Acute effect of methadone maintenance dose on brain fMRI response to heroin-related cues
Acute effect of methadone maintenance dose on brain fMRI response to heroin-related cues
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DOI：
10.1176/appi.ajp.2007.07010070
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发表时间：
2008-03-01
影响因子：
17.7
通讯作者：
Childress, Anna R.
中科院分区：
文献类型：
--
作者：
Langleben, Daniel D.;Ruparel, Kosha;Childress, Anna R.
目的：环境药物相关线索被认为是海洛因依赖的美沙酮维持治疗期间非法使用海洛因的原因。作者试图确定美沙酮维持治疗患者对视觉海洛因相关刺激的大脑反应的功能神经解剖学。方法：使用事件相关功能磁共振成像来比较 25 名接受美沙酮维持治疗的患者对海洛因相关刺激和匹配中性刺激的大脑反应。对患者在服用每日常规美沙酮剂量之前和之后进行了研究。结果：在服用每日美沙酮剂量后，岛叶、杏仁核和海马复合体（而非眶额和腹侧前扣带皮层）对海洛因相关刺激的增强反应急剧降低。结论：患者的内侧前额叶皮质和扩展的边缘系统 有海洛因依赖史的美沙酮维持患者仍然对显着的药物线索有反应，这表明仍然容易复发。在 24 小时服药间隔结束时，脆弱性可能最高。
Objective: Environmental drug-related cues have been implicated as a cause of illicit heroin use during methadone maintenance treatment of heroin dependence. The authors sought to identify the functional neuroanatomy of the brain response to visual heroin-related stimuli in methadone maintenance patients.Method: Event-related functional magnetic resonance imaging was used to compare brain responses to heroin-related stimuli and matched neutral stimuli in 25 patients in methadone maintenance treatment. Patients were studied before and after administration of their regular daily methadone dose.Results: The heightened responses to heroin-related stimuli in the insula, amygdala, and hippocampal complex, but not the orbitofrontal and ventral anterior cingulate cortices, were acutely reduced after administration of the daily methadone dose.Conclusions: The medial prefrontal cortex and the extended limbic system in methadone maintenance patients with a history of heroin dependence remains responsive to salient drug cues, which suggests a continued vulnerability to relapse. Vulnerability may be highest at the end of the 24-hour interdose interval.