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Neuroimaging in Pregnancy to Assess Effects of Opioid Use Disorder

妊娠期神经影像学评估阿片类药物使用障碍的影响

基本信息

批准号：
10665962
负责人：
Rupa Radhakrishnan
金额：
$ 23.78万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10665962
关键词：
Adult American Anatomy Body Weight Brain Buprenorphine Child Childhood Clinical Cognitive Data Diffusion Magnetic Resonance Imaging Dose Early identification Effectiveness Exposure to Functional Magnetic Resonance Imaging Future Goals Health Human Individual Infant Knowledge Magnetic Resonance Imaging Mental Depression Metabolic Pathway Metabolism Methods Mothers Neonatal Neonatal Abstinence Syndrome Neurobiology Opioid Opioid replacement therapy Outcome Pharmaceutical Preparations Physiological Plasma Postpartum Period Pregnancy Pregnancy Outcome Pregnant Women Prevention Psyche structure Public Health Relapse Research Research Personnel Rest Risk Severities Structure Third Pregnancy Trimester Up-Regulation Variant Weight Gain Withdrawal Symptom Woman adverse outcome antenatal behavioral outcome buprenorphine treatment craving design drug relapse drug withdrawal experience fetal opioid exposure gray matter high risk imaging biomarker improved individual variation infant outcome insight maternal opioid use maternal outcome maternal risk multimodal neuroimaging neural circuit neurodevelopment neuroimaging neuroimaging marker neuromechanism non-opioid analgesic novel opioid epidemic opioid exposure opioid use disorder outcome prediction pandemic disease polysubstance use predictive marker pregnant prenatal prevent prognostic prognostic tool relapse prediction response risk minimization risk prediction tool treatment response white matter

项目摘要

Project Summary: Opioid use disorder (OUD) in pregnant American women is a major and growing public health concern. Despite medication treatment for OUD with buprenorphine, these pregnant women continue to be at high risk for early relapse, polysubstance use and depression worsening their and their children’s outcomes. We and other investigators have previously shown altered brain resting state functional MRI (rs-fMRI) connectivity in infants with prenatal opioid exposure that correlate with outcomes. However, there are no neuroimaging studies in pregnant women with OUD to understand the neurobiological effects of OUD, buprenorphine dose response and effects of concomitant polysubstance use in pregnant women. In pregnant women on buprenorphine OUD, there is variability in dose escalation and requirement to prevent withdrawal symptoms and craving due to increasing body weight and variable upregulation of buprenorphine metabolic pathways. Individual variability to buprenorphine metabolism may underlie variations in treatment response and individual poor neurobiological outcomes including postpartum relapse and depression. Our research is focused on fulfilling the critical unmet need to better understand the structural and functional brain alterations in pregnancy that correlate with buprenorphine treatment doses and plasma exposures to optimize maternal OUD outcomes. The objective of this application is to characterize OUD-related prenatal maternal brain structural and rs-fMRI alterations, and how buprenorphine treatment influences these alterations identified on neuroimaging. The specific aims of our project are to assess OUD related alterations in maternal brain structure and rs-fMRI connectivity in pregnant women and assess the associations of maternal brain structural and rs-fMRI connectivity alterations with plasma buprenorphine in pregnant women with OUD. This proposal is expected to provide critical new knowledge on the impact of buprenorphine treatment on maternal brain, and insight into the impact of individual buprenorphine metabolism upregulation in pregnancy on these brain alterations. Eventually, these results will help develop maternal neuroimaging as a potential prognostic tool for early identification of maternal and infant outcomes.

项目总结：阿片类药物使用障碍（OUD）在美国孕妇中是一个主要的和日益增长的公众问题