Risk for opioid misuse in chronic pain patients is associated with endogenous opioid system dysregulation.

Autor: Ballester J; Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.; Mental Health Addiction Services, VA Salt Lake City Health Care System, Salt Lake City, UT, USA., Baker AK; Department of Anesthesiology, Duke University, Durham, NC, USA., Martikainen IK; Department of Radiology, Medical Imaging Center, Tampere University Hospital, Tampere, Finland., Koppelmans V; Department of Psychiatry, University of Utah, Salt Lake City, UT, USA., Zubieta JK; Department of Psychiatry, Northwell Health, John T. Mather Memorial Hospital, Port Jefferson, NY, USA., Love TM; Department of Psychiatry, University of Utah, Salt Lake City, UT, USA. tiffany.love@utah.edu.
Jazyk: angličtina
Zdroj: Translational psychiatry [Transl Psychiatry] 2022 Jan 12; Vol. 12 (1), pp. 20. Date of Electronic Publication: 2022 Jan 12.
DOI: 10.1038/s41398-021-01775-z
Abstrakt: µ-Opioid receptors (MOR) are a major target of endogenous and exogenous opioids, including opioid pain medications. The µ-opioid neurotransmitter system is heavily implicated in the pathophysiology of chronic pain and opioid use disorder and, as such, central measures of µ-opioid system functioning are increasingly being considered as putative biomarkers for risk to misuse opioids. To explore the relationship between MOR system function and risk for opioid misuse, 28 subjects with chronic nonspecific back pain completed a clinically validated measure of opioid misuse risk, the Pain Medication Questionnaire (PMQ), and were subsequently separated into high (PMQ > 21) and low (PMQ ≤ 21) opioid misuse risk groups. Chronic pain patients along with 15 control participants underwent two separate [ 11 C]-carfentanil positron emission tomography scans to explore MOR functional measures: one at baseline and one during a sustained pain-stress challenge, with the difference between the two providing an indirect measure of stress-induced endogenous opioid release. We found that chronic pain participants at high risk for opioid misuse displayed higher baseline MOR availability within the right amygdala relative to those at low risk. By contrast, patients at low risk for opioid misuse showed less pain-induced activation of MOR-mediated, endogenous opioid neurotransmission in the nucleus accumbens. This study links human in vivo MOR system functional measures to the development of addictive disorders and provides novel evidence that MORs and µ-opioid system responsivity may underlie risk to misuse opioids among chronic pain patients.
(© 2022. The Author(s).)
Databáze: MEDLINE
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