Abstract
IntroductionFunctional imaging studies of addiction following protracted abstinence have not been systematically conducted to look at the associations between severity of use of different drugs and brain dysfunction. Findings from such studies may be relevant to implement specific interventions for treatment. The aim of this study was to examine the association between resting-state regional brain metabolism (measured with 18F-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and the severity of use of cocaine, heroin, alcohol, MDMA and cannabis in a sample of polysubstance users with prolonged abstinence from all drugs used.MethodsOur sample consisted of 49 polysubstance users enrolled in residential treatment. We conducted correlation analyses between estimates of use of cocaine, heroin, alcohol, MDMA and cannabis and brain metabolism (BM) (using Statistical Parametric Mapping voxel-based (VB) whole-brain analyses). In all correlation analyses conducted for each of the drugs we controlled for the co-abuse of the other drugs used.ResultsThe analysis showed significant negative correlations between severity of heroin, alcohol, MDMA and cannabis use and BM in the dorsolateral prefrontal cortex (DLPFC) and temporal cortex. Alcohol use was further associated with lower metabolism in frontal premotor cortex and putamen, and stimulants use with parietal cortex.ConclusionsDuration of use of different drugs negatively correlated with overlapping regions in the DLPFC, whereas severity of cocaine, heroin and alcohol use selectively impact parietal, temporal, and frontal-premotor/basal ganglia regions respectively. The knowledge of these associations could be useful in the clinical practice since different brain alterations have been associated with different patterns of execution that may affect the rehabilitation of these patients.
Highlights
Functional imaging studies of addiction following protracted abstinence have not been systematically conducted to look at the associations between severity of use of different drugs and brain dysfunction
Functional neuroimaging studies have revealed that the use of different classes of drugs is associated with dysfunctions in a range of overlapping brain regions including ventromedial and dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex, inferior frontal gyrus, insula, amygdala, basal ganglia and cerebellum [2]
The amount of alcohol used was negatively associated with three clusters: one cluster included the left middle and superior temporal cortex; a second cluster included the bilateral superior frontal cortex extending to the left DLPFC and the right supplementary motor area; and a third cluster included the right DLPFC extending to the superior frontal gyrus (Figure 1.2)
Summary
Functional imaging studies of addiction following protracted abstinence have not been systematically conducted to look at the associations between severity of use of different drugs and brain dysfunction. These negative findings and controversies might be linked to the impact of relevant confounding variables One of these is the fact that neuroimaging studies have frequently tested drug users currently using drugs or having brief periods of abstinence (24–48 h) [13,14]; under these conditions, the presumed link between lifetime drug use and brain dysfunction could be masked by several other factors, including recent drug use or psychological symptoms associated with withdrawal and short-term abstinence [2]. Another key variable for consideration is the concurrent use of multiple types of substances, which can introduce significant confounds in the interpretation of the data
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