Abstract
Substance use disorders (SUDs) are defined by obsessive and uncontrolled consumption, which is related to neurobiological changes. Based on previous work, this study investigated potential alterations in brain structure in poly-drug use disordered (PUD) patients in comparison to controls from the normal population. This study involved a sample of 153 right-handed men aged between 18 and 41 years, comprising a clinical group of 78 PUD and a group of 75 healthy controls. Group differences in gray matter (GM) and white matter (WM), as well as cortical thickness (CT), were investigated by means of diffusion tensor imaging using automated fiber quantification (AFQ) and voxel-based morphometry. We observed significant WM impairments in PUD, especially in the bilateral corticospinal tracts and the inferior longitudinal fasciculi. Furthermore, we found reduced CT in the PUD group especially in the left insular and left lateral orbitofrontal cortex. There were no group differences in GM. In addition, PUD exhibited a higher amount of psychiatric symptoms (Brief Symptom Inventory) and impairments in cognitive functions (Wonderlic Personnel Test). In line with previous research, this study revealed substantial impairments in brain structure in the PUD group in areas linked with affective, cognitive, and motor functions. We therefore hypothesize a neurologically informed treatment approach for SUD. Future studies should consequently explore a potential positive neuroplasticity in relation to a better therapeutic outcome.
Highlights
Within the European Union, a lifetime prevalence of up to 3% for substance use disorders (SUDs) has been shown for the general population [1, 2]
This study investigated alterations in brain structure in an unprecedented large sample of poly-drug use disordered (PUD) patients compared to controls from the general population
Analyses revealed impaired white matter (WM) integrity along with reduced cortical thickness (CT) in the PUD sample but no alterations in gray matter (GM). These findings were mirrored by significant differences between PUD and healthy controls regarding behavioral measures, such as a higher amount of psychiatric symptom burden as well as lower cognitive abilities
Summary
Within the European Union, a lifetime prevalence of up to 3% for substance use disorders (SUDs) has been shown for the general population [1, 2]. It is widely accepted that many drugs may “hijack” the reward centers of the brain, setting in motion a downward spiral towards SUD [7]. Some authors have challenged this view by arguing that the complex mechanisms underlying SUD cannot be explained by neural dysfunction alone [8]. SUD have been widely discussed in relation to dysfunctional attempts of selfmedication [9] and misled attachment needs [10]. It should be noted that premorbid brain abnormalities might lead to severe psychiatric disturbances such as SUD [11, 12]
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