The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder
| Autor: | Kanchana Jagannathan, An-Li Wang, Victoria P. Fairchild, Daniel D. Langleben, James H. Padley, Zhenhao Shi, Charles P. O'Brien, Anna Rose Childress |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Adolescent media_common.quotation_subject Medicine (miscellaneous) Prefrontal Cortex Craving Nucleus accumbens Amygdala Nucleus Accumbens 03 medical and health sciences Young Adult 0302 clinical medicine Conditioning Psychological medicine Humans media_common Pharmacology Brain Mapping Motivation business.industry Addiction Brain Opioid use disorder Middle Aged medicine.disease Opioid-Related Disorders Magnetic Resonance Imaging 030227 psychiatry Substance Withdrawal Syndrome Psychiatry and Mental health medicine.anatomical_structure Opioid Cue reactivity Orbitofrontal cortex Female medicine.symptom Cues business Neuroscience 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Addiction biologyREFERENCES. 26(4) |
| ISSN: | 1369-1600 |
| Popis: | Opioid use disorder (OUD) is characterized by heightened cognitive, physiological, and neural responses to opioid-related cues that are mediated by mesocorticolimbic brain pathways. Craving and withdrawal are key symptoms of addiction that persist during physiological abstinence. The present study evaluated the relationship between the brain response to drug cues in OUD and baseline levels of craving and withdrawal. We used functional magnetic resonance imaging (fMRI) to examine brain responses to opioid-related pictures and control pictures in 29 OUD patients. Baseline measures of drug use severity, opioid craving, and withdrawal symptoms were assessed prior to cue exposure and correlated with subsequent brain responses to drug cues. Mediation analysis was conducted to test the indirect effect of drug use severity on brain cue reactivity through craving and withdrawal symptoms. We found that baseline drug use severity and opioid withdrawal symptoms, but not craving, were positively associated with the neural response to drug cues in the nucleus accumbens, orbitofrontal cortex, and amygdala. Withdrawal, but not craving, mediated the effect of drug use severity on the nucleus accumbens' response to drug cues. We did not find similar effects for the neural responses to stimuli unrelated to drugs. Our findings emphasize the central role of withdrawal symptoms as the mediator between the clinical severity of OUD and the brain correlates of sensitization to opioid-related cues. They suggest that in OUD, baseline withdrawal symptoms signal a high vulnerability to drug cues. |
| Databáze: | OpenAIRE |
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