Prescription opioid misusers exhibit blunted parasympathetic regulation during inhibitory control challenge.
Prescription opioid misusers exhibit blunted parasympathetic regulation during inhibitory control challenge.
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处方阿片类药物滥用者在抑制控制挑战期间表现出副交感神经调节迟钝。
DOI：
10.1007/s00213-020-05729-z
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发表时间：
2021-03
影响因子：
3.4
通讯作者：
Howard MO
中科院分区：
文献类型：
--
作者：
Garland EL;Howard MO
在阿片类药物治疗的慢性疼痛患者中，情绪背景下的反应抑制缺陷可能导致阿片类药物滥用。使用高频心率变异性（HF-HRV）指数受损的反应抑制，我们研究了阿片类药物滥用和反应抑制之间的关联，在阿片类药物治疗的慢性疼痛患者的样本中的情绪和中性背景。接受阿片类镇痛药≥ 90天的慢性疼痛患者（N = 97）完成了情绪Go/NoGo任务，该任务在中性、阿片类、负性情感和正性情感背景图像的背景下呈现抑制控制挑战，同时记录HF-HRV。评估阿片类药物滥用和渴求。使用当前阿片类药物滥用测量的有效临界点，将参与者分类为阿片类药物滥用者或非滥用者。阿片类药物滥用被视为反应抑制的行为和HF-HRV指标的预测因子。与中性和积极情感图像相比，消极情感图像和阿片类图像分别引起更多的委托错误（p = 0.002，η 2偏= 0.16）和反应时间减慢（p = 0.045，η 2偏= 0.09）。虽然在任务中没有观察到组间行为差异，但阿片类药物滥用者在任务期间相对于非滥用者表现出显著钝化的相位HF-HRV（p = .027，η 2偏= .11）。任务期间HF-HRV与阿片类药物渴求呈显著负相关。尚不清楚这些自主神经发现是否反映了阿片类药物给药和戒断的组间或组间差异的持久表型差异。抑制控制挑战期间副交感神经调节减少可能表明阿片类药物治疗的慢性疼痛患者中阿片类药物滥用风险增加。
Among opioid-treated chronic pain patients, response inhibition deficits in emotional contexts may contribute to opioid misuse. Using high frequency heart rate variability (HF-HRV) to index impaired response inhibition, we examined associations between opioid misuse and response inhibition in emotional and neutral contexts in a sample of opioid-treated chronic pain patients. Chronic pain patients taking opioid analgesics (N = 97) for ≥ 90 days completed an Emotional Go/NoGo Task that presented an inhibitory control challenge in the context of neutral, opioid, negative affective, and positive affective background images while HF-HRV was recorded. Opioid misuse and craving were assessed. Using a validated cut-point on the Current Opioid Misuse Measure, participants were classified as opioid misusers or non-misusers. Opioid misuse was examined as a predictor of behavioral and HF-HRV metrics of response inhibition. Negative affective and opioid images elicited more errors of commission (p = .002, η2partial = .16) and slowed reaction times (p = .045, η2partial = .09) than neutral and positive affective images, respectively. Though no between-groups behavioral differences were observed on the task, opioid misusers exhibited significantly blunted phasic HF-HRV during the task relative to non-misusers (p = .027, η2partial = .11). HF-HRV during the task was significantly inversely associated with opioid craving. It was not clear whether these autonomic findings reflected a durable phenotypic difference between groups or between-groups differences in opioid dosing and withdrawal. Reduced parasympathetic regulation during inhibitory control challenge may indicate heightened opioid misuse risk among opioid-treated chronic pain patients.
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