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Zheng H, Zhai T, Lin X, Dong G, Yang Y, Yuan TF. The resting-state brain activity signatures for addictive disorders. MED 2024; 5:201-223.e6. [PMID: 38359839 PMCID: PMC10939772 DOI: 10.1016/j.medj.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/20/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Addiction is a chronic and relapsing brain disorder. Despite numerous neuroimaging and neurophysiological studies on individuals with substance use disorder (SUD) or behavioral addiction (BEA), currently a clear neural activity signature for the addicted brain is lacking. METHODS We first performed systemic coordinate-based meta-analysis and partial least-squares regression to identify shared or distinct brain regions across multiple addictive disorders, with abnormal resting-state activity in SUD and BEA based on 46 studies (55 contrasts), including regional homogeneity (ReHo) and low-frequency fluctuation amplitude (ALFF) or fractional ALFF. We then combined Neurosynth, postmortem gene expression, and receptor/transporter distribution data to uncover the potential molecular mechanisms underlying these neural activity signatures. FINDINGS The overall comparison between addiction cohorts and healthy subjects indicated significantly increased ReHo and ALFF in the right striatum (putamen) and bilateral supplementary motor area, as well as decreased ReHo and ALFF in the bilateral anterior cingulate cortex and ventral medial prefrontal cortex, in the addiction group. On the other hand, neural activity in cingulate cortex, ventral medial prefrontal cortex, and orbitofrontal cortex differed between SUD and BEA subjects. Using molecular analyses, the altered resting activity recapitulated the spatial distribution of dopaminergic, GABAergic, and acetylcholine system in SUD, while this also includes the serotonergic system in BEA. CONCLUSIONS These results indicate both common and distinctive neural substrates underlying SUD and BEA, which validates and supports targeted neuromodulation against addiction. FUNDING This work was supported by the National Natural Science Foundation of China and Intramural Research Program of the National Institute on Drug Abuse, National Institutes of Health.
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Affiliation(s)
- Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China
| | - Tianye Zhai
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Guangheng Dong
- Department of Psychology, Yunnan Normal University, Kunming 650092, China
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, China; Institute of Mental Health and Drug Discovery, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang 325000, China.
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Lee CY, Wang WH, Lee CH, Ho MC. Betel Quid Dependence Effects on Working Memory and Remote Memory in Chewers with Concurrent Use of Cigarette and Alcohol. Subst Use Misuse 2022; 57:105-113. [PMID: 34678114 DOI: 10.1080/10826084.2021.1990338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The current study asked whether BQ dependence level could affect working memory (WM) and remote memory for the chewers with concurrent use of cigarettes and alcohol, a common phenomenon in Taiwan. METHODS The standardized neuropsychological tests (Wechsler Memory Scale III (WMS-III) and Remote Memory Test) were adopted to address the BQ chewers' verbal WM, spatial WM and remote memory. The Spatial Span Test and the Digit Span Test from WMS-III and the Remote Memory Test were adopted. The Betel Nut Dependency Scale (BNDS), the Fagerstrom Test for Nicotine Dependence (FTND), and the Alcohol Use Disorders Identification Test (AUDIT) were adopted to measure the dependence levels. RESULTS The BQ dependence level and Last BQ did not affect spatial WM, verbal WM, and remote memory. Last Cigarette is critical in affecting WM; namely, longer interval led to worse performance. Finally, higher alcohol dependence level could lead to better remote memory. CONCLUSIONS To our knowledge, there are no BQ studies addressing the effects of concurrent use of cigarettes and alcohol on memory. The current results suggest that cigarette smoking and alcohol drinking, rather than BQ chewing, are critical for memory performance.
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Affiliation(s)
- Chih-Ying Lee
- Clinical Psychology Department, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wei-Han Wang
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
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Fu L, Chen H, Liu T, Liu L, Fu Q, Huang W, Chen F. Altered Spontaneous Brain Activity in Betel Quid Dependence Chewers: A Resting-State Functional MRI Study With Percent Amplitude of Fluctuation. Front Psychiatry 2022; 13:830541. [PMID: 35586413 PMCID: PMC9109957 DOI: 10.3389/fpsyt.2022.830541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/08/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aimed to investigate brain spontaneous neural activity changes in betel quid dependence (BQD) chewers using the percent amplitude of fluctuation (PerAF) method. METHODS This study included 48 BQD chewers. The healthy control (HC) group comprised 35 volunteers who were matched with BQD chewers in age, gender, and educational status. All subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological tests. The PerAF method was used to identify BQD-related regional brain activity changes. An independent samples t-test was used to evaluate the PerAF difference across two groups. The association between PerAF changes and clinical features such as BQD scores, duration of BQD, Hamilton Depression Rating Scale-24 item (HAMD-24), and Hamilton Anxiety Rating Scale-14 item (HAMA-14) was evaluated by using Spearman's correlation analysis. It assessed the ability of the PerAF method to distinguish between BQD chewers and HCs using a receiver operating characteristic (ROC) curve. RESULTS Compared to the control group, BQD chewers showed decreased PerAF in right anterior cingulate cortex (ACC), right middle frontal gyrus (MFG), right insula, right precuneus, left putamen, left supramarginal gyrus (SMG), and left cerebellum and increased PerAF in right orbitofrontal and left superior temporal gyrus (STG) [P < 0.05, Gaussian random field (GRF) corrected]. PerAF values of the right MFG and right ACC had a significant negative relationship with the duration of BQD (P < 0.05). The average values of PerAF in the left putamen, left cerebellum, and left STG showed significant discriminatory power in distinguishing BQD chewers from HCs, with relatively prime area under the curve (AUC) values. CONCLUSION Our findings suggested that betel quid chewing is associated with spontaneous neural activity alterations in the impulsivity areas (MFG and ACC), cognitive (MFG, ACC, precuneus, and the cerebellum), and reward (orbitofrontal, putamen, and insula) systems, which may be correlated with neuropathological mechanisms of BQD. Also, PerAF may be useful as a potential sensitive biomarker for identifying spontaneous brain activity changes in BQD chewers.
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Affiliation(s)
- Lili Fu
- Department of Radiology, Hainan General Hospital (The Hainan Affiliated Hospital, Hengyang Medical School, University of South China), Haikou, China
| | - Huijuan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Tao Liu
- Department of Neurology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Liting Liu
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Qingqing Fu
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Weiyuan Huang
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
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Giampiccolo D, Nunes S, Cattaneo L, Sala F. Functional Approaches to the Surgery of Brain Gliomas. Adv Tech Stand Neurosurg 2022; 45:35-96. [PMID: 35976447 DOI: 10.1007/978-3-030-99166-1_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In the surgery of gliomas, recent years have witnessed unprecedented theoretical and technical development, which extensively increased indication to surgery. On one hand, it has been solidly demonstrated the impact of gross total resection on life expectancy. On the other hand, the paradigm shift from classical cortical localization of brain function towards connectomics caused by the resurgence of awake surgery and the advent of tractography has permitted safer surgeries focused on subcortical white matter tracts preservation and allowed for surgical resections within regions, such as Broca's area or the primary motor cortex, which were previously deemed inoperable. Furthermore, new asleep electrophysiological techniques have been developed whenever awake surgery is not an option, such as operating in situations of poor compliance (including paediatric patients) or pre-existing neurological deficits. One such strategy is the use of intraoperative neurophysiological monitoring (IONM), enabling the identification and preservation of functionally defined, but anatomically ambiguous, cortico-subcortical structures through mapping and monitoring techniques. These advances tie in with novel challenges, specifically risk prediction and the impact of neuroplasticity, the indication for tumour resection beyond visible borders, or supratotal resection, and most of all, a reappraisal of the importance of the right hemisphere from early psychosurgery to mapping and preservation of social behaviour, executive control, and decision making.Here we review current advances and future perspectives in a functional approach to glioma surgery.
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Affiliation(s)
- Davide Giampiccolo
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, University of Verona, Verona, Italy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Institute of Neurosciences, Cleveland Clinic London, London, UK
| | - Sonia Nunes
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, University of Verona, Verona, Italy
| | - Luigi Cattaneo
- Center for Mind and Brain Sciences (CIMeC) and Center for Medical Sciences (CISMed), University of Trento, Trento, Italy
| | - Francesco Sala
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, University of Verona, Verona, Italy.
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Huang W, Liu T, Chen H, Fu Q, Fu L, Xu X, Liu L, Guo Y, Balasubramanian PS, Chen F. Mapping white matter structural and network alterations in betel quid-dependent chewers using high angular resolution diffusion imaging. Front Psychiatry 2022; 13:1036728. [PMID: 36545042 PMCID: PMC9760978 DOI: 10.3389/fpsyt.2022.1036728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To evaluate brain white matter diffusion characteristics and anatomical network alterations in betel quid dependence (BQD) chewers using high angular resolution diffusion imaging (HARDI). METHODS The current study recruited 53 BQD chewers and 37 healthy controls (HC) in two groups. We explored regional diffusion metrics alternations in the BQD group compared with the HC group using automated fiber quantification (AFQ). We further employed the white matter (WM) anatomical network of HARDI to explore connectivity alterations in BQD chewers using graph theory. RESULTS BQD chewers presented significantly lower FA values in the left and right cingulum cingulate, the left and right thalamic radiation, and the right uncinate. The BQD has a significantly higher RD value in the right uncinate fasciculus than the HC group. At the global WM anatomical network level, global network efficiency (p = 0.008) was poorer and Lp (p = 0.016) was greater in the BQD group. At the nodal WM anatomical network level, nodal efficiency (p < 0.05) was lower in the BQD group. CONCLUSION Our findings provide novel morphometric evidence that brain structural changes in BQD are characterized by white matter diffusivity and anatomical network connectivity among regions of the brain, potentially leading to the enhanced reward system and impaired inhibitory control.
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Affiliation(s)
- Weiyuan Huang
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Tao Liu
- Department of Geriatric Center, Hainan General Hospital, Hainan, China
| | - Huijuan Chen
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Qingqing Fu
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Lili Fu
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Xiaolin Xu
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Liting Liu
- Department of Radiology, Yueyang Central Hospital, Shanghai, China
| | - Yihao Guo
- Department of Radiology, Hainan General Hospital, Hainan, China
| | - Priya S Balasubramanian
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, NY, United States
| | - Feng Chen
- Department of Radiology, Hainan General Hospital, Hainan, China
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Linli Z, Huang X, Liu Z, Guo S, Sariah A. A multivariate pattern analysis of resting-state functional MRI data in Naïve and chronic betel quid chewers. Brain Imaging Behav 2021; 15:1222-1234. [PMID: 32712800 DOI: 10.1007/s11682-020-00322-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Betel quid (BQ) is the fourth most commonly consumed psychoactive substance in the world. However, comprehensive functional magnetic resonance imaging (fMRI) studies exploring the neurophysiological mechanism of BQ addiction are lacking. Betel-quid-dependent (BQD) individuals (n = 24) and age-matched healthy controls (HC) (n = 26) underwent fMRI before and after chewing BQ. Multivariate pattern analysis (MVPA) was used to explore the acute effects of BQ-chewing in both groups. A cross-sectional comparison was conducted to explore the chronic effects of BQ-chewing. Regression analysis was used to investigate the relationship between altered circuits of BQD individuals and the severity of BQ addiction. MVPA achieved classification accuracies of up to 90% in both groups for acute BQ-chewing. Suppression of the default-mode network was the most prominent feature. BQD showed more extensive and intensive within- and between-network dysconnectivity of the default, frontal-parietal, and occipital regions associated with high-order brain functions such as self-awareness, inhibitory control, and decision-making. In contrast, the chronic effects of BQ on the brain function were mild, but impaired circuits were predominately located in the default and frontal-parietal networks which might be associated with compulsive drug use. Simultaneously quantifying the effects of both chronic and acute BQ exposure provides a possible neuroimaging-based BQ addiction foci. Results from this study may help us understand the neural mechanisms involved in BQ-chewing and BQ dependence.
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Affiliation(s)
- Zeqiang Linli
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, People's Republic of China
- Key Laboratory of Applied Statistics and Data Science, Hunan Normal University, College of Hunan Province, Changsha, People's Republic of China
| | - Xiaojun Huang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Shuixia Guo
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, People's Republic of China.
- Key Laboratory of Applied Statistics and Data Science, Hunan Normal University, College of Hunan Province, Changsha, People's Republic of China.
| | - Adellah Sariah
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
- Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.
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A CNN-Based Autoencoder and Machine Learning Model for Identifying Betel-Quid Chewers Using Functional MRI Features. Brain Sci 2021; 11:brainsci11060809. [PMID: 34207169 PMCID: PMC8234239 DOI: 10.3390/brainsci11060809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Betel quid (BQ) is one of the most commonly used psychoactive substances in some parts of Asia and the Pacific. Although some studies have shown brain function alterations in BQ chewers, it is virtually impossible for radiologists’ to visually distinguish MRI maps of BQ chewers from others. In this study, we aimed to construct autoencoder and machine-learning models to discover brain alterations in BQ chewers based on the features of resting-state functional magnetic resonance imaging. Resting-state functional magnetic resonance imaging (rs-fMRI) was obtained from 16 BQ chewers, 15 tobacco- and alcohol-user controls (TA), and 17 healthy controls (HC). We used an autoencoder and machine learning model to identify BQ chewers among the three groups. A convolutional neural network (CNN)-based autoencoder model and supervised machine learning algorithm logistic regression (LR) were used to discriminate BQ chewers from TA and HC. Classifying the brain MRIs of HC, TA controls, and BQ chewers by conducting leave-one-out-cross-validation (LOOCV) resulted in the highest accuracy of 83%, which was attained by LR with two rs-fMRI feature sets. In our research, we constructed an autoencoder and machine-learning model that was able to identify BQ chewers from among TA controls and HC, which were based on data from rs-fMRI, and this might provide a helpful approach for tracking BQ chewers in the future.
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Huang X, Wu Z, Liu Z, Liu D, Huang D, Long Y. Acute Effect of Betel Quid Chewing on Brain Network Dynamics: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2021; 12:701420. [PMID: 34504445 PMCID: PMC8421637 DOI: 10.3389/fpsyt.2021.701420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022] Open
Abstract
Betel quid (BQ) is one of the most popular addictive substances in the world. However, the neurophysiological mechanism underlying BQ addiction remains unclear. This study aimed to investigate whether and how BQ chewing would affect brain function in the framework of a dynamic brain network model. Resting-state functional magnetic resonance imaging scans were collected from 24 male BQ-dependent individuals and 26 male non-addictive healthy individuals before and promptly after chewing BQ. Switching rate, a measure of temporal stability of functional brain networks, was calculated at both global and local levels for each scan. The results showed that BQ-dependent and healthy groups did not significantly differ on switching rate before BQ chewing (F = 0.784, p = 0.381, analysis of covariance controlling for age, education, and head motion). After chewing BQ, both BQ-dependent (t = 2.674, p = 0.014, paired t-test) and healthy (t = 2.313, p = 0.029, paired t-test) individuals showed a significantly increased global switching rate compared to those before chewing BQ. Significant corresponding local-level effects were observed within the occipital areas for both groups, and within the cingulo-opercular, fronto-parietal, and cerebellum regions for BQ-dependent individuals. Moreover, in BQ-dependent individuals, switching rate was significantly correlated with the severity of BQ addiction assessed by the Betel Quid Dependence Scale scores (Spearman's rho = 0.471, p = 0.020) before BQ chewing. Our study provides preliminary evidence for the acute effects of BQ chewing on brain functional dynamism. These findings may provide insights into the neural mechanisms of substance addictions.
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Affiliation(s)
- Xiaojun Huang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical Psychology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zhipeng Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Dayi Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Danqing Huang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yicheng Long
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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Liu T, Liu L, Chen HJ, Fu Q, Fu L, Huang W, Chen F. Altered Topological Organization of Functional Brain Networks in Betel Quid Dependence: A Resting-State Functional MRI Study. Front Psychiatry 2021; 12:779878. [PMID: 35046854 PMCID: PMC8762206 DOI: 10.3389/fpsyt.2021.779878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Betel quid dependence (BQD) is associated with abnormalities in the widespread inter-regional functional connectivity of the brain. However, no studies focused on the abnormalities in the topological organization of brain functional networks in chewers in Mainland China. Methods: In the current study, resting-state functional magnetic resonance images were acquired from 53 BQD individuals and 37 gender- and age-matched healthy controls (HCs). A functional network was constructed by calculating the Pearson correlation coefficients among 90 subregions in the human Brainnetome Atlas. The topological parameters were compared between BQD individuals and HCs. Results: The results showed that BQD individuals presented a small-world topology, but the normalized characteristic path length (λ) increased compared with HCs (0.563 ± 0.030 vs. 0.550 ± 0.027). Compared to HCs, BQ chewers showed increased betweenness centrality (Be) in the right supplementary motor area, right medial superior frontal gyrus, right paracentral lobule, right insula, left posterior cingulate gyrus, right hippocampus, right post-central gyrus, right superior parietal gyrus, and right supramarginal gyrus, while decreased Be was found in the orbitofrontal area and temporal area, which is associated with reward network, cognitive system, and default mode network. The area under the curve (AUC) value of λ displayed a positive correlation with the duration of BQ chewing (r = 0.410, p = 0.002). Conclusions: The present study revealed the disruption of functional connectome in brain areas of BQD individuals. The findings may improve our understanding of the neural mechanism of BQD from a brain functional network topological organization perspective.
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Affiliation(s)
- Tao Liu
- Department of Neurology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Liting Liu
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Hui Juan Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Qingqing Fu
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Lili Fu
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Weiyuan Huang
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
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Ko AMS, Lee CH, Ko AMJ, Ko YC. Betel quid dependence mechanism and potential cessation therapy. Prog Neuropsychopharmacol Biol Psychiatry 2020; 103:109982. [PMID: 32454163 DOI: 10.1016/j.pnpbp.2020.109982] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Global reports estimate the number of betel quid (BQ) chewers up to 600 million. The proportion of betel quid dependence (BQD) is 20%-90% among current users. BQD mechanisms are not fully understood, and no pharmacological solution exists for its cessation therapy. METHODS We present a systematic review on BQD mechanisms and examine potential cessation therapeutic drugs. We conducted a systematic literature search in PubMed and Web of Science databases and identified the latest 10 years' relevant articles for reviews. RESULTS Functional magnetic resonance imaging results demonstrate that neurological mechanisms link the brain reward, cognitive, and impulsive systems in BQ or BQD users. The use of the areca nut increases both brain serotonin and noradrenaline levels, whereas arecoline, a potentially addictive areca nut component, has monoamine oxidase-A (MAO-A) inhibitor-like properties. MAO-A inhibitors prevent neurotransmitter breakdown and increase dopamine and serotonin concentrations in the brain. A reduction of daily BQ use was observed among patients with depression after antidepressant therapy, including MAO-A inhibitor and selective serotonin reuptake inhibitor (SSRI). Arecoline is a nicotinic acetylcholine receptor agonist expressed in Xenopus oocytes. However, relatively negligible amounts of nicotine are detected in the areca nut. CONCLUSION In conclusion, the current evidence provides a better understanding of the neurological and pharmacological mechanisms behind BQD. Arecoline, an MAO-A inhibitor, may account for BQD. Future translational studies are needed to verify the efficacy of potential BQD cessation drugs. MAO-A inhibitor and SSRI would thus be potentially promising targets for clinical trials.
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Affiliation(s)
- Albert Min-Shan Ko
- Key Laboratory of Vertebrate Evolution and Human Origins of Chinese Academy of Sciences, Institute of Vertebrate Paleontology and Paleoanthropology, Chinese Academy of Sciences, Beijing, China
| | - Chien-Hung Lee
- Department of Public Health and Research Center for Environment Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Allen Min-Jen Ko
- Medical Imaging and Radiology, Alpenglow Australia, Sydney, New South Wales, Australia
| | - Ying-Chin Ko
- Environment-Omics-Disease Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan; Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan.
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11
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Qian Z, Liu S, Zhu X, Kong L, Liu N, Wang D, Jiang C, Zhan Z, Yuan F. Higher Trait Impulsivity and Altered Frontostriatal Connectivity in Betel-Quid Dependent Individuals. Front Hum Neurosci 2020; 14:578913. [PMID: 33192412 PMCID: PMC7658367 DOI: 10.3389/fnhum.2020.578913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/22/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: Betel quid dependency (BQD) is characterized by functional and structural brain alterations. Trait impulsivity may influence substance dependence by impacting its neurobiological underpinnings in the frontostriatal circuit. However, little is known about the trait impulsivity and its neural correlates in individuals with BQD. Methods: Forty-eight participants with BQD and 22 normal controls (NCs) were recruited and scanned on a 3T MRI scanner. Barratt impulsiveness scale (BIS) was used to measure trait impulsivity: motor, attention, and no plan impulsivity. We used voxel-based morphometry (VBM) to assess the relationship between trait impulsivity and gray matter volumes. The relevant clusters identified were served as regions of interest (ROI) seeds. The whole-volume psycho-physiological interactions (PPI) analysis was used to investigate the changes of functional connectivity related to ROI seeds in the cue-reactivity task condition (BQ and control images). Results: Behaviorally, the BQD group showed significantly higher trait impulsivity including motor and no plan impulsivity than the NCs group. VBM analyses showed that motor impulsivity was negatively associated with gray matter volume of right caudate in the whole sample. No difference in gray matter volume between the two groups was observed. PPI analyses showed that there was a significantly decreased functional connectivity between the right caudate and right dorsolateral prefrontal cortex (DLPFC) when watching BQ related images than control images in individuals with BQD. Furthermore, functional connectivity between the right caudate and right DLPFC was negatively correlated with BQ dependency scores. Conclusions: Our study demonstrated the structural basis of trait impulsivity in the caudate and provided evidence for abnormal interactions within frontostriatal circuitsin individuals with BQD, which may provide insight into the selection of potential novel therapeutic targets for the treatment of BQ dependency.
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Affiliation(s)
- Zhaoxin Qian
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Shaohui Liu
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xueling Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lingyu Kong
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Neng Liu
- Department of Nursing, Xiangya Hospital, Central South University, Changsha, China
| | - Dongcui Wang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Canhua Jiang
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zhongyuan Zhan
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Fulai Yuan
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
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12
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Tsai JD, Ho MC, Lee HY, Shen CY, Li JY, Weng JC. Disrupted white matter connectivity and organization of brain structural connectomes in tuberous sclerosis complex patients with neuropsychiatric disorders using diffusion tensor imaging. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:189-200. [PMID: 32715372 DOI: 10.1007/s10334-020-00870-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/02/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Tuberous sclerosis complex (TSC) is a genetic neurocutaneous syndrome with variable and unpredictable neurological comorbidity that includes epilepsy, intellectual disability (ID), autism spectrum disorder, and neurobehavioral abnormalities. The degree of white matter involvement is believed to be associated with the severity of neurological impairment. The goal of the present study was to evaluate diffusion characteristics of tubers, white matter lesions, and brain structural network alterations in TSC patients using diffusion tensor imaging (DTI), graph theoretical analysis (GTA), and network-based statistical (NBS) analysis. MATERIALS AND METHODS Forty-two patients with a definitive diagnosis of TSC were recruited for this study. All patients underwent brain DTI examination using a 3 T magnetic resonance imaging system. Mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) values, and fractional anisotropy (FA) mapping in 52 tubers and white matter lesions were measured and compared with those of contralateral normal regions. GTA was performed on the inter-regional connectivity matrix, and NBS analysis was used to identify the significance of any connected subnetworks evident in the set of altered connections. For neurological severity subgrouping, a neurological severity score was assigned to TSC patients including those with ID, seizure, autism, and other neuropsychiatric disorders (NPDs). RESULTS Significantly higher MD, AD, and RD, and lower FA values, were found in TSC lesions compared with those measured in contralateral normal regions for tubers (P < 0.05). GTA and NBS analysis provided better local segregation but worse global integration of the structural network (regular-like network) in TSC patients with ID, seizure, and higher Neurological Severity Score. Disrupted subnetworks in TSC patients with severe status included connections from the frontal lobe to the parietal lobe, temporal lobe to the caudate, and temporal lobe to the insula. DISCUSSION DTI has the potential to provide valuable information about cytoarchitectural changes in TSC lesions beyond morphological MRI findings alone. Using GTA and NBS, current results provide the information of disrupted white matter connectivity and organization in TSC patients with different neuropsychological impairments.
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Affiliation(s)
- Jeng-Dau Tsai
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
- Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hom-Yi Lee
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
| | - Chao-Yu Shen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jheng-Yan Li
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 33302, Taiwan.
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital At Linkou, Taoyuan, Taiwan.
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.
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13
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Huang B, Zachar JJ. Social and behavioural determinants of areca nut consumption in adolescents. Oral Dis 2020; 26:1820-1826. [PMID: 32516860 DOI: 10.1111/odi.13467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of areca nut consumption and to identify social and behavioural determinants among a Taiwanese adolescent population. SUBJECTS AND METHODS A random sample of 5,343 high school students aged between 15-18 years in Kaohsiung, Taiwan, participated in the study. Participants underwent a clinical dental examination and completed a self-administered questionnaire. Data analyses were performed using multivariate logistic regression to establish a relationship between areca nut consumption as well as social and behavioural characteristics. RESULTS The prevalence of areca nut consumption was 3.0%. The chewing habit was more prevalent among older adolescents (p < .001, OR = 1.50, 95% CI: 1.26, 1.78), males (p < .001, OR = 17.91, 95% CI: 8.57, 37.40), pupils living with non-birth parent(s) (p = .003, OR = 2.13, 95% CI: 1.29, 3.50), children of family heads with primary (p = .001, OR = 2.90, 95% CI: 1.50, 5.59) or secondary level of education (p < .001, OR = 2.78, 95% CI: 1.74, 4.46), frequent risk takers (p < .001, OR = 1.35, 95% CI: 1.27, 1.43) and students of low physical fitness (p < .001, OR = 3.65, 95% CI: 1.81, 7.35). CONCLUSIONS Areca nut consumption has become an ongoing pertinent issue in adolescent health. Future investigations into neurocognitive influences of risk-taking behaviour on areca nut consumption and social dependence of the habit are indicated.
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Affiliation(s)
- Boyen Huang
- Department of Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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14
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Ho MC, Huang GJ, Tyan YS, Tseng HC, Weng JC. Neural response to betel quid cues in chewers: a functional magnetic resonance imaging study. Brain Imaging Behav 2020; 13:1135-1145. [PMID: 30051327 DOI: 10.1007/s11682-018-9933-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The World Health Organization regards betel quid (BQ) as a human carcinogen. The current study analyzes whether the BQ cues can elicit activity in the chewers' craving-related brain areas. We adopted a cue-reactivity paradigm to examine the changes in the brain activities. The urge intensity was also included to examine whether it can moderate the brain areas stimulated by BQ cues. Sixteen male BQ chewers and 16 healthy male controls were recruited and analyzed. Four types of cues were adopted: BQ cues, matched food cues, visual control cues, and resting crosshair cued. The most direct and important comparison was between the brain activities elicited by the BQ cues versus those by the food cues. Furthermore, to test the current urge intensity effect, we compared BQ chewers with a strong urge versus those with a weak urge. All of the three-dimension anatomical and multi-slice task-based functional images were acquired using 3 T MRI. We found that (1) the BQ chewers and the healthy controls had similar brain activation patterns when comparing any two cue types, (2) the high-urge (not the low-urge) chewers showed craving-related activations (e.g., anterior cingulate cortex, medial orbitofrontal gyrus, and superior frontal gyrus) in the critical BQ cues vs. the food cue comparisons. (3) The high-urge chewers had larger contrast activations (BQ - Food) in many craving-related brain areas than low-urge chewers did (e.g., frontal gyrus). The urge states endorsed by the chewers can moderate the neural responses to BQ cues. Multisensory cues should be considered to elicit more intense and consistent cravings.
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Affiliation(s)
- Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Guo-Joe Huang
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan
| | - Yeu-Sheng Tyan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsien-Chun Tseng
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 33302, Taiwan. .,Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.
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15
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Sariah A, Guo S, Zuo J, Pu W, Liu H, Rolls ET, Xue Z, Liu Z, Huang X. Acute and Chronic Effects of Betel Quid Chewing on Brain Functional Connectivity. Front Psychiatry 2020; 11:198. [PMID: 32256411 PMCID: PMC7094756 DOI: 10.3389/fpsyt.2020.00198] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/02/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The active alkaloid in Betel quid is arecoline. Consumption of betel quid is associated with both acute effects and longer-term addictive effects. Despite growing evidence that betel quid use is linked with altered brain function and connectivity, the neurobiology of this psychoactive substance in initial acute chewing, and long-term dependence, is not clear. METHODS In this observational study, functional magnetic resonance imaging in a resting-state was performed in 24 male betel quid-dependent chewers and 28 male controls prior to and promptly after betel quid chewing. Network-based statistics were employed to determine significant differences in functional connectivity between brain networks for both acute effects and in long-term betel users versus controls. A support vector machine was employed for pattern classification analysis. RESULTS Before chewing betel quid, higher functional connectivity in betel quid-dependent chewers than in controls was found between the temporal, parietal and frontal brain regions (right medial orbitofrontal cortex, right lateral orbital frontal cortex, right angular gyrus, bilateral inferior temporal gyrus, superior parietal gyrus, and right medial superior frontal gyrus). In controls, the effect of betel quid chewing was significantly increased functional connectivity between the subcortical regions (caudate, putamen, pallidum, and thalamus), and the visual cortex (superior occipital gyrus and right middle occipital gyrus). CONCLUSION These findings show that individuals who chronically use betel quid have higher functional connectivity than controls of the orbitofrontal cortex, and inferior temporal and angular gyri. Acute effects of betel quid are to increase the functional connectivity of some visual cortical areas (which may relate to the acute symptoms) and the basal ganglia and thalamus.
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Affiliation(s)
- Adellah Sariah
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.,Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Shuixia Guo
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, China.,Key Laboratory of Applied Statistics and Data Science, Hunan Normal University, Changsha, China
| | - Jing Zuo
- Department of Psychiatry, Brain Hospital of Hunan Province, Changsha, China
| | - Weidan Pu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Haihong Liu
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, China
| | - Edmund T Rolls
- Oxford Centre for Computational Neuroscience, Oxford, England.,Department of Computer Science, University of Warwick, Coventry, England
| | - Zhimin Xue
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojun Huang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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16
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Sariah A, Pu W, Xue Z, Liu Z, Huang X. Reduced Cortical Thickness in the Right Caudal Middle Frontal Is Associated With Symptom Severity in Betel Quid-Dependent Chewers. Front Psychiatry 2020; 11:654. [PMID: 32754064 PMCID: PMC7366340 DOI: 10.3389/fpsyt.2020.00654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/24/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Findings from brain structural imaging studies on betel quid dependence have supported relations between betel quid chewing and alterations in gray matter volume and white matter integrity. However, the effect of betel quid chewing on cortical thickness and the link between cortical thickness and symptom severity remains unascertained. METHODS In this observational study, we compared cortical thickness measures from 24 male betel quid-dependent chewers with 27 male healthy controls. Using FreeSufer, we obtained three-dimensional T1-weighted images that were used to compute the thickness of the cerebral cortex throughout the cortical layer. RESULTS Compared to healthy controls, betel quid dependent chewers displayed significant decreased cortical thickness in the precuneus, entorhinal, right paracentral, middle temporal, and caudal middle frontal gyri. Betel quid dependence scale scores negatively correlated (r = -0.604; p = 0.002) with reduced cortical thickness in the right caudal middle frontal of betel quid-dependent chewers. CONCLUSION The findings provide evidence for cortical thickness abnormality in betel dependent chewers and further propose that the severity of betel quid symptoms may be a critical aspect associated with the cortical alterations. The observed alterations may serve as potential mechanisms to explain why BQ chewing behavior is persistent among individuals with betel quid dependence.
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Affiliation(s)
- Adellah Sariah
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Weidan Pu
- Medical Psychological Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhimin Xue
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaojun Huang
- National Clinical Research Centre for Mental Disorders, Institute of Mental Health and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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17
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Sariah A, Liu Z, Pu W, Liu H, Xue Z, Huang X. Structural and Functional Alterations in Betel-Quid Chewers: A Systematic Review of Neuroimaging Findings. Front Psychiatry 2019; 10:16. [PMID: 30761025 PMCID: PMC6361845 DOI: 10.3389/fpsyt.2019.00016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/11/2019] [Indexed: 12/21/2022] Open
Abstract
Background: A number of neuroimaging studies have investigated structural, metabolic, and functional connectivity changes in betel quid (BQ) chewers. We present a systematic review of neuroimaging studies with emphasis on key brain systems affected by BQ chewing to bring a better understanding on the neuro mechanisms involved in BQD. Methods: All BQ neuroimaging studies were identified by searching PubMed, EMBASE, and Google scholar for English articles published until March 2018 using the key words: Betel-quid, resting state, functional MRI, structural MRI, diffusion tensor imaging (DTI), and betel quid dependence basing on the PRISMA criteria. We also sought unpublished studies, and the rest were obtained from reference lists of the retrieved articles. All neuroimaging studies investigating brain structural, and functional alterations related to BQ chewing and BQ dependence were included. Our systematic review registration number is CRD42018092669. Results: A review of 12 studies showed that several systems in the brain of BQ chewers exhibited structural, metabolic, and functional alterations. BQ chewing was associated with alterations in the reward [areas in the midbrain, and prefrontal cortex (PFC)], impulsivity (anterior cingulate cortex, PFC) and cognitive (PFC, the default mode, frontotemporal, frontoparietal, occipital/temporal, occipital/parietal, temporal/limbic networks, hippocampal/hypothalamus, and the cerebellum) systems in the brain. BQ duration and severity of betel quid dependence were associated with majority of alterations in BQ chewers. Conclusion: Betel quid chewing is associated with brain alterations in structure, metabolism and function in the cognitive, reward, and impulsivity circuits which are greatly influenced by duration and severity of betel quid dependence.
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Affiliation(s)
- Adellah Sariah
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China.,Department of Mental Health and Psychiatric Nursing, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Weidan Pu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Haihong Liu
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, China
| | - Zhimin Xue
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojun Huang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
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