Abstract
BackgroundMethadone maintenance treatment (MMT) is recognized as one of the most effective treatments for heroin addiction but its effect is dimmed by the high incidence of heroin relapse. However, underlying neurobiology mechanism of heroin relapse under MMT is still largely unknown. Here, we took advantage of a resting-state fMRI technique by analysis of regional homogeneity (ReHo), and tried to explore the difference of brain function between heroin relapsers and non-relapsers in MMT.MethodsForty MMT patients were included and received a 12-month follow-up. All patients were given baseline resting-state fMRI scans by using a 3.0 T GE Signa Excite HD whole-body MRI system. Monthly self-report and urine test were used to assess heroin relapse or non-relapse. Subjective craving was measured with visual analog scale. The correlation between ReHo and the degree of heroin relapse was analyzed.ResultsCompared with the non-relapsers, ReHo values were increased in the bilateral medial orbitofrontal cortex, right caudate, and right cerebellum of the heroin relapsers while those in the left parahippocampal gyrus, left middle temporal gyrus, right lingual gyrus, and precuneus were decreased in heroin relapsers. Importantly, altered ReHo in the right caudate were positively correlated with heroin relapse rates or subjective craving response.ConclusionsUsing the resting-state fMRI technique by analysis of ReHo, we provided the first resting-state fMRI evidence that right caudate may serve as a potential biomarker for heroin relapse prediction and also as a promising target for reducing relapse risk.
Highlights
Methadone maintenance treatment (MMT) is recognized as one of the most effective treatments for heroin addiction but its effect is dimmed by the high incidence of heroin relapse
Statistical analysis To analyse the differences of regional homogeneity (ReHo) values between heroin relapse and non-relapse patients under MMT, a two-sample t test was performed on the individual normalized ReHo maps in a voxel-by-voxel manner
There were no significant differences between heroin relapsers and non-relapsers in their age, education, number of cigarettes smoked per day, duration of cigarette smoking, duration of heroin abuse and daily/accumulated dosage of heroin/methadone (Table 1)
Summary
Participants Sixty male former heroin addicts were recruited from the outpatient of the Baqiao Methadone Maintenance Treatment Center in Xi’an, Shaanxi Province, China. According to the inclusion criteria exclusion criteria, 20 participants were excluded for having other active neurological and psychiatric disorders, head trauma, or contraindications to MRI examination, and 40 were included and received a baseline resting-state fMRI scanning following with a succeeding 12-month clinical follow-up. Statistical analysis To analyse the differences of ReHo values between heroin relapse and non-relapse patients under MMT, a two-sample t test was performed on the individual normalized ReHo maps in a voxel-by-voxel manner. Correlation analysis To evaluate the association of altered ReHo in different brain regions with heroin relapse in these relapsers, we performed Spearman's correlation analysis between mean ReHo values and relapse rates (as defined above) or subjective heroin craving indicated by VAS scores of each heroin relapser. Threshold levels of significance for correlation coefficients were adjusted for multiple comparisons by a Bonferroni’s correction (p value was set as 0.05, and the number of tests was 8)
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