Synopsis

Our research aims to compare PA with MMT,to reveal which abstinence way is better to recover the brain function in heroin-dependent individuals.24 heroin-dependent patients under PA ,19 heroin-dependent patients under MMT and 20 healthy volunteers were recruited. The functional images were acquired by using a spin-echo EPI. In the last part of this study, we proved PA is closer to healthy group.This study showed that PA is more advantageous than MMT to reduce heroin addiction in drug cue-reactivity.

Introduction Addiction, the most severe form of substance use disorder, is a chronic brain disorder molded by strong biosocial factors that has devastating consequences to individuals and to society¹.Heroin addiction in particular has become an increasingly serious problem for China in recent years².Methadone maintenance treatment (MMT) and protracted abstinence (PA) are common methods of therapy in heroin addiction as both suppress the craving for drug use. However, the difference in patterns of brain function between two groups is unknown. We combined fMRI and drug cue-induced task to explore PA and MMT for heroin-dependent and compare the differences between subjective craving and brain response to heroin-related cues in heroin-dependent males, and to evaluate the curative effect of these two methods in treatment.

Materials and Methods 24 heroin-dependent male males with at least 6 months of protracted abstinence, 19 heroin-dependent male patients stabilized on methadone maintenance for at least 6 months and 20 demographically matched healthy controls completed an event-related fMRI task including heroin-related and neutral cues. The fMRI data were acquired by a 3T MRI system and preprocessed and statistically analyzed by the Matlab 7.5, SPM12 software package. Self-reported craving scores were collected before and after the task.

Results Under the condition of heroin-related > neutral cues, MMT,PA and healthy group in drug cues have a statistically significant difference in the following brain areas(p<0.05):Midbrain, Cerebellum, ACC, PCC, SPL, Caudate, Thalamus, Parahippocampalgyrus, Putamen, DLPFC, Fusiform Gyrus, Hippocampal Gyrus, Postcentral Gyrus, Middle Occipital Gyrus, IPL, Superior Occipital .Post hoc analysis showed that MMT group were significantly enhanced in cue-reactivity in the above brain regions than the PA group and healthy group; compared with healthy group, PA group was no statistical differences in the brain regions. MMT group and PA group were no statistical differences in before and after cue-reactivity of craving changes; the cue-induced activity of PA group near to healthy group.

Discussion and Conclusion In previous reports, little research was compared PA with MMT, and little known which therapeutic method is help patients to get good withdrawal effect ³. Here, we obtained new results about this. We know that the four classical neural circuits associated with addiction include reward circuit, motivation/drive circuit, memory and learning circuit and cognitive control circuit ⁴. In our results, these brain regions are related to mesolimbic dopamine system (reward), Visual-spatial attention system (craving) and Prefrontal system (inhibitory control), which are important to research drug addiction⁵.This study further suggested that compared with MMT, PA is more advantageous to reduce heroin addiction in drug cue-reactivity, which can reduce dominant value in drug cue for heroin addiction, further reduce the relapse susceptibility of the heroin-dependence . We have further approved that the prefrontal, mesocorticolimbic regions and thalamus play an important role in visual heroin-related cue induced reactivity in heroin addicts.

Acknowledgements

References

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