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Müller UJ, Schmalenbach LJ, Dobrowolny H, Guest PC, Schlaaff K, Mawrin C, Truebner K, Bogerts B, Gos T, Bernstein HG, Steiner J. Reduced anterior insular cortex volume in male heroin addicts: a postmortem study. Eur Arch Psychiatry Clin Neurosci 2023; 273:1233-1241. [PMID: 36719479 PMCID: PMC9888352 DOI: 10.1007/s00406-023-01553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/09/2023] [Indexed: 02/01/2023]
Abstract
We and others have observed reduced volumes of brain regions, including the nucleus accumbens, globus pallidus, hypothalamus, and habenula in opioid addiction. Notably, the insular cortex has been under increasing study in addiction, and a smaller anterior insula has been found in alcohol-addicted cases. Here, we have investigated whether similar effects occur in heroin addicts compared to healthy controls. Volumes of the anterior and posterior insula in heroin addicts (n = 14) and controls (n = 13) were assessed by morphometry of Nissl-myelin-stained serial whole-brain coronal sections. The mean relative volume of the anterior insular cortex was smaller than in non-addicted controls (3010 ± 614 *10-6 versus 3970 ± 1306 *10-6; p = 0.021). However, no significant differences in neuronal cell counts were observed. Therefore, the observed volume reduction appears to be a consequence of damaged connecting structures such as neuropil and glial cells. The findings were not confounded by age or duration of autolysis. Our results provide further evidence of structural deficits in key hubs of the addiction circuitry in heroin-dependent individuals and warrant further research in this area.
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Affiliation(s)
- Ulf J Müller
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany
| | - Lucas J Schmalenbach
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Paul C Guest
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Konstantin Schlaaff
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- German Center for Mental Health (DZP), Center for Intervention and Research On Adaptive and Maladaptive Brain Circuits Underlying, Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Christian Mawrin
- Department of Neuropathology, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Kurt Truebner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Bernhard Bogerts
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Salus Institute, Magdeburg, Germany
| | - Tomasz Gos
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Hans-Gert Bernstein
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany.
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany.
- Center for Behavioral Brain Sciences, Magdeburg, Germany.
- German Center for Mental Health (DZP), Center for Intervention and Research On Adaptive and Maladaptive Brain Circuits Underlying, Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
- Center for Health Und Medical Prevention (CHaMP), Magdeburg, Germany.
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Upadhyay J, Verrico CD, Cay M, Kodele S, Yammine L, Koob GF, Schreiber R. Neurocircuitry basis of the opioid use disorder-post-traumatic stress disorder comorbid state: conceptual analyses using a dimensional framework. Lancet Psychiatry 2022; 9:84-96. [PMID: 34774203 DOI: 10.1016/s2215-0366(21)00008-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/11/2020] [Accepted: 01/06/2021] [Indexed: 12/17/2022]
Abstract
Understanding the interface between opioid use disorder (OUD) and post-traumatic stress disorder (PTSD) is challenging. By use of a dimensional framework, such as research domain criteria, convergent and targetable neurobiological processes in OUD-PTSD comorbidity can be identified. We hypothesise that, in OUD-PTSD, circuitry that is implicated in two research domain criteria systems (ie, negative valence and cognitive control) underpins dysregulation of incentive salience, negative emotionality, and executive function. We also propose that the OUD-PTSD state might be systematically investigated with approaches outlined within a neuroclinical assessment framework for addictions and PTSD. Our dimensional analysis of the OUD-PTSD state shows how first-line therapeutic approaches (ie, partial μ-type opioid receptor [MOR1] agonism) modulate overlapping neurobiological and clinical features and also provides mechanistic rationale for evaluating polytherapeutic strategies (ie, partial MOR1 agonism, κ-type opioid receptor [KOR1] antagonism, and α-2A adrenergic receptor [ADRA2A] agonism). A combination of these therapeutic mechanisms is projected to facilitate recovery in patients with OUD-PTSD by mitigating negative valence states and enhancing executive control.
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Affiliation(s)
- Jaymin Upadhyay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA.
| | - Christopher D Verrico
- Department of Psychiatry and Behavioral Sciences and Department of Pharmacology, Baylor College of Medicine, Houston, TX, USA
| | - Mariesa Cay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Sanda Kodele
- Faculty of Psychology and Neuroscience, Section Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, Netherlands
| | - Luba Yammine
- Louis A Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - George F Koob
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Rudy Schreiber
- Faculty of Psychology and Neuroscience, Section Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, Netherlands
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Bach P, Frischknecht U, Reinhard I, Bekier N, Demirakca T, Ende G, Vollstädt-Klein S, Kiefer F, Hermann D. Impaired working memory performance in opioid-dependent patients is related to reduced insula gray matter volume: a voxel-based morphometric study. Eur Arch Psychiatry Clin Neurosci 2021; 271:813-822. [PMID: 31422451 DOI: 10.1007/s00406-019-01052-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/07/2019] [Indexed: 11/30/2022]
Abstract
Opioid-dependent patients frequently show deficits in multiple cognitive domains that might impact on their everyday life performance and interfere with therapeutic efforts. To date, the neurobiological underpinnings of those deficits remain to be determined. We investigated working memory performance and gray matter volume (GMV) differences in 17 patients on opioid maintenance treatment (OMT) and 17 healthy individuals using magnetic resonance imaging and voxel-based morphometry. In addition, we explored associations between substance intake, gray matter volume, and working memory task performance. Patients on OMT committed more errors during the working memory task than healthy individuals and showed smaller insula and putamen GMV. The duration of heroin use prior to OMT was associated with working memory performance and insula GMV in patients. Neither the substitution agent (methadone and buprenorphine) nor concurrent abuse of illegal substances during the 3 months prior to the experiment was significantly associated with GMV. Results indicate that impaired working memory performance and structural deficits in the insula of opioid-dependent patients are related to the duration of heroin use. This suggests that early inclusion into OMT or abstinence-oriented therapies that shorten the period of heroin abuse may limit the impairments to GMV and cognitive performance of opioid-dependent individuals.
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Affiliation(s)
- Patrick Bach
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Square J5, 68159, Mannheim, Germany.
| | - Ulrich Frischknecht
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Square J5, 68159, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Nina Bekier
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Square J5, 68159, Mannheim, Germany
| | - Traute Demirakca
- Department of Neuroimaging, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Gabriele Ende
- Department of Neuroimaging, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Square J5, 68159, Mannheim, Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Square J5, 68159, Mannheim, Germany
| | - Derik Hermann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Square J5, 68159, Mannheim, Germany
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Müller UJ, Ahrens M, Vasilevska V, Dobrowolny H, Schiltz K, Schlaaff K, Mawrin C, Frodl T, Bogerts B, Gos T, Truebner K, Bernstein HG, Steiner J. Reduced habenular volumes and neuron numbers in male heroin addicts: a post-mortem study. Eur Arch Psychiatry Clin Neurosci 2021; 271:835-845. [PMID: 33001272 DOI: 10.1007/s00406-020-01195-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/17/2020] [Indexed: 11/24/2022]
Abstract
The Habenula is increasingly being investigated in addiction. Reduced volumes of other relevant brain regions in addiction, such as nucleus accumbens, globus pallidus and hypothalamus have been reported. Reduced volumes of the habenula as well as reduced neuronal cell count in the habenula have also been reported in mood disorders and an overlap between mood disorders and addiction is clinically widely recognized. Thus, our aim was to investigate possible volume and neuronal cell count differences in heroin addicts compared to healthy controls. Volumes of the medial (MHB) and lateral habenula (LHB) in heroin addicts (n = 12) and healthy controls (n = 12) were assessed by morphometry of 20 µm serial whole brain sections. Total brain volume was larger in the heroin group (mean 1466.6 ± 58.5 cm3 vs. mean 1331.5 ± 98.8 cm3), possibly because the heroin group was about 15 years younger (p = 0.001). Despite larger mean whole brain volume, the mean relative volume of the MHB was smaller than in healthy non-addicted controls (6.94 ± 2.38 × 10-6 vs.10.64 ± 3.22 × 10-6; p = 0.004). A similar finding was observed regarding relative volumes of the LHB (46.62 ± 10.90 × 10-6 vs. 63.05 ± 16.42 × 10-6 p = 0.009). In parallel, neuronal cell numbers were reduced in the MHB of heroin-addicted subjects (395,966 ± 184,178 vs. 644,149 ± 131,140; p < 0.001). These findings were not significantly confounded by age and duration of autolysis. Our results provide further evidence for brain-structural deficits in heroin addiction.
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Affiliation(s)
- Ulf J Müller
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany.
- Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany.
| | - Moritz Ahrens
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Veronika Vasilevska
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Kolja Schiltz
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Konstantin Schlaaff
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Christian Mawrin
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Department of Neuropathology, University of Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Bernhard Bogerts
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Salus Institute, Magdeburg, Germany
| | - Tomasz Gos
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
- Department of Forensic Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Kurt Truebner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Hans-Gert Bernstein
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.
- Translational Psychiatry Laboratory, University of Magdeburg, Magdeburg, Germany.
- Center for Behavioral Brain Sciences, Magdeburg, Germany.
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Blackwood CA, Cadet JL. The molecular neurobiology and neuropathology of opioid use disorder. CURRENT RESEARCH IN NEUROBIOLOGY 2021; 2. [PMID: 35548327 PMCID: PMC9090195 DOI: 10.1016/j.crneur.2021.100023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The number of people diagnosed with opioid use disorder has skyrocketed as a consequence of the opioid epidemic and the increased prescribing of opioid drugs for chronic pain relief. Opioid use disorder is characterized by loss of control of drug taking, continued drug use in the presence of adverse consequences, and repeated relapses to drug taking even after long periods of abstinence. Patients who suffer from opioid use disorder often present with cognitive deficits that are potentially secondary to structural brain abnormalities that vary according to the chemical composition of the abused opioid. This review details the neurobiological effects of oxycodone, morphine, heroin, methadone, and fentanyl on brain neurocircuitries by presenting the acute and chronic effects of these drugs on the human brain. In addition, we review results of neuroimaging in opioid use disorder patients and/or histological studies from brains of patients who had expired after acute intoxication following long-term use of these drugs. Moreover, we include relevant discussions of the neurobiological mechanisms involved in promoting abnormalities in the brains of opioid-exposed patients. Finally, we discuss how novel strategies could be used to provide pharmacological treatment against opioid use disorder. Brain abnormalities caused by opioid intoxication. Intoxication of opioids leads to defects in brain neurocircuitries. Insight into the molecular mechanisms associated with craving in heroin addicts.
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Affiliation(s)
| | - Jean Lud Cadet
- Corresponding author.Molecular Neuropsychiatry Research Branch NIH/NIDA Intramural Research Program 251 Bayview Boulevard Baltimore, MD, USA
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Opioid and neuroHIV Comorbidity - Current and Future Perspectives. J Neuroimmune Pharmacol 2020; 15:584-627. [PMID: 32876803 PMCID: PMC7463108 DOI: 10.1007/s11481-020-09941-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/02/2020] [Indexed: 12/14/2022]
Abstract
With the current national opioid crisis, it is critical to examine the mechanisms underlying pathophysiologic interactions between human immunodeficiency virus (HIV) and opioids in the central nervous system (CNS). Recent advances in experimental models, methodology, and our understanding of disease processes at the molecular and cellular levels reveal opioid-HIV interactions with increasing clarity. However, despite the substantial new insight, the unique impact of opioids on the severity, progression, and prognosis of neuroHIV and HIV-associated neurocognitive disorders (HAND) are not fully understood. In this review, we explore, in detail, what is currently known about mechanisms underlying opioid interactions with HIV, with emphasis on individual HIV-1-expressed gene products at the molecular, cellular and systems levels. Furthermore, we review preclinical and clinical studies with a focus on key considerations when addressing questions of whether opioid-HIV interactive pathogenesis results in unique structural or functional deficits not seen with either disease alone. These considerations include, understanding the combined consequences of HIV-1 genetic variants, host variants, and μ-opioid receptor (MOR) and HIV chemokine co-receptor interactions on the comorbidity. Lastly, we present topics that need to be considered in the future to better understand the unique contributions of opioids to the pathophysiology of neuroHIV. Blood-brain barrier and the neurovascular unit. With HIV and opiate co-exposure (represented below the dotted line), there is breakdown of tight junction proteins and increased leakage of paracellular compounds into the brain. Despite this, opiate exposure selectively increases the expression of some efflux transporters, thereby restricting brain penetration of specific drugs. ![]()
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Ponté C, Giron A, Crequy M, Lapeyre-Mestre M, Fabre N, Salles J. Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature. Headache 2019; 59:576-589. [PMID: 30957220 DOI: 10.1111/head.13516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To describe a case series of 7 patients presenting cluster headache (CH) criteria and a substance use disorder, reported to a French Addictovigilance center. Then, to assess clinical, pharmacological, and neurobiological linkages between substance use and CH onset. BACKGROUND CH patients are presenting a higher prevalence of comorbidities, among which the use of psychoactive substances, licit or illicit, have been explored by a few authors. Recently, 3 cases of CH in patients seen in the hospital-based addiction care center have been reported to the Toulouse addictovigilance center. METHODS Other cases have been identified in the same tertiary hospital after a collaborative investigation done with the departments of neurology and psychiatry and included in the case series. A narrative review was performed to assess the potential of psychoactive substance consumption to induce or facilitate CH. RESULTS From 2016 to 2018, 6 males and 1 female aged between 26 and 54 years old, presenting CH criteria and a substance use disorder, were included in our case series. Among substances used, there are: (1) daily use of tobacco and alcohol in 5/7 subjects; (2) daily or almost daily use of cocaine in 5/7 subjects; (3) regular use of cannabis before attacks beginning in 4/7 subjects; and (4) opioids, as a substitutive medication or abused, in 5/7 subjects. The intranasal route administration is reported by all the subjects and precedes the beginning of attacks for 5/7 subjects. CONCLUSIONS We have found a CH prevalence of 0.9% in our studied population, while it is estimated at 0.1% in the general population. The coexistence of cluster headache and addiction behaviors reflects possible common neurobiological pathways, which would include the hypothalamus. Research could be conducted on the potential of hypothalamic therapeutic targets.
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Affiliation(s)
- Camille Ponté
- Service de Pharmacologie Médicale et Clinique, Centre d'Evaluation et Information sur la Pharmacodépendance-Addictovigilance, Faculté de Médecine, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Aurélie Giron
- Service de Psychiatrie et Psychologie, Université de Toulouse III, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Marie Crequy
- Service Universitaire de Psychiatrie et Psychologie Médicale, Centre de Soins d'Accompagnement et de Prévention en Addictologie, Hopital La Grave, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Maryse Lapeyre-Mestre
- Service de Pharmacologie Médicale et Clinique, Centre d'Evaluation et Information sur la Pharmacodépendance-Addictovigilance, INSERM UMR 1027, CIC INSERM 1436, Faculté de Médecine, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Nelly Fabre
- Departement de Neurologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Juliette Salles
- Service de Psychiatrie et Psychologie, INSERM UMR 1043, Université de Toulouse III, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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Müller UJ, Mawrin C, Frodl T, Dobrowolny H, Busse S, Bernstein HG, Bogerts B, Truebner K, Steiner J. Reduced volumes of the external and internal globus pallidus in male heroin addicts: a postmortem study. Eur Arch Psychiatry Clin Neurosci 2019; 269:317-324. [PMID: 30173319 DOI: 10.1007/s00406-018-0939-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/22/2018] [Indexed: 01/11/2023]
Abstract
Deep brain stimulation (DBS) of the globus pallidus internus was recently proposed as a potential new treatment target for opioid addiction. DBS requires computer-assisted-3D planning to implant the stimulation electrode precisely. As volumes of brain regions may differ in addiction compared to healthy controls, our aim was to investigate possible volume differences in addicts compared to healthy controls. Volumes of the globus pallidus externus (PE) and internus (PI) in heroin addicts (n = 14) and healthy controls (n = 12) were assessed using morphometry of serial whole-brain sections. Total brain volume was larger in the heroin group (mean 1479 ± 62 cm3 vs. mean 1352 ± 103 cm3), as the heroin group was more than 10 years younger (p = 0.001). Despite larger mean whole brain volume, the mean relative volume of the PE and PI was smaller in addicted subjects compared to healthy controls (PE 0.658 ± 0.183 × 10-3 vs. 0.901 ± 0.284 × 10-3; ANOVA F(1, 24) = 6.945, p = 0.014, η2 = 0.224; PI 0.253 ± 0.095 × 10-3 vs. 0.345 ± 0.107 × 10-3; ANOVA F(1, 24) = 5.374, p = 0.029, η2 = 0.183). These findings were not significantly confounded by age, duration of autolysis, and fixation time. Our results provide further evidence for structural and not only functional deficits of the globus pallidus in addiction. In the context of previous studies, our findings support the idea of shared pathophysiological processes between comorbid depression and impulsivity in opioid addiction.
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Affiliation(s)
- Ulf J Müller
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany. .,Center for Behavioral Brain Sciences, Magdeburg, Germany. .,Department of Psychiatry and Psychotherapy, Saarland University, 66421, Homburg, Germany.
| | - Christian Mawrin
- Center for Behavioral Brain Sciences, Magdeburg, Germany.,Department of Neuropathology, University of Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Stefan Busse
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany
| | - Hans-Gert Bernstein
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Bernhard Bogerts
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Kurt Truebner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, University of Magdeburg, 39120, Magdeburg, Germany. .,Center for Behavioral Brain Sciences, Magdeburg, Germany.
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