REGIONAL CEREBRAL BLOOD FLOW IN OPIATE DEPENDENCE RELATES TO SUBSTANCE USE AND NEUROPSYCHOLOGICAL PERFORMANCE

摘要

Neuroimaging of opiate-dependent individuals indicates both altered brain structure and function. Magnetic resonance-based arterial spin labeling has been used to measure non-invasively cerebral blood flow (i.e., perfusion) in alcohol, tobacco, and stimulant dependence; only one arterial spin labeling paper in opiate-dependent individuals demonstrated frontal and parietal perfusion deficits. Additional research on regional brain perfusion in opiate dependence and its relationship to cognition and self-regulation (impulsivity, risk taking, decision-making) may inform treatment approaches for opiate-dependent individuals. Continuous arterial spin labeling magnetic resonance imaging at 4 Tesla and neuropsychological measures assessed absolute brain perfusion levels, cognition, and self-regulation in 18 cigarette smoking opiate-dependent individuals (sODI) stable on buprenorphine maintenance therapy. The sODI were compared to 20 abstinent smoking alcohol-dependent individuals (sALC; a substance-dependent control group), 35 smoking controls (sCON), and 29 non-smoking controls (nsCON). sODI had lower perfusion in several cortical and subcortical regions including regions within the brain reward/executive oversight system (BREOS) compared to sALC and nsCON. Perfusion was increased in anterior cingulate cortex and globus pallidus of sODI. Compared to all other groups, sODI had greater age-related declines in perfusion in most BREOS and some other regions. In sODI, lower regional perfusion related to greater substance use, higher impulsivity, and weaker visuospatial skills. Overall, sODI showed cortical and subcortical hypo- and hyperperfusion. Relating to neuropsychological performance and substance use quantities, the frontal perfusion alterations are clinically relevant and constitute potential targets for pharmacological and cognitive-based therapeutic interventions to improve treatment outcome in opiate dependence.