnetic resonance imaging (fMRI). RESULTS Patients with BPD generally performed worse on the MSIT relative to HC participants; the BPD group had significantly lower performance accuracy and made more omission errors. Further, fMRI analyses revealed differential patterns of activation between the groups during the MSIT. Region of interest (ROI) analyses revealed that relative to HC participants, patients with BPD activated significantly fewer voxels within the cingulate cortex (CC) and more voxels within prefrontal cortex (PFC), although the PFC findings did not survive more stringent significance thresholds. LIMITATIONS Patients and HCs were not matched for age, sex, and premorbid verbal IQ, however, these variables were controlled for statistically. Medication usage in the BPD group may have possibly impacted the results. Given a priori hypotheses, ROI analyses were utilized. CONCLUSIONS Decreased CC activation and increased PFC activation may be associated with impaired cognitive control, demonstrated by BPD patients when completing the MSIT. Identifying the neural mechanisms which underlie key cognitive abnormalities in BPD may aid in clarifying the pathophysiology of this disorder and inform selection of potential targets for cognition remediation in BPD.
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Affiliation(s)
- Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States.
| | - M Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychology, Tufts University, Medford, MA 02155, United States
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States
| | - Lesley Norris
- Schizophrenia and Bipolar Disorders Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Bruce M Cohen
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Dost Ongur
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States; Schizophrenia and Bipolar Disorders Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Kathryn E Lewandowski
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States; Schizophrenia and Bipolar Disorders Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
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Fischer IW, Hansen TM, Lelic D, Brokjaer A, Frøkjær J, Christrup LL, Olesen AE. Objective methods for the assessment of the spinal and supraspinal effects of opioids. Scand J Pain 2016; 14:15-24. [PMID: 28850426 DOI: 10.1016/j.sjpain.2016.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 09/30/2016] [Accepted: 10/03/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Opioids are potent analgesics. Opioids exert effects after interaction with opioid receptors. Opioid receptors are present in the peripheral- and central nervous system (CNS), but the analgesic effects are primarily mediated via receptors in the CNS. Objective methods for assessment of opioid effects may increase knowledge on the CNS processes responsible for analgesia. The aim of this review was to provide an overview of the most common objective methods for assessment of the spinal and supraspinal effects of opioids and discuss their advantages and limitations. METHOD The literature search was conducted in Pub Med (http://www.ncbi.nlm.nih.gov/pubmed) from November 2014 to June 2016, using free-text terms: "opioid", "morphine" and "oxycodone" combined with the terms "pupillometry," "magnetic resonance spectroscopy," "fMRI," "BOLD," "PET," "pharmaco-EEG", "electroencephalogram", "EEG," "evoked potentials," and "nociceptive reflex". Only original articles published in English were included. RESULTS For assessment of opioid effects at the supraspinal level, the following methods are evaluated: pupillometry, proton magnetic resonance spectroscopy, functional resonance magnetic imaging (fMRI), positron emission tomography (PET), spontaneous electroencephalogram (EEG) and evoked potentials (EPs). Pupillometry is a non-invasive tool used in research as well as in the clinical setting. Proton magnetic resonance spectroscopy has been used for the last decades and it is a non-invasive technique for measurement of in vivo brain metabolite concentrations. fMRI has been a widely used non-invasive method to estimate brain activity, where typically from the blood oxygen level-dependent (BOLD) signal. PET is a nuclear imaging technique based on tracing radio labeled molecules injected into the blood, where receptor distribution, density and activity in the brain can be visualized. Spontaneous EEG is typically quantified in frequency bands, power spectrum and spectral edge frequency. EPs are brain responses (assessed by EEG) to a predefined number of short phasic stimuli. EPs are quantified by their peak latencies and amplitudes, power spectrum, scalp topographies and brain source localization. For assessment of opioid effects at the spinal level, the following methods are evaluated: the nociceptive withdrawal reflex (NWR) and spinal EPs. The nociceptive withdrawal reflex can be recorded from all limbs, but it is standard to record the electromyography signal at the biceps femoris muscle after stimulation of the ipsilateral sural nerve; EPs can be recorded from the spinal cord and are typically recorded after stimulation of the median nerve at the wrist. CONCLUSION AND IMPLICATIONS The presented methods can all be used as objective methods for assessing the centrally mediated effects of opioids. Advantages and limitations should be considered before implementation in drug development, future experimental studies as well as in clinical settings. In conclusion, pupillometry is a sensitive measurement of opioid receptor activation in the CNS and from a practical and economical perspective it may be used as a biomarker for opioid effects in the CNS. However, if more detailed information is needed on opioid effects at different levels of the CNS, then EEG, fMRI, PET and NWR have the potential to be used. Finally, it is conceivable that information from different methods should be considered together for complementary information.
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Affiliation(s)
- Iben W Fischer
- Mech-Sense, Department of Gastroenterology &Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark.,Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tine M Hansen
- Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dina Lelic
- Mech-Sense, Department of Gastroenterology &Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark
| | - Anne Brokjaer
- Mech-Sense, Department of Gastroenterology &Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark
| | - Jens Frøkjær
- Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lona L Christrup
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne E Olesen
- Mech-Sense, Department of Gastroenterology &Hepatology, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark.,Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Murray DE, Durazzo TC, Schmidt TP, Abé C, Guydish J, Meyerhoff DJ. Frontal Metabolite Concentration Deficits in Opiate Dependence Relate to Substance Use, Cognition, and Self-Regulation. JOURNAL OF ADDICTION RESEARCH & THERAPY 2016; 7:286. [PMID: 27695638 PMCID: PMC5042152 DOI: 10.4172/2155-6105.1000286] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Proton magnetic resonance spectroscopy (1H MRS) in opiate dependence showed abnormalities in neuronal viability and glutamate concentration in the anterior cingulate cortex (ACC). Metabolite levels in dorsolateral prefrontal cortex (DLPFC) or orbitofrontal cortex (OFC) and their neuropsychological correlates have not been investigated in opiate dependence. METHODS Single-volume proton MRS at 4 Tesla and neuropsychological testing were conducted in 21 opiate-dependent individuals (OD) on buprenorphine maintenance therapy. Results were compared to 28 controls (CON) and 35 alcohol-dependent individuals (ALC), commonly investigated treatment-seekers providing context for OD evaluation. Metabolite concentrations were measured from ACC, DLPFC, OFC and parieto-occipital cortical (POC) regions. RESULTS Compared to CON, OD had lower concentrations of N-acetylaspartate (NAA), glutamate (Glu), creatine +phosphocreatine (Cr) and myo-Inositol (mI) in the DLPFC and lower NAA, Cr, and mI in the ACC. OD, ALC, and CON were equivalent on metabolite levels in the POC and γ-aminobutyric acid (GABA) concentration did not differ between groups in any region. In OD, prefrontal metabolite deficits in ACC Glu as well as DLPFC NAA and choline containing metabolites (Cho) correlated with poorer working memory, executive and visuospatial functioning; metabolite deficits in DLPFC Glu and ACC GABA and Cr correlated with substance use measures. In the OFC of OD, Glu and choline-containing metabolites were elevated and lower Cr concentration related to higher nonplanning impulsivity. Compared to 3 week abstinent ALC, OD had significant DLPFC metabolite deficits. CONCLUSION The anterior frontal metabolite profile of OD differed significantly from that of CON and ALC. The frontal lobe metabolite abnormalities in OD and their neuropsychological correlates may play a role in treatment outcome and could be explored as specific targets for improved OD treatment.
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Affiliation(s)
- Donna E Murray
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Timothy C Durazzo
- Department of Psychiatry and Behavioural Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Mental Illness Research Mental Illness Research and Education Clinical Centers; Sierra-Pacific War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto CA, USA
| | - Thomas P Schmidt
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Christoph Abé
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Nobelsväg 9, 17177 Stockholm, Sweden
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Nanga RPR, Hariharan H, Reddy R. Fully automated macromolecule suppressed single voxel glutamate spectroscopy (FAMOUS SVGS). J Transl Med 2016; 14:220. [PMID: 27456699 PMCID: PMC4960747 DOI: 10.1186/s12967-016-0970-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/11/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of the study was to develop and validate a new localized (1)H MRS pulse sequence and automated post-processing software for the quantification of brain Glutamate (Glu) in clinical conditions at 7.0T in order to get reliable and reproducible results for acute intervention studies. METHODS Here we describe a new localized proton MRS method "Fully Automated MacrOmolecUle Suppressed Single Voxel Glutamate Spectroscopy (FAMOUS SVGS)" for measuring Glu. FAMOUS SVGS method consists of a new pulse sequence with optimized switchable water, metabolites and outer volume suppression modules, as well as a frequency selective inversion pulse and automated post-processing of the five spectra obtained. FAMOUS SVGS method was first validated with glutamate phantoms and then validated with test-retest repeatability studies in the occipital cortex of five normal volunteers at 7.0T. RESULTS Glutamate concentrations estimated from phantoms with FAMOUS SVGS method correlated well with actual concentrations. Test-retest repeatability studies in human brain in vivo yielded less than 0.3 mM intra-subject variations in Glu concentrations. CONCLUSIONS FAMOUS SVGS method enables Glu quantification in vivo at 7.0T with test-retest variability of less than 0.3 mM. We expect that we can reliably measure ≥0.5 mM change in glutamate due to any acute intervention.
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Affiliation(s)
- Ravi Prakash Reddy Nanga
- Department of Radiology, Center for Magnetic Resonance and Optical Imaging, University of Pennsylvania, B1 Stellar-Chance Laboratories, 422 Curie Boulevard, Philadelphia, PA, 19104-6100, USA.
| | - Hari Hariharan
- Department of Radiology, Center for Magnetic Resonance and Optical Imaging, University of Pennsylvania, B1 Stellar-Chance Laboratories, 422 Curie Boulevard, Philadelphia, PA, 19104-6100, USA
| | - Ravinder Reddy
- Department of Radiology, Center for Magnetic Resonance and Optical Imaging, University of Pennsylvania, B1 Stellar-Chance Laboratories, 422 Curie Boulevard, Philadelphia, PA, 19104-6100, USA
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Liberg B, Rahm C, Panayiotou A, Pantelis C. Brain change trajectories that differentiate the major psychoses. Eur J Clin Invest 2016; 46:658-74. [PMID: 27208657 DOI: 10.1111/eci.12641] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 05/18/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bipolar disorder and schizophrenia are highly heritable, often chronic and debilitating psychotic disorders that can be difficult to differentiate clinically. Their brain phenotypes appear to overlap in both cross-sectional and longitudinal structural neuroimaging studies, with some evidence to suggest areas of differentiation with differing trajectories. The aim of this review was to investigate the notion that longitudinal trajectories of alterations in brain structure could differentiate the two disorders. DESIGN Narrative review. We searched MEDLINE and Web of Science databases in May 2016 for studies that used structural magnetic resonance imaging to investigate longitudinal between-group differences in bipolar disorder and schizophrenia. Ten studies met inclusion criteria, namely longitudinal structural magnetic resonance studies comparing bipolar disorder (or affective psychosis) and schizophrenia within the same study. RESULTS Our review of these studies implicates illness-specific trajectories of morphological change in total grey matter volume, and in regions of the frontal, temporal and cingulate cortices. The findings in schizophrenia suggest a trajectory involving progressive grey matter loss confined to fronto-temporal cortical regions. Preliminary findings identify a similar but less severely impacted trajectory in a number of regions in bipolar disorder, however, bipolar disorder is also characterized by differential involvement across cingulate subregions. CONCLUSION The small number of available studies must be interpreted with caution but provide initial evidence supporting the notion that bipolar disorder and schizophrenia have differential longitudinal trajectories that are influenced by brain maturation.
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Affiliation(s)
- Benny Liberg
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christoffer Rahm
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Anita Panayiotou
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Western Centre for Health Research & Education, Sunshine Hospital, University of Melbourne, St Albans, Vic., Australia.,Sunshine Hospital, Western Health, St Albans, Vic., Australia
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Western Centre for Health Research & Education, Sunshine Hospital, University of Melbourne, St Albans, Vic., Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, Vic., Australia.,Department of Electrical and Electronic Engineering, Centre for Neural Engineering, University of Melbourne, Parkville, Vic., Australia
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Caravaggio F, Nakajima S, Plitman E, Gerretsen P, Chung JK, Iwata Y, Graff-Guerrero A. The effect of striatal dopamine depletion on striatal and cortical glutamate: A mini-review. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:49-53. [PMID: 26334687 PMCID: PMC5323253 DOI: 10.1016/j.pnpbp.2015.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 08/19/2015] [Accepted: 08/27/2015] [Indexed: 02/07/2023]
Abstract
Understanding the interplay between the neurotransmitters dopamine and glutamate in the striatum has become the highlight of several theories of neuropsychiatric illnesses, such as schizophrenia. Using in vivo brain imaging in humans, alterations in dopamine and glutamate concentrations have been observed in several neuropsychiatric disorders. However, it is unclear a priori how alterations in striatal dopamine should modulate glutamate concentrations in the basal ganglia. In this selective mini-review, we examine the consequence of reducing striatal dopamine functioning on glutamate concentrations in the striatum and cortex; regions of interest heavily examined in the human brain imaging studies. We examine the predictions of the classical model of the basal ganglia, and contrast it with findings in humans and animals. The review concludes that chronic dopamine depletion (>4months) produces decreases in striatal glutamate levels which are consistent with the classical model of the basal ganglia. However, acute alterations in striatal dopamine functioning, specifically at the D2 receptors, may produce opposite affects. This has important implications for models of the basal ganglia and theorizing about neurochemical alterations in neuropsychiatric diseases. Moreover, these findings may help guide a priori hypotheses for (1)H-MRS studies measuring glutamate changes given alterations in dopaminergic functioning in humans.
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Affiliation(s)
- Fernando Caravaggio
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 2374 Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Shinichiro Nakajima
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Eric Plitman
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 2374 Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Philip Gerretsen
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 2374 Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Jun Ku Chung
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 2374 Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Yusuke Iwata
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 2374 Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Ariel Graff-Guerrero
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 2374 Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
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Kimani ST, Patel NB, Kioy PG. Memory deficits associated with khat (Catha edulis) use in rodents. Metab Brain Dis 2016; 31:45-52. [PMID: 26423676 DOI: 10.1007/s11011-015-9738-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/21/2015] [Indexed: 11/25/2022]
Abstract
Khat products and chewing practices are common in East Africa, Middle East for centuries with concomitant socio-economic and public health repercussions. We assessed memory deficits associated with khat use in rodents. Young male CBA mice, 5-7 weeks old (n = 20), weighing 25-35 g were used. Mice were treated with either 40, 120 or 360 mg/kg body weight (bw) methanolic khat extract, or 0.5 ml saline for 10 days. Spatial acquisition, reversal and reference memory were assessed using modified Morris Water maze (MMWM). Mice treated with 40 mg/kg khat extract had longer (t4 = 4.12 p = 0.015) and t4 = 2.28 p = 0.065) escape latency on first and second day during reversal relative to the baseline. Under 120 mg/kg khat dose, the escape latency was shorter (t4 = -2.49 p = 0.05) vs (t3 = -2.5 p = 0.05) on third and fourth day. Further, treatment with 360 mg/kg khat extract resulted in significantly longer time (49.13, 33.5, 40.2 and 35.75) vs. (23.5 s), compared to baseline. Mice treated with khat or control preferred the target quadrant post acquisition while differential pattern was seen during reversal phase. Mice treated with 40 or 120 mg/kg khat showed significant preference for target quadrant. Substantial time (19.9) was spent in the old target compared to the new (16.9 s) by animals treated with highest dose however, the difference was not significant. There is a biological plausibility that chronic khat use may induce memory deficits and impair cognitive flexibility. The differential patterns of memory deficits may reflect the differences in dose effect as well as time dependent impairment.
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Affiliation(s)
- S T Kimani
- School of Nursing Sciences, University of Nairobi, P.O Box 30197, 00100, Nairobi, Kenya.
| | - N B Patel
- Department of Medical Physiology, University of Nairobi, P.O Box 30197, 00100, Nairobi, Kenya
| | - P G Kioy
- Department of Medical Physiology, University of Nairobi, P.O Box 30197, 00100, Nairobi, Kenya
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Moeller SJ, London ED, Northoff G. Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity. Neurosci Biobehav Rev 2016; 61:35-52. [PMID: 26657968 PMCID: PMC4731270 DOI: 10.1016/j.neubiorev.2015.11.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/05/2015] [Accepted: 11/21/2015] [Indexed: 12/29/2022]
Abstract
Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications.
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Affiliation(s)
- Scott J Moeller
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Edythe D London
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georg Northoff
- Brain Imaging and Neuroethics Research Unit, Institute of Mental Health Research, Ottawa, Canada.
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Deng Y, Wang Y, Ding X, Tang YY. The relevance of fractional amplitude of low-frequency fluctuation to interference effect. Behav Brain Res 2016; 296:401-407. [DOI: 10.1016/j.bbr.2015.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 07/25/2015] [Accepted: 08/17/2015] [Indexed: 12/20/2022]
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Hone-Blanchet A, Ciraulo DA, Pascual-Leone A, Fecteau S. Noninvasive brain stimulation to suppress craving in substance use disorders: Review of human evidence and methodological considerations for future work. Neurosci Biobehav Rev 2015; 59:184-200. [PMID: 26449761 PMCID: PMC5365234 DOI: 10.1016/j.neubiorev.2015.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/10/2015] [Accepted: 10/01/2015] [Indexed: 12/19/2022]
Abstract
Substance use disorders (SUDs) can be viewed as a pathology of neuroadaptation. The pharmacological overstimulation of neural mechanisms of reward, motivated learning and memory leads to drug-seeking behavior. A critical characteristic of SUDs is the appearance of craving, the motivated desire and urge to use, which is a main focus of current pharmacological and behavioral therapies. Recent proof-of-concept studies have tested the effects of noninvasive brain stimulation on craving. Although its mechanisms of action are not fully understood, this approach shows interesting potential in tuning down craving and possibly consumption of diverse substances. This article reviews available results on the use of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES) in SUDs, specifically tobacco, alcohol and psychostimulant use disorders. We discuss several important factors that need to be addressed in future works to improve clinical assessment and effects of noninvasive brain stimulation in SUDs. Factors discussed include brain stimulation devices and parameters, study designs, brain states and subjects' characteristics.
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Affiliation(s)
- Antoine Hone-Blanchet
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Domenic A Ciraulo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Shirley Fecteau
- Laboratory of Canada Research Chair in Cognitive Neuroplasticity, Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Faculté de Médecine, Université Laval, Québec, QC, Canada; Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Translational Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Yavari F, Shahbabaie A, Leite J, Carvalho S, Ekhtiari H, Fregni F. Noninvasive brain stimulation for addiction medicine: From monitoring to modulation. PROGRESS IN BRAIN RESEARCH 2015; 224:371-99. [PMID: 26822367 DOI: 10.1016/bs.pbr.2015.08.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Addiction is a chronic relapsing brain disease with significant economical and medical burden on the societies but with limited effectiveness in the available treatment options. Better understanding of the chemical, neuronal, regional, and network alterations of the brain due to drug abuse can ultimately lead to tailoring individualized and more effective interventions. To this end, employing new assessment and intervention procedures seems crucial. Noninvasive brain stimulation (NIBS) techniques including transcranial electrical and magnetic stimulations (tES and TMS) have provided promising opportunities for the addiction medicine in two main domains: (1) providing new insights into neurochemical and neural circuit changes in the human brain cortex and (2) understanding the role of different brain regions by using NIBS and modulating cognitive functions, such as drug craving, risky decision making, inhibitory control and executive functions to obtain specific treatment outcomes. In spite of preliminary positive results, there are several open questions, which need to be addressed before routine clinical utilization of NIBS techniques in addiction to medicine, such as how to account for interindividual differences, define optimal cognitive and neural targets, optimize stimulation protocols, and integrate NIBS with other therapeutic methods. Therefore, in this chapter we revise the available literature on the use of NIBS (TMS and tES) in the diagnostic, prognostic, and therapeutic aspects of the addiction medicine.
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Affiliation(s)
- Fatemeh Yavari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Shahbabaie
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran
| | - Jorge Leite
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Sandra Carvalho
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Braga, Portugal
| | - Hamed Ekhtiari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Felipe Fregni
- Department of Physical Medicine and Rehabilitation, Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Abstract
The effects of methadone maintenance treatment (MMT) on neurophysiological function are unclear. Using an auditory oddball paradigm, event-related potential (ERP) amplitudes and latencies were measured in 32 patients undertaking MMT, 17 opiate users who were addicted but not receiving substitution treatment and 25 healthy control subjects. Compared with healthy control subjects, the MMT and opiate user groups showed an increased P200 amplitude in response to target stimuli. The opiate user group also exhibited a decreased amplitude and an increased latency of N200, and a greater number of task-related errors than either healthy control subjects or patients undertaking MMT. There were no significant group differences in the P300 amplitude. However, it is noteworthy that the frontal P300 amplitude of the MMT group was greater than that of opiate users or healthy controls. Our findings suggest that altered sensory information processing associated with a history of opiate use remains in patients undertaking MMT. However, there are less marked ERP abnormalities in those receiving MMT than in active opiate users. The deficits in information processing associated with illicit opiate use are likely to be reduced during MMT.
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Affiliation(s)
- Grace Y Wang
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Robert Kydd
- Centre for Brain Research, University of Auckland, Auckland, New Zealand Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Bruce R Russell
- Centre for Brain Research, University of Auckland, Auckland, New Zealand School of Pharmacy, University of Auckland, Auckland, New Zealand
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Greenwald MK, Woodcock EA, Khatib D, Stanley JA. Methadone maintenance dose modulates anterior cingulate glutamate levels in heroin-dependent individuals: A preliminary in vivo (1)H MRS study. Psychiatry Res 2015; 233:218-24. [PMID: 26188663 DOI: 10.1016/j.pscychresns.2015.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 05/18/2015] [Accepted: 07/03/2015] [Indexed: 01/23/2023]
Abstract
Mu-opioid receptor agonists alter brain glutamate (GLU) levels in laboratory animals. This clinical study used proton magnetic resonance spectroscopy ((1)H MRS) to examine regional brain GLU levels during experimental manipulation of methadone (MTD) maintenance dose under double-blind, within-subject conditions in seven heroin-dependent volunteers. Subjects were scanned first at a high MTD dose (100 mg/day), underwent a 3-week outpatient MTD dose taper, and then were scanned again at a low MTD dose (10-25 mg/day; modified for participant comfort). Five age- and cigarette smoking-matched controls were scanned once. In vivo short echo time (TE = 22 ms), single voxel (1)H MRS data from midline pregenual anterior cingulate cortex (ACC) and thalamus (4.5 cm(3) each) were collected using PRESS on a 4-Tesla MRI system. Absolute metabolite levels were quantified. GLU levels in the ACC, but not the thalamus, were higher at the low relative to the high MTD dose in heroin-dependent subjects. No other metabolites differed by MTD dose, or between control vs. heroin-dependent subjects (at either MTD dose). GLU levels in the ACC were inversely related to the duration of cigarette smoking (controls) and heroin use (experimental group). Future studies are warranted to investigate the relationship between GLU levels during treatment (and detoxification), and withdrawal symptoms or relapse.
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Affiliation(s)
- Mark K Greenwald
- Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Tolan Park Medical Building, 3901 Chrysler Drive, Suite 2A, Detroit, MI 48201, USA; Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA.
| | - Eric A Woodcock
- Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Tolan Park Medical Building, 3901 Chrysler Drive, Suite 2A, Detroit, MI 48201, USA; Brain Imaging Research Division, Wayne State University, Detroit, MI, USA
| | - Dalal Khatib
- Brain Imaging Research Division, Wayne State University, Detroit, MI, USA
| | - Jeffrey A Stanley
- Brain Imaging Research Division, Wayne State University, Detroit, MI, USA
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Abstract
Adolescence is a time when the ability to engage cognitive control is linked to crucial life outcomes. Despite a historical focus on prefrontal cortex functioning, recent evidence suggests that differences between individuals may relate to interactions between distributed brain regions that collectively form a cognitive control network (CCN). Other research points to a spatially distinct and functionally antagonistic system--the default-mode network (DMN)--which typically deactivates during performance of control tasks. This literature implies that individual differences in cognitive control are determined either by activation or functional connectivity of CCN regions, deactivation or functional connectivity of DMN regions, or some combination of both. We tested between these possibilities using a multilevel fMRI characterization of CCN and DMN dynamics, measured during performance of a cognitive control task and during a task-free resting state, in 73 human adolescents. Better cognitive control performance was associated with (1) reduced activation of CCN regions, but not deactivation of the DMN; (2) variations in task-related, but not resting-state, functional connectivity within a distributed network involving both the CCN and DMN; (3) functional segregation of core elements of these two systems; and (4) task-dependent functional integration of a set of peripheral nodes into either one network or the other in response to prevailing stimulus conditions. These results indicate that individual differences in adolescent cognitive control are not solely attributable to the functioning of any single region or network, but are instead dependent on a dynamic and context-dependent interplay between the CCN and DMN.
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Searby A, Maude P, McGrath I. An Ageing Methadone Population: A Challenge to Aged Persons' Mental Health Services? Issues Ment Health Nurs 2015; 36:927-31. [PMID: 26631866 DOI: 10.3109/01612840.2015.1081655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Oral administration of methadone has been used as a treatment strategy for opiate addiction for many years. The state of Victoria, Australia, has a long-running methadone program with a large number of participants. Accordingly, a growing number of adults have utilised methadone maintenance treatment for a number of years and are now moving into older age due to advances in medical treatment and harm reduction initiatives. The objective of this review is to examine the literature pertaining to co-occurring mental illness in older methadone treatment participants and to explore the future challenges this growing cohort of ageing adults pose to aged persons’ psychiatry services. As part of a broader study into dual diagnosis in older adults, a search of the Scopus, ProQuest, and CINAHL journal databases was performed. Twenty abstracts from literature published within the previous 15 years (1999–2014) were identified that explored methadone maintenance programs and the older adults maintained on them. A number of researchers have identified the ageing methadone population to have a high degree of comorbid mental illness and psychological distress. Studies also indicate that individuals enrolled in methadone maintenance programs may engage in a degree of continual substance use, potentially leading to deleterious effects on their psychosocial function. An ageing methadone population experiencing a high degree of comorbid mental illness is likely to challenge aged persons’ psychiatry services. These services are likely to be increasingly called on to manage these individuals, particularly within Victoria where few substance use services exist for those over the age of 65. It is essential that aged persons’ psychiatry services prepare to provide care for these individuals in a responsive manner that is inclusive of both their mental health and substitution pharmacotherapy.
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Affiliation(s)
- Adam Searby
- a Alfred Health, Caulfield Hospital Mobile Aged Psychiatry Service , Caulfield , Australia , and RMIT University, School of Health Sciences , Bundoora , Australia
| | - Phil Maude
- b RMIT University, School of Health Sciences , Bundoora , Australia
| | - Ian McGrath
- b RMIT University, School of Health Sciences , Bundoora , Australia
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Alterations in brain connectivity in three sub-regions of the anterior cingulate cortex in heroin-dependent individuals: Evidence from resting state fMRI. Neuroscience 2014; 284:998-1010. [PMID: 25446365 DOI: 10.1016/j.neuroscience.2014.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 11/03/2014] [Accepted: 11/05/2014] [Indexed: 01/18/2023]
Abstract
Previous studies that utilized task-based approaches have demonstrated that the chronic use of heroin is associated with altered activity of the anterior cingulate cortex (ACC). However, few studies have focused on examining the variation in resting-state functional connectivity in heroin-dependent individuals, which might help further understanding the mechanisms underlying heroin addiction. Due to the structural and functional heterogeneity of the ACC, we systematically mapped the resting-state functional connectivity patterns of three sub-regions of the ACC in heroin-dependent individuals, wondered whether the partition of three sub-regions of the ACC is feasible in heroin-dependent individuals, and identified how heroin affected the correlated activities among three sub-regions of the ACC using resting-state functional magnetic resonance imaging (fMRI). In the present study, fMRI data were acquired from 21 heroin-dependent individuals (Her group) and 15 non-addicted controls (CN group). Compared to controls, there were reduced functional connectivities in the dorsal ACC (dACC) and rostral ACC (rACC) networks with different areas of the dorsal striatum (the caudate and the putamen) in the Her group. Meanwhile, there exhibited an inverted alteration of pattern for orbital frontal cortex (OFC) and superior frontal gyrus (SFG) in the functional connectivity network with the dACC and subcallosal ACC (sACC), and a different alteration of the cerebellum and the amygdala in the functional connectivity network with the rACC and the sACC. In addition, we also found reduced connectivities between dACC and rACC, as well as reduced connectivities between sACC and dACC. Our findings of variations of functional connectivities in three sub-regions of ACC in Her group implied that these sub-regions of the ACC together with other key brain areas (such as dorsal striatum, OFC, SFG, cerebellum, amygdale, etc.) might potentially play independent and/or overlapping roles in heroin addiction, which might indicate the potential direction of future research.
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Hansen TM, Olesen AE, Simonsen CW, Drewes AM, Frøkjær JB. Cingulate metabolites during pain and morphine treatment as assessed by magnetic resonance spectroscopy. J Pain Res 2014; 7:269-76. [PMID: 24899823 PMCID: PMC4038455 DOI: 10.2147/jpr.s61193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Experimental investigation of cerebral mechanisms underlying pain and analgesia are important in the development of methods for diagnosis and treatment of pain. The aim of the current study was to explore brain metabolites in response to pain and treatment with morphine. Methods Proton magnetic resonance spectroscopy of the anterior cingulate cortex was performed in 20 healthy volunteers (13 males and seven females, aged 24.9±2.6 years) during rest and acute pain before and during treatment with 30 mg of oral morphine or placebo in a randomized, double-blinded, cross-over study design. Pain was evoked by skin stimulation applied to the right upper leg using a contact heat-evoked potential stimulator. Results Data from 12 subjects were valid for analysis. Painful stimulation induced an increase in N-acetylaspartate/creatine compared with rest (F=5.5, P=0.04). During treatment with morphine, painful stimulation induced decreased glutamate/creatine (F=7.3, P=0.02), myo-inositol/creatine (F=8.38, P=0.02), and N-acetylaspartate/creatine (F=13.8, P=0.004) concentrations, whereas an increase in the pain-evoked N-acetylaspartate/creatine concentration (F=6.1, P=0.04) was seen during treatment with placebo. Conclusion This explorative study indicates that neuronal metabolites in the anterior cingulate cortex, such as N-acetylaspartate, glutamate, and myo-inositol, could be related to the physiology of pain and treatment with morphine. This experimental method has the potential to enable the study of brain metabolites involved in pain and its treatment, and may in the future be used to provide further insight into these mechanisms.
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Affiliation(s)
- Tine Maria Hansen
- Mech-Sense, Department of Radiology, Aalborg University, Aalborg, Denmark
| | - Anne Estrup Olesen
- Mech-Sense, Department of Gastroenterology, Aalborg University, Aalborg, Denmark
| | | | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology, Aalborg University, Aalborg, Denmark ; Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Liao DL, Huang CY, Hu S, Fang SC, Wu CS, Chen WT, Lee TSH, Chen PC, Li CSR. Cognitive control in opioid dependence and methadone maintenance treatment. PLoS One 2014; 9:e94589. [PMID: 24727743 PMCID: PMC3984179 DOI: 10.1371/journal.pone.0094589] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/18/2014] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Substance misuse is associated with cognitive dysfunction. We used a stop signal task to examine deficits in cognitive control in individuals with opioid dependence (OD). We examined how response inhibition and post-error slowing are compromised and whether methadone maintenance treatment (MMT), abstinence duration, and psychiatric comorbidity are related to these measures in individuals with OD. METHODS Two-hundred-and-sixty-four men with OD who were incarcerated at a detention center and abstinent for up to 2 months (n = 108) or at a correctional facility and abstinent for approximately 6 months (n = 156), 65 OD men under MMT at a psychiatric clinic, and 64 age and education matched healthy control (HC) participants were assessed. We computed the stop signal reaction time (SSRT) to index the capacity of response inhibition and post-error slowing (PES) to represent error-related behavioral adjustment, as in our previous work. We examined group effects with analyses of variance and covariance analyses, followed by planned comparisons. Specifically, we compared OD and HC participants to examine the effects of opioid dependence and MMT and compared OD sub-groups to examine the effects of abstinence duration and psychiatric comorbidity. RESULTS The SSRT was significantly prolonged in OD but not MMT individuals, as compared to HC. The extent of post-error slowing diminished in OD and MMT, as compared to HC (trend; p = 0.061), and there was no difference between the OD and MMT groups. Individuals in longer abstinence were no less impaired in these measures. Furthermore, these results remained when psychiatric comorbidities including misuse of other substances were accounted for. CONCLUSIONS Methadone treatment appears to be associated with relatively intact cognitive control in opioid dependent individuals. MMT may facilitate public health by augmenting cognitive control and thereby mitigating risky behaviors in heroin addicts.
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Affiliation(s)
- Ding-Lieh Liao
- Department of Addiction Psychiatry, Bali Psychiatric Center, Department of Health, New Taipei City, Taiwan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
- * E-mail: (DLL); (CSRL)
| | - Cheng-Yi Huang
- Department of Addiction Psychiatry, Bali Psychiatric Center, Department of Health, New Taipei City, Taiwan
| | - Sien Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Su-Chen Fang
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wei-Ti Chen
- School of Nursing, Yale University, New Haven, Connecticut, United States of America
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chiang-shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail: (DLL); (CSRL)
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Cheetham A, Allen NB, Whittle S, Simmons J, Yücel M, Lubman DI. Volumetric differences in the anterior cingulate cortex prospectively predict alcohol-related problems in adolescence. Psychopharmacology (Berl) 2014; 231:1731-42. [PMID: 24553579 DOI: 10.1007/s00213-014-3483-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 02/03/2014] [Indexed: 12/24/2022]
Abstract
RATIONALE Individual differences in brain structure and function are suggested to exist prior to the onset of alcohol abuse. Cross-sectional studies have demonstrated abnormalities in brain regions underlying affective processes that may form a pathway to the emergence of later alcohol abuse and dependence in vulnerable individuals. However, no prospective studies have examined whether these abnormalities predict later problems with alcohol. OBJECTIVE This study aims to examine whether individual differences in affect and brain volume prospectively predict alcohol-related problems in adolescence. METHOD Adolescent drinkers (n = 98) were recruited from an ongoing prospective, longitudinal study examining adolescent emotional development. At age 12, participants underwent structural magnetic resonance imaging to obtain volumetric data on the amygdala, hippocampus, orbitofrontal cortex, and anterior cingulate cortex (ACC), and completed a self-report measure of affective temperament. At age 16, participants completed a questionnaire measuring alcohol use, with 39 % reporting alcohol-related problems in the past year. RESULTS Pre-existing differences in the left ACC predicted problem drinking. Alcohol-related problems were associated with higher levels of temperamental negative affectivity; however, these were not correlated with anterior cingulate volumes. CONCLUSIONS These findings indicate that individual differences in the structural morphology of the anterior cingulate, a region implicated in affective processes, self-control, and drug addiction, predict later alcohol-related problems. Although this finding remained significant after controlling for other substance use and psychopathology, future research is required to test its specificity for alcohol use disorders.
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Affiliation(s)
- Ali Cheetham
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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Naim-Feil J, Fitzgerald PB, Bradshaw JL, Lubman DI, Sheppard D. Neurocognitive deficits, craving, and abstinence among alcohol-dependent individuals following detoxification. Arch Clin Neuropsychol 2013; 29:26-37. [PMID: 24334264 DOI: 10.1093/arclin/act090] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Alcohol dependence, a chronic relapsing disorder, is characterized by an impaired ability to regulate compulsive urges to consume alcohol. Very few empirical studies have examined the presence of these executive deficits, how they relate to craving, and the enduring nature of these deficits during abstinence. As such, the current study aimed to characterize these cognitive deficits within a sample of 24 alcohol-dependent participants post-detoxification and 23 non-alcohol-dependent participants. Participants were administered the Sustained Attention to Response Task to measure response inhibition and sustained attention and the Random Number Generation Task to examine executive deficits. Correlations between cognitive performance and clinical measures of alcohol dependence were examined. As predicted, the alcohol-dependent group exhibited poorer performance across the domains of response inhibition, executive function, and attentional control. Cognitive performance was related to clinical measures of craving and years of alcohol consumption, whereas the duration of abstinence was not associated with improved cognitive performance. These findings highlight the need for therapeutic strategies to target these enduring neurocognitive deficits in improving the treatment of alcohol dependence.
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Affiliation(s)
- Jodie Naim-Feil
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Prahran, Victoria, Australia
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