Abstract
The brain activity induced by heroin-related cues may play a role in the maintenance of heroin dependence. Whether the reinforcement or processing biases construct an everlasting feature of heroin addiction remains to be resolved. We used an event-related fMRI paradigm to measure brain activation in response to heroin cue-related pictures versus neutral pictures as the control condition in heroin-dependent patients undergoing short-term and long-term abstinence. The self-reported craving scores were significantly increased after cue exposure in the short-term abstinent patients (t = 3.000, P = 0.008), but no increase was found in the long-term abstinent patients (t = 1.510, P = 0.149). However, no significant differences in cue-induced craving changes were found between the two groups (t = 1.193, P = 0.850). Comparing between the long-term abstinence and short-term abstinence groups, significant decreases in brain activation were detected in the bilateral anterior cingulated cortex, left medial prefrontal cortex, caudate, middle occipital gyrus, inferior parietal lobule and right precuneus. Among all of the heroin dependent patients, the abstinence duration was negatively correlated with brain activation in the left medial prefrontal cortex and left inferior parietal lobule. These findings suggest that long-term abstinence may be useful for heroin-dependent patients to diminish their saliency value of heroin-related cues and possibly lower the relapse vulnerability to some extent.
Highlights
Heroin dependence is a complex disorder of the brain, involving both affective and cognitive processes, characterized by a compulsive drive to take drugs despite serious negative consequences [1]
We found another significant negative correlation in a cluster region (60 voxels) located in the left inferior parietal lobule (IPL); centered at MNI x, y, z coordinates of 248, 257, 54 (P,0.05, corrected with Monte Carlo simulation). (Figure S1) There were no significant correlations between changes in craving and brain responses to heroin versus neutral cues
Employing the event-related fMRI paradigm, we found that the long-term abstinent (LA) group demonstrated significantly decreased activity to heroinrelated cues than the short-term abstinent (SA) group in the cognitive control related regions, reward related region, and visuospatial attention regions
Summary
Heroin dependence is a complex disorder of the brain, involving both affective and cognitive processes, characterized by a compulsive drive to take drugs despite serious negative consequences [1]. The measure of inpatient abstinence is generally used in order to reduce the probability of relapse after detoxification. An existing problem with heroin dependence is that most heroindependent individuals will often relapse after certain periods of abstinence [2], especially after a short period of abstinence. It was demonstrated that relapse was highly associated with shorter treatment duration for drug addicted individuals [3]. Whether long-term abstinence has a positive effect on brain function of heroin-dependent individuals is an important issue which is not very clear. Investigation of heroin-related cues induced craving and brain response may be a key to solving this problem
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