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Courtney KE, Liu W, Andrade G, Schulze J, Doran N. Attentional Bias, Pupillometry, and Spontaneous Blink Rate: Eye Characteristic Assessment Within a Translatable Nicotine Cue Virtual Reality Paradigm. JMIR Serious Games 2024; 12:e54220. [PMID: 38952012 PMCID: PMC11220568 DOI: 10.2196/54220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/05/2024] [Accepted: 06/01/2024] [Indexed: 07/03/2024] Open
Abstract
Background Incentive salience processes are important for the development and maintenance of addiction. Eye characteristics such as gaze fixation time, pupil diameter, and spontaneous eyeblink rate (EBR) are theorized to reflect incentive salience and may serve as useful biomarkers. However, conventional cue exposure paradigms have limitations that may impede accurate assessment of these markers. Objective This study sought to evaluate the validity of these eye-tracking metrics as indicators of incentive salience within a virtual reality (VR) environment replicating real-world situations of nicotine and tobacco product (NTP) use. Methods NTP users from the community were recruited and grouped by NTP use patterns: nondaily (n=33) and daily (n=75) use. Participants underwent the NTP cue VR paradigm and completed measures of nicotine craving, NTP use history, and VR-related assessments. Eye-gaze fixation time (attentional bias) and pupillometry in response to NTP versus control cues and EBR during the active and neutral VR scenes were recorded and analyzed using ANOVA and analysis of covariance models. Results Greater subjective craving, as measured by the Tobacco Craving Questionnaire-Short Form, following active versus neutral scenes was observed (F1,106=47.95; P<.001). Greater mean eye-gaze fixation time (F1,106=48.34; P<.001) and pupil diameter (F1,102=5.99; P=.02) in response to NTP versus control cues were also detected. Evidence of NTP use group effects was observed in fixation time and pupillometry analyses, as well as correlations between these metrics, NTP use history, and nicotine craving. No significant associations were observed with EBR. Conclusions This study provides additional evidence for attentional bias, as measured via eye-gaze fixation time, and pupillometry as useful biomarkers of incentive salience, and partially supports theories suggesting that incentive salience diminishes as nicotine dependence severity increases.
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Affiliation(s)
| | - Weichen Liu
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States
| | - Gianna Andrade
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Jurgen Schulze
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States
| | - Neal Doran
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Veterans Affairs San Diego Healthcare System, La Jolla, CA, United States
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2
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Lehmann CM, Miller NE, Nair VS, Costa KM, Schoenbaum G, Moussawi K. Generalized cue reactivity in dopamine neurons after opioids. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.02.597025. [PMID: 38853878 PMCID: PMC11160774 DOI: 10.1101/2024.06.02.597025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Cue reactivity is the maladaptive neurobiological and behavioral response upon exposure to drug cues and is a major driver of relapse. The leading hypothesis is that dopamine release by addictive drugs represents a persistently positive reward prediction error that causes runaway enhancement of dopamine responses to drug cues, leading to their pathological overvaluation compared to non-drug reward alternatives. However, this hypothesis has not been directly tested. Here we developed Pavlovian and operant procedures to measure firing responses, within the same dopamine neurons, to drug versus natural reward cues, which we found to be similarly enhanced compared to cues predicting natural rewards in drug-naïve controls. This enhancement was associated with increased behavioral reactivity to the drug cue, suggesting that dopamine release is still critical to cue reactivity, albeit not as previously hypothesized. These results challenge the prevailing hypothesis of cue reactivity, warranting new models of dopaminergic function in drug addiction, and provide critical insights into the neurobiology of cue reactivity with potential implications for relapse prevention.
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Affiliation(s)
- Collin M. Lehmann
- Department of Psychiatry, University of Pittsburgh; Pittsburgh, 15219, USA
| | - Nora E. Miller
- Department of Psychiatry, University of Pittsburgh; Pittsburgh, 15219, USA
| | - Varun S. Nair
- Department of Psychiatry, University of Pittsburgh; Pittsburgh, 15219, USA
| | - Kauê M. Costa
- Department of Psychology, University of Alabama at Birmingham; Birmingham, 35233, USA
| | - Geoffrey Schoenbaum
- National Institute on Drug Abuse, National Institutes of Health; Baltimore, 21224, USA
| | - Khaled Moussawi
- Department of Psychiatry, University of Pittsburgh; Pittsburgh, 15219, USA
- Department of Neurology, University of California San Francisco; San Francisco, 94158, USA
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3
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Wheeler AR, Truckenbrod LM, Cooper EM, Betzhold SM, Setlow B, Orsini CA. Effects of fentanyl self-administration on risk-taking behavior in male rats. Psychopharmacology (Berl) 2023; 240:2529-2544. [PMID: 37612455 PMCID: PMC10878692 DOI: 10.1007/s00213-023-06447-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
RATIONALE Individuals with opioid use disorder (OUD) exhibit impaired decision making and elevated risk-taking behavior. In contrast to the effects of natural and semi-synthetic opioids, however, the impact of synthetic opioids on decision making is still unknown. OBJECTIVES The objective of the current study was to determine how chronic exposure to the synthetic opioid fentanyl alters risk-based decision making in adult male rats. METHODS Male rats underwent 14 days of intravenous fentanyl or oral sucrose self-administration. After 3 weeks of abstinence, rats were tested in a decision-making task in which they chose between a small, safe food reward and a large food reward accompanied by variable risk of footshock punishment. Following testing in the decision-making task, rats were tested in control assays that assessed willingness to work for food and shock reactivity. Lastly, rats were tested on a probabilistic reversal learning task to evaluate enduring effects of fentanyl on behavioral flexibility. RESULTS Relative to rats in the sucrose group, rats in the fentanyl group displayed greater choice of the large, risky reward (risk taking), an effect that was present as long as 7 weeks into abstinence. This increased risk taking was driven by enhanced sensitivity to the large rewards and diminished sensitivity to punishment. The fentanyl-induced elevation in risk taking was not accompanied by alterations in food motivation or shock reactivity or impairments in behavioral flexibility. CONCLUSIONS Results from the current study reveal that the synthetic opioid fentanyl leads to long-lasting increases in risk taking in male rats. Future experiments will extend this work to females and identify neural mechanisms that underlie these drug-induced changes in risk taking.
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Affiliation(s)
- Alexa-Rae Wheeler
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - Leah M Truckenbrod
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - Emily M Cooper
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Sara M Betzhold
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Barry Setlow
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
- Center for Addiction Research and Education, University of Florida, Gainesville, FL, USA
| | - Caitlin A Orsini
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX, USA.
- Department of Psychology, University of Texas at Austin, Austin, TX, USA.
- Department of Neurology, University of Texas at Austin, Austin, TX, USA.
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX, USA.
- Department of Psychology & Neurology, Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, 1601B Trinity Street, Austin, TX, 78712, USA.
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4
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A neuroeconomic signature of opioid craving: How fluctuations in craving bias drug-related and nondrug-related value. Neuropsychopharmacology 2022; 47:1440-1448. [PMID: 34916590 PMCID: PMC9205977 DOI: 10.1038/s41386-021-01248-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022]
Abstract
How does craving bias decisions to pursue drugs over other valuable, and healthier, alternatives in addiction? To address this question, we measured the in-the-moment economic decisions of people with opioid use disorder as they experienced craving, shortly after receiving their scheduled opioid maintenance medication and ~24 h later. We found that higher cravers had higher drug-related valuation, and that moments of higher craving within-person also led to higher drug-related valuation. When experiencing increased opioid craving, participants were willing to pay more for personalized consumer items and foods more closely related to their drug use, but not for alternative "nondrug-related" but equally desirable options. This selective increase in value with craving was greater when the drug-related options were offered in higher quantities and was separable from the effects of other fluctuating psychological states like negative mood. These findings suggest that craving narrows and focuses economic motivation toward the object of craving by selectively and multiplicatively amplifying perceived value along a "drug relatedness" dimension.
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Liu W, Andrade G, Schulze J, Doran N, Courtney KE. Using Virtual Reality to Induce and Assess Objective Correlates of Nicotine Craving: Paradigm Development Study. JMIR Serious Games 2022; 10:e32243. [PMID: 35166685 PMCID: PMC8889474 DOI: 10.2196/32243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Craving is a clinically important phenotype for the development and maintenance of nicotine addiction. Virtual reality (VR) paradigms are successful in eliciting cue-induced subjective craving and may even elicit stronger craving than traditional picture-cue methods. However, few studies have leveraged the advances of this technology to improve the assessment of craving. OBJECTIVE This report details the development of a novel, translatable VR paradigm designed to both elicit nicotine craving and assess multiple eye-related characteristics as potential objective correlates of craving. METHODS A VR paradigm was developed, which includes three Active scenes with nicotine and tobacco product (NTP) cues present, and three Neutral scenes devoid of NTP cues. A pilot sample (N=31) of NTP users underwent the paradigm and completed subjective measures of nicotine craving, sense of presence in the VR paradigm, and VR-related sickness. Eye-gaze fixation time ("attentional bias") and pupil diameter toward Active versus Neutral cues, as well as spontaneous blink rate during the Active and Neutral scenes, were recorded. RESULTS The NTP Cue VR paradigm was found to elicit a moderate sense of presence (mean Igroup Presence Questionnaire score 60.05, SD 9.66) and low VR-related sickness (mean Virtual Reality Sickness Questionnaire score 16.25, SD 13.94). Scene-specific effects on attentional bias and pupil diameter were observed, with two of the three Active scenes eliciting greater NTP versus control cue attentional bias and pupil diameter (Cohen d=0.30-0.92). The spontaneous blink rate metrics did not differ across Active and Neutral scenes. CONCLUSIONS This report outlines the development of the NTP Cue VR paradigm. Our results support the potential of this paradigm as an effective laboratory-based cue-exposure task and provide early evidence of the utility of attentional bias and pupillometry, as measured during VR, as useful markers for nicotine addiction.
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Affiliation(s)
- Weichen Liu
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States
| | - Gianna Andrade
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Jurgen Schulze
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States
| | - Neal Doran
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Veterans Affairs San Diego Healthcare System, La Jolla, CA, United States
| | - Kelly E Courtney
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
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6
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Tolomeo S, Steele JD, Ekhtiari H, Baldacchino A. Chronic heroin use disorder and the brain: Current evidence and future implications. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110148. [PMID: 33169674 DOI: 10.1016/j.pnpbp.2020.110148] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/10/2020] [Accepted: 10/17/2020] [Indexed: 11/18/2022]
Abstract
The incidence of chronic heroin use disorder, including overdose deaths, has reached epidemic proportions. Here we summarise and evaluate our knowledge of the relationship between chronic heroin use disorder and the brain through a narrative review. A broad range of areas was considered including causal mechanisms, cognitive and neurological consequences of chronic heroin use and novel neuroscience-based clinical interventions. Chronic heroin use is associated with limited or very limited evidence of impairments in memory, cognitive impulsivity, non-planning impulsivity, compulsivity and decision-making. Additionally, there is some evidence for certain neurological disorders being caused by chronic heroin use, including toxic leukoencephalopathy and neurodegeneration. However, there is insufficient evidence on whether these impairments and disorders recover after abstinence. Whilst there is a high prevalence of comorbid psychiatric disorders, there is no clear evidence that chronic heroin use per se causes depression, bipolar disorder, PTSD and/or psychosis. Despite the growing burden on society from heroin use, knowledge of the long-term effects of chronic heroin use disorder on the brain remains limited. Nevertheless, there is evidence for progress in neuroscience-based interventions being made in two areas: assessment (cognitive assessment and neuroimaging) and interventions (cognitive training/remediation and neuromodulation). Longitudinal studies are needed to unravel addiction and neurotoxic mechanisms and clarify the role of pre-existing psychiatric symptoms and cognitive impairments.
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Affiliation(s)
- Serenella Tolomeo
- Department of Psychology, National University of Singapore (NUS), Singapore.
| | - J Douglas Steele
- School of Medicine, University of Dundee and Department of Neurology, NHS Tayside, Ninewells Hospital and Medical School, UK
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA
| | - Alex Baldacchino
- Division of Population and Behavioural Sciences, University of St Andrews, Fife, Scotland, United Kingdom
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7
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Shi Z, Jagannathan K, Padley JH, Wang A, Fairchild VP, O'Brien CP, Childress AR, Langleben DD. The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder. Addict Biol 2021; 26:e12977. [PMID: 33098179 DOI: 10.1111/adb.12977] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023]
Abstract
Opioid use disorder (OUD) is characterized by heightened cognitive, physiological, and neural responses to opioid-related cues that are mediated by mesocorticolimbic brain pathways. Craving and withdrawal are key symptoms of addiction that persist during physiological abstinence. The present study evaluated the relationship between the brain response to drug cues in OUD and baseline levels of craving and withdrawal. We used functional magnetic resonance imaging (fMRI) to examine brain responses to opioid-related pictures and control pictures in 29 OUD patients. Baseline measures of drug use severity, opioid craving, and withdrawal symptoms were assessed prior to cue exposure and correlated with subsequent brain responses to drug cues. Mediation analysis was conducted to test the indirect effect of drug use severity on brain cue reactivity through craving and withdrawal symptoms. We found that baseline drug use severity and opioid withdrawal symptoms, but not craving, were positively associated with the neural response to drug cues in the nucleus accumbens, orbitofrontal cortex, and amygdala. Withdrawal, but not craving, mediated the effect of drug use severity on the nucleus accumbens' response to drug cues. We did not find similar effects for the neural responses to stimuli unrelated to drugs. Our findings emphasize the central role of withdrawal symptoms as the mediator between the clinical severity of OUD and the brain correlates of sensitization to opioid-related cues. They suggest that in OUD, baseline withdrawal symptoms signal a high vulnerability to drug cues.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Kanchana Jagannathan
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - James H. Padley
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - An‐Li Wang
- Department of Psychiatry Icahn School of Medicine at Mount Sinai New York New York USA
| | - Victoria P. Fairchild
- Department of Psychology, Queens College The City University of New York New York New York USA
| | - Charles P. O'Brien
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Daniel D. Langleben
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
- Annenberg Public Policy Center University of Pennsylvania Philadelphia Pennsylvania USA
- Behavioral Health Service Corporal Michael J. Crescenz Veterans Administration Medical Center Philadelphia Pennsylvania USA
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8
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Leyton M. Ubiquitous Dopamine Deficit Hypotheses in Cocaine Use Disorder Lack Support. Am J Psychiatry 2021; 178:469. [PMID: 33979542 DOI: 10.1176/appi.ajp.2021.20111581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Marco Leyton
- Department of Psychiatry, McGill University, Montreal
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9
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Mill RD, Winfield EC, Cole MW, Ray S. Structural MRI and functional connectivity features predict current clinical status and persistence behavior in prescription opioid users. NEUROIMAGE-CLINICAL 2021; 30:102663. [PMID: 33866300 PMCID: PMC8060550 DOI: 10.1016/j.nicl.2021.102663] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/24/2021] [Accepted: 04/02/2021] [Indexed: 01/10/2023]
Abstract
Prescription opioid use disorder (POUD) has reached epidemic proportions in the United States, raising an urgent need for diagnostic biological tools that can improve predictions of disease characteristics. The use of neuroimaging methods to develop such biomarkers have yielded promising results when applied to neurodegenerative and psychiatric disorders, yet have not been extended to prescription opioid addiction. With this long-term goal in mind, we conducted a preliminary study in this understudied clinical group. Univariate and multivariate approaches to distinguishing between POUD (n = 26) and healthy controls (n = 21) were investigated, on the basis of structural MRI (sMRI) and resting-state functional connectivity (restFC) features. Univariate approaches revealed reduced structural integrity in the subcortical extent of a previously reported addiction-related network in POUD subjects. No reliable univariate between-group differences in cortical structure or edgewise restFC were observed. Contrasting these mixed univariate results, multivariate machine learning classification approaches recovered more statistically reliable group differences, especially when sMRI and restFC features were combined in a multi-modal model (classification accuracy = 66.7%, p < .001). The same multivariate multi-modal approach also yielded reliable prediction of individual differences in a clinically relevant behavioral measure (persistence behavior; predicted-to-actual overlap r = 0.42, p = .009). Our findings suggest that sMRI and restFC measures can be used to reliably distinguish the neural effects of long-term opioid use, and that this endeavor numerically benefits from multivariate predictive approaches and multi-modal feature sets. This can serve as theoretical proof-of-concept for future longitudinal modeling of prognostic POUD characteristics from neuroimaging features, which would have clearer clinical utility.
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Affiliation(s)
- Ravi D Mill
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Emily C Winfield
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Michael W Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA
| | - Suchismita Ray
- Department of Health Informatics, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ 07103, USA.
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10
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Lueptow LM, Shashkova EC, Miller MG, Evans CJ, Cahill CM. Insights into the Neurobiology of Craving in Opioid Use Disorder. CURRENT ANESTHESIOLOGY REPORTS 2021; 10:378-387. [PMID: 33424457 DOI: 10.1007/s40140-020-00420-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose of review Opioids remain the most potent form of pain relief currently available, yet have a high abuse liability. Here we discuss underlying neurobiological changes in Opioid Use Disorder (OUD) that likely contribute to drug craving, which in turn drives continued drug use and relapse. Recent findings Craving has emerged as a strong indicator in drug-seeking and relapse. Studies have demonstrated a number of allostatic changes in circuitry that facilitate learning of drug-stimuli relationships, thereby augmenting cue-triggered drug use and relapse. Summary This review will focus on key neurobiological changes in underlying circuitry observed during the initial and continued exposure to opioids that result in an increase in neural-reactivity to drug-related intrinsic and extrinsic drug cues, and to enhanced learning of drug-context correlations. This sensitized learning state may be an indication of the underlying framework that drives craving and ultimately, motivates increased salience of drug cues and drives drug-seeking.
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Affiliation(s)
- Lindsay M Lueptow
- Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90095, USA.,Shirley and Stefan Hatos Center for Neuropharmacology, Los Angeles, CA, 90095, USA.,Department of Psychology at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Elizabeth C Shashkova
- Shirley and Stefan Hatos Center for Neuropharmacology, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Margaret G Miller
- Shirley and Stefan Hatos Center for Neuropharmacology, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Christopher J Evans
- Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90095, USA.,Shirley and Stefan Hatos Center for Neuropharmacology, Los Angeles, CA, 90095, USA.,Jane & Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Catherine M Cahill
- Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90095, USA.,Shirley and Stefan Hatos Center for Neuropharmacology, Los Angeles, CA, 90095, USA.,Jane & Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, Los Angeles, CA, 90095, USA
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11
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Koob GF. Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development. Pharmacol Rev 2021; 73:163-201. [PMID: 33318153 PMCID: PMC7770492 DOI: 10.1124/pharmrev.120.000083] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Compulsive drug seeking that is associated with addiction is hypothesized to follow a heuristic framework that involves three stages (binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation) and three domains of dysfunction (incentive salience/pathologic habits, negative emotional states, and executive function, respectively) via changes in the basal ganglia, extended amygdala/habenula, and frontal cortex, respectively. This review focuses on neurochemical/neurocircuitry dysregulations that contribute to hyperkatifeia, defined as a greater intensity of negative emotional/motivational signs and symptoms during withdrawal from drugs of abuse in the withdrawal/negative affect stage of the addiction cycle. Hyperkatifeia provides an additional source of motivation for compulsive drug seeking via negative reinforcement. Negative reinforcement reflects an increase in the probability of a response to remove an aversive stimulus or drug seeking to remove hyperkatifeia that is augmented by genetic/epigenetic vulnerability, environmental trauma, and psychiatric comorbidity. Neurobiological targets for hyperkatifeia in addiction involve neurocircuitry of the extended amygdala and its connections via within-system neuroadaptations in dopamine, enkephalin/endorphin opioid peptide, and γ-aminobutyric acid/glutamate systems and between-system neuroadaptations in prostress corticotropin-releasing factor, norepinephrine, glucocorticoid, dynorphin, hypocretin, and neuroimmune systems and antistress neuropeptide Y, nociceptin, endocannabinoid, and oxytocin systems. Such neurochemical/neurocircuitry dysregulations are hypothesized to mediate a negative hedonic set point that gradually gains allostatic load and shifts from a homeostatic hedonic state to an allostatic hedonic state. Based on preclinical studies and translational studies to date, medications and behavioral therapies that reset brain stress, antistress, and emotional pain systems and return them to homeostasis would be promising new targets for medication development. SIGNIFICANCE STATEMENT: The focus of this review is on neurochemical/neurocircuitry dysregulations that contribute to hyperkatifeia, defined as a greater intensity of negative emotional/motivational signs and symptoms during withdrawal from drugs of abuse in the withdrawal/negative affect stage of the drug addiction cycle and a driving force for negative reinforcement in addiction. Medications and behavioral therapies that reverse hyperkatifeia by resetting brain stress, antistress, and emotional pain systems and returning them to homeostasis would be promising new targets for medication development.
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Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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12
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Zakiniaeiz Y, Cosgrove KP. Designing Neuroimaging Studies to Help Inform the Clinical Treatment of Addiction. Biol Psychiatry 2020; 88:741-743. [PMID: 33092691 PMCID: PMC11265605 DOI: 10.1016/j.biopsych.2020.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Yasmin Zakiniaeiz
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut; Yale Positron Emission Tomography Center, Yale University, New Haven, Connecticut
| | - Kelly P Cosgrove
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut; Yale Positron Emission Tomography Center, Yale University, New Haven, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut.
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13
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Moussawi K, Ortiz MM, Gantz SC, Tunstall BJ, Marchette RCN, Bonci A, Koob GF, Vendruscolo LF. Fentanyl vapor self-administration model in mice to study opioid addiction. SCIENCE ADVANCES 2020; 6:eabc0413. [PMID: 32821843 PMCID: PMC7406365 DOI: 10.1126/sciadv.abc0413] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/17/2020] [Indexed: 05/23/2023]
Abstract
Intravenous drug self-administration is considered the "gold standard" model to investigate the neurobiology of drug addiction in rodents. However, its use in mice is limited by frequent complications of intravenous catheterization. Given the many advantages of using mice in biomedical research, we developed a noninvasive mouse model of opioid self-administration using vaporized fentanyl. Mice readily self-administered fentanyl vapor, titrated their drug intake, and exhibited addiction-like behaviors, including escalation of drug intake, somatic signs of withdrawal, drug intake despite punishment, and reinstatement of drug seeking. Electrophysiological recordings from ventral tegmental area dopamine neurons showed a lower amplitude of GABAB receptor-dependent currents during protracted abstinence from fentanyl vapor self-administration. This mouse model of fentanyl self-administration recapitulates key features of opioid addiction, overcomes limitations of the intravenous model, and allows investigation of the neurobiology of opioid addiction in unprecedented ways.
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Affiliation(s)
- K. Moussawi
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
- Neurology Department, Johns Hopkins Medicine, Baltimore, MD, USA
| | - M. M. Ortiz
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - S. C. Gantz
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
- Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, USA
| | - B. J. Tunstall
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - R. C. N. Marchette
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - A. Bonci
- Global Institutes on Addictions, Miami, FL, USA
| | - G. F. Koob
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - L. F. Vendruscolo
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
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Kleykamp BA, De Santis M, Dworkin RH, Huhn AS, Kampman KM, Montoya ID, Preston KL, Ramey T, Smith SM, Turk DC, Walsh R, Weiss RD, Strain EC. Craving and opioid use disorder: A scoping review. Drug Alcohol Depend 2019; 205:107639. [PMID: 31683241 DOI: 10.1016/j.drugalcdep.2019.107639] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/06/2019] [Accepted: 08/30/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The subjective experience of drug craving is a prominent and common clinical phenomenon for many individuals diagnosed with opioid use disorder (OUD), and could be a valuable clinical endpoint in medication development studies. The purpose of this scoping review is to provide an overview and critical analysis of opioid craving assessments located in the published literature examining OUD. METHOD Studies were identified through a search of PubMed, Embase, and PsychInfo databases and included for review if opioid craving was the focus and participants were diagnosed with or in treatment for OUD. RESULTS Fifteen opioid craving assessment instruments were identified across the 87 studies included for review. The most common were the Visual Analog Scale (VAS, 41 studies), Desires for Drug Questionnaire (DDQ, 12 studies), Heroin Craving Questionnaire (HCQ, 10 studies), and Obsessive-Compulsive Drug Use Scale (OCDUS, 10 studies). Craving assessments varied considerably in their format, content, time frame, and underlying subscales, and only 6 of 15 had been psychometrically evaluated. DISCUSSION This review identified a variety of opioid craving assessments, but few had been evaluated for their psychometric properties making it difficult to ascertain whether craving is being assessed optimally in studies of OUD. Thus, the development of a reliable and valid opioid craving assessment would be worthwhile and could be guided by recently published Food and Drug Administration Clinical Outcome Assessment (COA) guidelines. Importantly, a COA focused on opioid craving could be a valuable addition to research studies designed to evaluate novel treatments for OUD.
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Affiliation(s)
- Bethea A Kleykamp
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, USA.
| | | | - Robert H Dworkin
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, USA
| | - Andrew S Huhn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kyle M Kampman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kenzie L Preston
- Clinical Pharmacology and Therapeutics Research Branch, National Institute on Drug Abuse, Baltimore, MD, USA
| | - Tanya Ramey
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Shannon M Smith
- Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, USA
| | - Dennis C Turk
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Robert Walsh
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Roger D Weiss
- McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Eric C Strain
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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15
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Kiluk BD, Yip SW, DeVito EE, Carroll KM, Sofuoglu M. Anhedonia as a key clinical feature in the maintenance and treatment of opioid use disorder. Clin Psychol Sci 2019; 7:1190-1206. [PMID: 32042509 PMCID: PMC7009780 DOI: 10.1177/2167702619855659] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
There is a critical need for research on clinical features that may influence response to treatment for opioid use disorder (OUD). Given its neurobiology and relevance to opioid use, anhedonia may be one such promising clinical feature. We identified and reviewed 11 studies that measured anhedonia in humans with OUD to characterize the current state of evidence and highlight potential implications for treatment. The majority of studies were cross-sectional, indicating higher anhedonia scores in opioid-dependent samples compared to healthy controls. Rates of participants with clinically significant anhedonia ranged from 21% to 48%. Anhedonia scores were correlated with opioid craving and use, however there are significant knowledge gaps regarding its time course and impact on treatment adherence and outcomes. Repeated assessment of anhedonia early in treatment for OUD is recommended, as it may be a unique predictor of dropout or non-response, and a potential target for behavioral and/or pharmacological intervention.
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16
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Spagnolo PA, Kimes A, Schwandt ML, Shokri-Kojori E, Thada S, Phillips KA, Diazgranados N, Preston KL, Herscovitch P, Tomasi D, Ramchandani VA, Heilig M. Striatal Dopamine Release in Response to Morphine: A [ 11C]Raclopride Positron Emission Tomography Study in Healthy Men. Biol Psychiatry 2019; 86:356-364. [PMID: 31097294 PMCID: PMC6699765 DOI: 10.1016/j.biopsych.2019.03.965] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 02/04/2019] [Accepted: 03/05/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Preclinical and human positron emission tomography studies have produced inconsistent results regarding the effects of opioids on mesolimbic dopamine (DA). Here, we quantify striatal DA release (measured by [11C]raclopride displacement) in response to an intravenous infusion of morphine, and its relationship with morphine-induced subjective effects, in healthy, nondependent opioid-experienced participants. METHODS Fifteen healthy male participants were initially included. Sessions were on separate days. On session 1, participants received intravenous morphine (10 mg/70 kg) in the clinic to ensure tolerability. Participants without adverse reactions (n = 10) then received intravenous morphine and placebo (saline) sessions, in counterbalanced order, while undergoing [11C]raclopride positron emission tomography scans. Subjective and physiological responses were assessed. Region-of-interest and voxelwise image analyses were used to assess changes in [11C]raclopride nondisplaceable binding potential. RESULTS Morphine produced marked subjective and physiological effects and induced a significant decrease in [11C]raclopride nondisplaceable binding potential, particularly in the nucleus accumbens and globus pallidus, where the change in [11C]raclopride nondisplaceable binding potential was approximately 9%. However, the subjective effects of morphine did not show a simple pattern of correlation with DA release. CONCLUSIONS This is, to our knowledge, the first study providing in vivo human evidence that DA transmission in the ventral striatum is affected by morphine. Further studies are required to fully delineate the DA contribution to the reinforcing effects of opioids.
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Affiliation(s)
- Primavera A Spagnolo
- Human Motor Control Section, National Institute on Neurological Disorders and Stroke, National Instutes of Health, Bethesda, Maryland
| | - Alane Kimes
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Instutes of Health, Bethesda, Maryland
| | - Ehsan Shokri-Kojori
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Instutes of Health, Bethesda, Maryland
| | - Shantalaxmi Thada
- Positron Emission Tomography Department, Clinical Center, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Karran A Phillips
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Instutes of Health, Bethesda, Maryland
| | - Kenzie L Preston
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Peter Herscovitch
- Positron Emission Tomography Department, Clinical Center, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland
| | - Dardo Tomasi
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Instutes of Health, Bethesda, Maryland
| | - Vijay A Ramchandani
- Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, National Instutes of Health, Bethesda, Maryland.
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden.
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Li Y, Li Q, Li W, Chen J, Hu F, Liu Y, Wei X, Zhu J, Liu J, Ye J, Shi H, Wang Y, Wang W. The polymorphism of dopamine D2 receptor TaqIA gene is associated with brain response to drug cues in male heroin-dependent individuals during methadone maintenance treatment. Drug Alcohol Depend 2019; 198:150-157. [PMID: 30928885 DOI: 10.1016/j.drugalcdep.2019.01.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/21/2018] [Accepted: 01/16/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Polymorphism of the dopamine D2 receptor TaqIA gene is related to reward response, relapse risks and effect of therapy for drug addiction. Whether the cue-induced craving and brain response was related to dopamine D2 receptor TaqIA gene is unknown. METHODS Forty-nine male heroin-dependent individuals [31 with A1 allele of the TaqIA (A1+), 18 A2 allele carriers (A1-)] under methadone maintenance treatment and 20 healthy control subjects performed a heroin cue-reactivity task during functional magnetic resonance imaging. Cue-elicited craving was measured. Difference in cue induced craving and brain response were analyzed among the three groups. Correlation analyses between craving and differential brain response, heroin use and treatment history were performed within A1+ and A1- group respectively. RESULTS Compared with A1- group, A1+ group showed greater cue-induced response in the ventrolateral prefrontal cortex, medial orbitofrontal gyrus, dorsomedial prefrontal cortex, pallidum, putamen, thalamus, superior parietal lobule and superior occipital gyrus. No difference in craving was found. The response in right thalamus positively correlated with daily heroin and methadone dose in A1+ group. For A1- group, response in left ventral orbitofrontal cortex, medial orbitofrontal gyrus, ventral anterior cingulate cortex, caudate, precuneus, calcarine and bilateral pallidum negatively correlated with duration of heroin use. The response in left ventral orbitofrontal cortex, medial orbitofrontal gyrus, bilateral calcarine and right cerebellum negatively correlated with duration of methadone maintenance treatment in A1- group. CONCLUSIONS The findings supported that A1 allele of the TaqIA is associated with higher salience allocation to heroin-related cues in heroin-dependent patients.
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Affiliation(s)
- Yongbin Li
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China; Department of Radiology, The Second Affliated Hospital of Xi'an Medical College, Xi'an, 167 Fangdong Street, Baqiao District, China
| | - Qiang Li
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Wei Li
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Jiajie Chen
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Feng Hu
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Yan Liu
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Xuan Wei
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Jia Zhu
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Jierong Liu
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Jianjun Ye
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Hong Shi
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China
| | - Yarong Wang
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China; Department of Radiology, The First Affliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Yanta District, Xi'an 710061, China.
| | - Wei Wang
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, 569 Xinsi Road, Baqiao District, China.
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18
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Kamp F, Proebstl L, Penzel N, Adorjan K, Ilankovic A, Pogarell O, Koller G, Soyka M, Falkai P, Koutsouleris N, Kambeitz J. Effects of sedative drug use on the dopamine system: a systematic review and meta-analysis of in vivo neuroimaging studies. Neuropsychopharmacology 2019; 44:660-667. [PMID: 30188512 PMCID: PMC6372711 DOI: 10.1038/s41386-018-0191-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/31/2018] [Accepted: 08/03/2018] [Indexed: 12/11/2022]
Abstract
Use of alcohol, cannabis and opioids is highly prevalent and is associated with global disease burden and high economic costs. The exact pathophysiology of abuse or addiction associated with these sedative substances is not completely understood, but previous research implicates the important role of the striatal dopamine system in the addiction process. Multiple studies investigated changes in the striatal dopamine systems of users of sedative substances, but currently these results are very heterogeneous. Therefore, we conducted a meta-analysis of in vivo neuroimaging studies investigating dopaminergic alterations in the striatum of users of alcohol, opioids or cannabis. Analyses for each substance were conducted separately for the availability of D2/D3 dopamine receptors, dopamine transporters and dopamine synthesis capacity. In total, 723 substance users and 752 healthy controls were included. The results indicated a significant lower striatal D2/D3 receptor availability in alcohol users compared to controls (g = 0.46) but no difference in dopamine transporter availability or dopamine synthesis capacity. Our analysis indicated that changes of dopamine receptors and transporters are moderated by the duration of abstinence. Comparing opioid users with controls revealed a significant lower D2/D3 receptor availability (g = 1.17) and a significantly lower transporter availability (g = 1.55) in opioid users. For cannabis users, there was no significant difference in receptor availability compared to controls and too few studies provided information on dopamine transporter availability or synthesis capacity. Our analysis provides strong evidence for a central role of the striatal dopamine system in use of alcohol or opioids. Further studies are needed to clarify the impact of the dopamine system in cannabis users.
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Affiliation(s)
- Felicia Kamp
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - Lisa Proebstl
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nora Penzel
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Kristina Adorjan
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,0000 0004 1936 973Xgrid.5252.0Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Andrej Ilankovic
- 0000 0001 2166 9385grid.7149.bClinic of Psychiatry, Medical School, University of Belgrade, Belgrade, Serbia
| | - Oliver Pogarell
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Gabi Koller
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael Soyka
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter Falkai
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nikolaos Koutsouleris
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Joseph Kambeitz
- 0000 0004 1936 973Xgrid.5252.0Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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19
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Burns JA, Kroll DS, Feldman DE, Kure Liu C, Manza P, Wiers CE, Volkow ND, Wang GJ. Molecular Imaging of Opioid and Dopamine Systems: Insights Into the Pharmacogenetics of Opioid Use Disorders. Front Psychiatry 2019; 10:626. [PMID: 31620026 PMCID: PMC6759955 DOI: 10.3389/fpsyt.2019.00626] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 08/05/2019] [Indexed: 12/21/2022] Open
Abstract
Opioid use in the United States has steadily risen since the 1990s, along with staggering increases in addiction and overdose fatalities. With this surge in prescription and illicit opioid abuse, it is paramount to understand the genetic risk factors and neuropsychological effects of opioid use disorder (OUD). Polymorphisms disrupting the opioid and dopamine systems have been associated with increased risk for developing substance use disorders. Molecular imaging studies have revealed how these polymorphisms impact the brain and contribute to cognitive and behavioral differences across individuals. Here, we review the current molecular imaging literature to assess how genetic variations in the opioid and dopamine systems affect function in the brain's reward, cognition, and stress pathways, potentially resulting in vulnerabilities to OUD. Continued research of the functional consequences of genetic variants and corresponding alterations in neural mechanisms will inform prevention and treatment of OUD.
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Affiliation(s)
- Jamie A Burns
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Danielle S Kroll
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Dana E Feldman
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | | | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States.,National Institute on Drug Abuse, Bethesda, MD, United States
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
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20
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van Holst RJ, Sescousse G, Janssen LK, Janssen M, Berry AS, Jagust WJ, Cools R. Increased Striatal Dopamine Synthesis Capacity in Gambling Addiction. Biol Psychiatry 2018; 83:1036-1043. [PMID: 28728675 PMCID: PMC6698370 DOI: 10.1016/j.biopsych.2017.06.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 05/15/2017] [Accepted: 06/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The hypothesis that dopamine plays an important role in the pathophysiology of pathological gambling is pervasive. However, there is little to no direct evidence for a categorical difference between pathological gamblers and healthy control subjects in terms of dopamine transmission in a drug-free state. Here we provide evidence for this hypothesis by comparing dopamine synthesis capacity in the dorsal and ventral parts of the striatum in 13 pathological gamblers and 15 healthy control subjects. METHODS This was achieved using [18F]fluoro-levo-dihydroxyphenylalanine dynamic positron emission tomography scans and striatal regions of interest that were hand-drawn based on visual inspection of individual structural magnetic resonance imaging scans. RESULTS Our results show that dopamine synthesis capacity was increased in pathological gamblers compared with healthy control subjects. Dopamine synthesis was 16% higher in the caudate body, 17% higher in the dorsal putamen, and 17% higher in the ventral striatum in pathological gamblers compared with control subjects. Moreover, dopamine synthesis capacity in the dorsal putamen and caudate head was positively correlated with gambling distortions in pathological gamblers. CONCLUSIONS Taken together, these results provide empirical evidence for increased striatal dopamine synthesis in pathological gambling.
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21
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Sandiego CM, Matuskey D, Lavery M, McGovern E, Huang Y, Nabulsi N, Ropchan J, Picciotto MR, Morris ED, McKee SA, Cosgrove KP. The Effect of Treatment with Guanfacine, an Alpha2 Adrenergic Agonist, on Dopaminergic Tone in Tobacco Smokers: An [ 11C]FLB457 PET Study. Neuropsychopharmacology 2018; 43:1052-1058. [PMID: 28944773 PMCID: PMC5854798 DOI: 10.1038/npp.2017.223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/11/2017] [Accepted: 09/14/2017] [Indexed: 11/10/2022]
Abstract
Guanfacine, a noradrenergic alpha2a agonist, reduced tobacco smoking in a 4-week trial and in animal models has been shown to reduce cortical dopamine release, which is critically involved in the reinforcing effect of tobacco smoking. We measured amphetamine-induced extrastriatal dopamine release before and after treatment with guanfacine with [11C]FLB457, a dopamine D2/D3 receptor radiotracer, and positron emission tomography (PET). Sixteen tobacco smokers had one set of [11C]FLB457 PET scans on the same day, one before and one at 2.5-3 h after amphetamine (0.4-0.5 mg/kg, PO). A subset (n=12) then underwent guanfacine treatment (3 mg/day for 3 weeks) and the set of scans were repeated. [11C]FLB457-binding potential (BPND) was measured pre- and post amphetamine in extrastriatal brain regions. The fractional change in BPND after vs before amphetamine (Δ BPND) is an indirect measure of DA release and was compared between the untreated and guanfacine-treated conditions. Guanfacine treatment attenuated amphetamine-induced DA release; however, the change was due to a global 8% decrease in baseline BPND from the untreated to the guanfacine-treated condition. Chronic guanfacine treatment reduced [11C]FLB457 BPND in tobacco smokers, suggesting an increase in dopaminergic tone. Guanfacine-induced normalization of dopamine signaling may be an important mesocortical mechanism contributing to its ability to aid in tobacco smoking cessation.
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Affiliation(s)
- Christine M Sandiego
- Department of Psychiatry, Yale University, New Haven, CT, USA
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - David Matuskey
- Department of Psychiatry, Yale University, New Haven, CT, USA
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Meaghan Lavery
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Erin McGovern
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Yiyun Huang
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Nabeel Nabulsi
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Jim Ropchan
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | | | - Evan D Morris
- Department of Psychiatry, Yale University, New Haven, CT, USA
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Sherry A McKee
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Kelly P Cosgrove
- Department of Psychiatry, Yale University, New Haven, CT, USA
- PET Center, Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
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McLaughlin T, Blum K, Steinberg B, Modestino EJ, Fried L, Baron D, Siwicki D, Braverman ER, Badgaiyan RD. Pro-dopamine regulator, KB220Z, attenuates hoarding and shopping behavior in a female, diagnosed with SUD and ADHD. J Behav Addict 2018; 7:192-203. [PMID: 29316800 PMCID: PMC6035027 DOI: 10.1556/2006.6.2017.081] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Addictive-like behaviors (e.g., hoarding and shopping) may be the result of the cumulative effects of dopaminergic and other neurotransmitter genetic variants as well as elevated stress levels. We, therefore, propose that dopamine homeostasis may be the preferred goal in combating such challenging and unwanted behaviors, when simple dopaminergic activation through potent agonists may not provide any resolution. Case presentation C.J. is a 38-year-old, single, female, living with her mother. She has a history of substance use disorder as well as attention deficit hyperactivity disorder, inattentive type. She had been stable on buprenorphine/naloxone combination and amphetamine, dextroamphetamine mixed salts for many years when unexpectedly she lost her job for oversleeping and not calling into work. KB200z (a pro-dopamine compound) was added to her regimen for complaints of low drive and motivation. After taking this nutraceutical for 4 weeks, she noticed a marked improvement in her mental status and many behaviors. She noted that her shopping and hoarding addictions had appreciably decreased. Furthermore, her lifelong history of terrifying lucid dreams was eliminated. Finally, she felt more in control; her locus of control shifted from external to more internal. Discussion The hypothesis is that C.J.'s reported, behavioral, and psychological benefits resulted from the pro-dopamine-regulating effect of KB220Z across the brain reward system. Conclusions This effect, we surmise, could be the result of a new dopamine balance, across C.J.'s brain reward system. Dopamine homeostasis is an effect of KB220Z seen in both animal and human placebo-controlled fMRI experiments.
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Affiliation(s)
- Thomas McLaughlin
- 1 Department of Psychopharmacology, Center for Psychiatric Medicine , Lawrence, MA, USA
| | - Kenneth Blum
- 2 Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University , Dayton, OH, USA
- 3 Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine , Gainesville, FL, USA
- 4 Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California , Los Angeles, CA, USA
- 5 Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC , North Kingstown, RI, USA
- 6 Department of Precision Medicine, Geneus Health LLC , San Antonio, TX, USA
- 7 Department of Addiction Research & Therapy, Nupathways Inc. , Innsbrook, MO, USA
- 8 Department of Clinical Neurology, Path Foundation , New York, NY, USA
- 9 Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center , Port Saint Lucie, FL, USA
- 10 Institute of Psychology, Eötvös Loránd University , Budapest, Hungary
| | - Bruce Steinberg
- 11 Department of Psychology, Curry College , Milton, MA, USA
| | | | - Lyle Fried
- 9 Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center , Port Saint Lucie, FL, USA
| | - David Baron
- 4 Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California , Los Angeles, CA, USA
| | - David Siwicki
- 6 Department of Precision Medicine, Geneus Health LLC , San Antonio, TX, USA
| | - Eric R Braverman
- 8 Department of Clinical Neurology, Path Foundation , New York, NY, USA
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23
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Xu S, Liu Y, Li Y, Deng Y, Yuan J, Lv R, Wang Y, Zhang G, Guo Z, Fu D, Zeng H, Han M, Liu X. Availability of dopamine transporters in heroin-dependent subjects: A 18F-FECNT PET imaging study. Psychiatry Res Neuroimaging 2017; 263:121-126. [PMID: 28376406 DOI: 10.1016/j.pscychresns.2017.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 03/21/2017] [Accepted: 03/24/2017] [Indexed: 10/19/2022]
Abstract
This study was to reconfirm the reduced dopamine transporter (DAT) availability in heroin-dependent subjects and validate the use of 2β-carbomethoxy-3β-(4-chlorophenyl)-8-(2-fluoroethyl)-nortropane (18F-FECNT) as a PET radiotracer to assess the changes of striatal DAT in drug addicted subjects. Herein, we assessed DAT standardized uptake values (SUV) of 18F-FECNT in the striatum and cerebellum of 20 heroin-dependent subjects and 10 healthy controls and analyzed the correlation between DAT availability and heroin withdrawal symptom scores and anxiety/depression rating scales in heroin-dependent subjects, as well as the relationship between the withdrawal symptoms scores and age. The striatal DAT availability in heroin-dependent subjects was significantly lower (by ~15.7-17.6%) than that in healthy controls. Age was positively related to heroin withdrawal symptom scores. The withdrawal symptom scores in older patients (Age: 49.5±2.5) were significantly higher (by ~20%) than those in younger patients (Age: 30.9±4.8). These results confirm that chronic heroin use induces striatal DAT reduction, suggesting that 18F-FECNT could be used as an alternative PET imaging radioligand for in vivo imaging of DAT in drug addicted subjects. Moreover, older patients might suffer more severe withdrawal symptoms than younger patients, suggesting that older patients with heroin withdrawal could be given more medication.
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Affiliation(s)
- Shasha Xu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, China; Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Liu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, China
| | - Yu Li
- Drug Rehabilitation Center, Shanghai, China
| | - Yangping Deng
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Jie Yuan
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Rongbin Lv
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuankai Wang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Guangming Zhang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhirui Guo
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, China
| | - Daxu Fu
- Shanghai Center of Biomedicine Development, Shanghai, China
| | - Hui Zeng
- Beijing LADO Technology Company, Beijing, China
| | - Mei Han
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, China.
| | - Xingdang Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai, China.
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Febo M, Blum K, Badgaiyan RD, Perez PD, Colon-Perez LM, Thanos PK, Ferris CF, Kulkarni P, Giordano J, Baron D, Gold MS. Enhanced functional connectivity and volume between cognitive and reward centers of naïve rodent brain produced by pro-dopaminergic agent KB220Z. PLoS One 2017; 12:e0174774. [PMID: 28445527 PMCID: PMC5405923 DOI: 10.1371/journal.pone.0174774] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/15/2017] [Indexed: 11/20/2022] Open
Abstract
Dopaminergic reward dysfunction in addictive behaviors is well supported in the literature. There is evidence that alterations in synchronous neural activity between brain regions subserving reward and various cognitive functions may significantly contribute to substance-related disorders. This study presents the first evidence showing that a pro-dopaminergic nutraceutical (KB220Z) significantly enhances, above placebo, functional connectivity between reward and cognitive brain areas in the rat. These include the nucleus accumbens, anterior cingulate gyrus, anterior thalamic nuclei, hippocampus, prelimbic and infralimbic loci. Significant functional connectivity, increased brain connectivity volume recruitment (potentially neuroplasticity), and dopaminergic functionality were found across the brain reward circuitry. Increases in functional connectivity were specific to these regions and were not broadly distributed across the brain. While these initial findings have been observed in drug naïve rodents, this robust, yet selective response implies clinical relevance for addicted individuals at risk for relapse, who show reductions in functional connectivity after protracted withdrawal. Future studies will evaluate KB220Z in animal models of addiction.
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Affiliation(s)
- Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Psychiatry, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States of America
- Department of Holistic Medicine, National Institute for Holistic Addiction Studies, North Miami Beach, Florida, United States of America
- Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, Rhode Island, United States of America
- Department of Psychiatry, Keck Medicine University of Southern California, Los Angeles, California, United States of America
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States of America
| | - Pablo D. Perez
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Luis M. Colon-Perez
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Panayotis K. Thanos
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, United States of America
| | - Craig F. Ferris
- Center for Translational Neuroimaging, Department of Psychology and Pharmaceutical Sciences, Northeastern University, Boston, Massachusetts, United States of America
| | - Praveen Kulkarni
- Center for Translational Neuroimaging, Department of Psychology and Pharmaceutical Sciences, Northeastern University, Boston, Massachusetts, United States of America
| | - John Giordano
- Department of Holistic Medicine, National Institute for Holistic Addiction Studies, North Miami Beach, Florida, United States of America
| | - David Baron
- Department of Psychiatry, Keck Medicine University of Southern California, Los Angeles, California, United States of America
| | - Mark S. Gold
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Psychiatry, Keck Medicine University of Southern California, Los Angeles, California, United States of America
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Liang CS, Ho PS, Yen CH, Chen CY, Kuo SC, Huang CC, Yeh YW, Ma KH, Huang SY. The relationship between the striatal dopamine transporter and novelty seeking and cognitive flexibility in opioid dependence. Prog Neuropsychopharmacol Biol Psychiatry 2017; 74:36-42. [PMID: 27940252 DOI: 10.1016/j.pnpbp.2016.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/18/2016] [Accepted: 12/05/2016] [Indexed: 12/31/2022]
Abstract
Novelty seeking (NS) is a core personality trait that primes the susceptibility to drug addiction. Striatal dopamine activity contributes to cognitive flexibility, an important cognitive strategy to inhibit impulsivity and compulsive drug-seeking behavior. Evidence supports the association between dopamine and NS. Opioid-dependent patients show higher levels of NS, and repeated opioid exposure can cause cognitive deficits including poor cognitive flexibility and impaired impulse control. However, in opioid-dependent patients, the link between NS, striatal dopamine activity, and cognitive flexibility is still unclear. We recruited 22 opioid-dependent individuals and 30 age- and sex-matched healthy controls. Single-photon emission computed tomography with [99mTc]TRODAT-1 as a ligand was used to measure the striatal dopamine transporter (DAT) availability. The Trail Making Test (TMT) was performed to assess cognitive flexibility. Cloninger's Tridimensional Personality Questionnaire (TPQ) was used to measure NS. We found that in opioid-dependent patients, the striatal DAT availability was lower and negatively associated with TMT Part B÷Part A. Moreover, an inverted-U shape significantly matched the scores of NS as a function of the striatal DAT availability, with maximum NS potential in the midrange of the DAT availability. An extra sum-of-squares F test was conducted, indicating that a quadratic model fitted the association between the DAT and NS better than a linear model did. In brief, in opioid-dependent patients, the striatal DAT availability is nonlinearly linked to NS and linearly linked to cognitive flexibility. The role of the striatal DAT in the transition from controlled to compulsive opioid use warrants further research.
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Affiliation(s)
- Chih-Sung Liang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Pei-Shen Ho
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Che-Hung Yen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chun-Yen Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Shin-Chang Kuo
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chang-Chih Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Psychiatry, Taipei Branch, Buddhist Tzu Chi General Hospital, Taipei, Taiwan, ROC
| | - Yi-Wei Yeh
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Kuo-Hsing Ma
- Department of anatomy and biology, National Defense Medical Center, Taipei, Taiwan, ROC
| | - San-Yuan Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
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Fareed A, Kim J, Ketchen B, Kwak WJ, Wang D, Shongo-Hiango H, Drexler K. Effect of heroin use on changes of brain functions as measured by functional magnetic resonance imaging, a systematic review. J Addict Dis 2017; 36:105-116. [DOI: 10.1080/10550887.2017.1280898] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Ayman Fareed
- Atlanta VA Medical Center, Decatur, Georgia, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jungjin Kim
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bethany Ketchen
- Atlanta VA Medical Center, Decatur, Georgia, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Woo Jin Kwak
- Atlanta VA Medical Center, Decatur, Georgia, USA
| | - Danzhao Wang
- Atlanta VA Medical Center, Decatur, Georgia, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Hilaire Shongo-Hiango
- Atlanta VA Medical Center, Decatur, Georgia, USA
- Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Karen Drexler
- Atlanta VA Medical Center, Decatur, Georgia, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
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Gorzelańczyk EJ, Walecki P, Feit J, Kunc M, Fareed A. Improvement of saccadic functions after dosing with methadone in opioid addicted individuals. J Addict Dis 2016; 35:52-7. [PMID: 26488804 DOI: 10.1080/10550887.2016.1107289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the current experiment, we used the saccadometric test to study the effect of a single therapeutic dose of methadone on the integrity of cortico-subcortical brain functioning. In this prospective study, we used the Saccadometer System (Advanced Clinical Instrumentation, Cambridge, UK). The saccadometric test was performed before and 1.5 hours after methadone dosing. We analyzed the following saccadic parameters: latency, duration, amplitude, average and peak velocity, and processing performance (promptness) as well as a number of different types of saccades (like correct/incorrect, under/overshoot, and left-sided/right-sided). The sample consists of 40 subjects with an average 18 years of opioid addiction. The mean age is 35.3 ± 7 (80% males and 20% females). The mean period of heroin dependence is 15.3 ± 6.3 years. The mean daily dose of methadone in substitution therapy is 90 ± 26.5 mg. After administration of a single therapeutic dose of methadone, there were statistically significant differences in the values of saccade duration and latency when compared to the values before the drug administration. Average duration of saccade was significantly longer [51.40 ± 8.75 ms versus 48.93 ± 6.91 ms, z = 2.53, p = .01] and average latency was significantly longer [198.85 ± 52.57 ms versus 183.05 ± 30.95 ms, z = 2.09 p < .03]. This is the first study to test the therapeutic effect of daily methadone dosing on the integrity of the cortico-subcortical brain functions as measured by the saccadometry. More research is needed to explore the effect of illicit opioid use on the integrity of brain structures and functions, and the protective effect of opioid agonist therapy on reversing the damaging effects of illicit opioid use.
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Affiliation(s)
- Edward Jacek Gorzelańczyk
- a Department of Theoretical Basis of Bio-Medical Sciences and Medical Informatics , Nicolaus Copernicus University Collegium Medicum , Bydgoszcz , Poland.,b Non-Public Health Care Center Sue Ryder Home , Bydgoszcz , Poland.,c Medseven-Outpatient Addiction Treatment , Rzeźniackiego, Bydgoszcz , Poland.,d Institute of Philosophy, Kazimierz Wielki University , Bydgoszcz , Poland
| | - Piotr Walecki
- e Medical College, Jagiellonian University , Kraków , Poland
| | - Julia Feit
- a Department of Theoretical Basis of Bio-Medical Sciences and Medical Informatics , Nicolaus Copernicus University Collegium Medicum , Bydgoszcz , Poland.,b Non-Public Health Care Center Sue Ryder Home , Bydgoszcz , Poland
| | | | - Ayman Fareed
- g Department of Psychiatry , School of Medicine, Emory University , Atlanta , Georgia , USA
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Trifilieff P, Ducrocq F, van der Veldt S, Martinez D. Blunted Dopamine Transmission in Addiction: Potential Mechanisms and Implications for Behavior. Semin Nucl Med 2016; 47:64-74. [PMID: 27987559 DOI: 10.1053/j.semnuclmed.2016.09.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Positron emission tomography (PET) imaging consistently shows blunted striatal dopamine release and decreased dopamine D2 receptor availability in addiction. Here, we review the preclinical and clinical studies indicating that this neurobiological phenotype is likely to be both a consequence of chronic drug consumption and a vulnerability factor in the development of addiction. We propose that, behaviorally, blunted striatal dopamine transmission could reflect the increased impulsivity and altered cost/benefit computations that are associated with addiction. The factors that influence blunted striatal dopamine transmission in addiction are unknown. Herein, we give an overview of various factors, genetic, environmental, and social, that are known to affect dopamine transmission and that have been associated with the vulnerability to develop addiction. Altogether, these data suggest that blunted dopamine transmission and decreased D2 receptor availability are biomarkers both for the development of addiction and resistance to treatment. These findings support the view that blunted dopamine reflects impulsive behavior and deficits in motivation, which lead to the escalation of drug use.
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Affiliation(s)
- Pierre Trifilieff
- Nutrition et Neurobiologie Intégrée, INRA UMR 1286, University of Bordeaux, Bordeaux, France.
| | - Fabien Ducrocq
- Nutrition et Neurobiologie Intégrée, INRA UMR 1286, University of Bordeaux, Bordeaux, France
| | - Suzanne van der Veldt
- Nutrition et Neurobiologie Intégrée, INRA UMR 1286, University of Bordeaux, Bordeaux, France; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Diana Martinez
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical College, New York, NY.
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29
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Bashir S, Yoo WK. Neuromodulation for Addiction by Transcranial Direct Current Stimulation: Opportunities and Challenges. Ann Neurosci 2016; 23:241-245. [PMID: 27780991 DOI: 10.1159/000449485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 06/08/2016] [Indexed: 01/18/2023] Open
Abstract
The field of neuromodulation encompasses a wide spectrum of interventional technologies that modify the pathological activity within the nervous system to achieve a therapeutic effect. Therapy, including transcranial direct current stimulation, has shown promising results across a range of neurological and neuropsychiatric disorders. This article reviews the state-of-the-art of neuromodulation for addiction and discusses the opportunities and challenges available for clinicians and researchers interested in advancing the neuromodulation therapy. A neuromodulation-based approach for addiction has the advantage that the effects might be immediate and selective to the dysfunction. If an alteration in the mechanisms of brain plasticity indeed represents the proximal cause for nicotine-associated cognitive decline and is a critical contributor to the early pathogenesis of addiction, novel interventions that forestall the development of symptoms might be possible.
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Affiliation(s)
- Shahid Bashir
- Department of Physiology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia; Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., USA
| | - Woo-Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Division of Neuroscience Center, Hallym University Sacred Heart Hospital, Chuncheon, Republic of Korea; Hallym Institute for Translational Genomics and Bioinformatics, Hallym University College of Medicine, Chuncheon, Republic of Korea
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30
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Heirene RM, Shearer D, Roderique-Davies G, Mellalieu SD. Addiction in Extreme Sports: An Exploration of Withdrawal States in Rock Climbers. J Behav Addict 2016; 5:332-41. [PMID: 27348554 PMCID: PMC5387785 DOI: 10.1556/2006.5.2016.039] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background and aims Extreme sports athletes are often labeled "adrenaline junkies" by the media, implying they are addicted to their sport. Research suggests during abstinence these athletes may experience withdrawal states characteristic of individuals with an addiction (Celsi, Rose, & Leigh, 1993; Franken, Zijlstra, & Muris, 2006; Willig, 2008). Despite this notion, no research has directly explored withdrawal experiences of extreme sports athletes. Methods Using semi-structured interviews, we explored withdrawal experiences of high (n = 4) and average-ability (n = 4) male rock climbers during periods of abstinence. We investigated the psychological and behavioral aspects of withdrawal, including craving, anhedonia, and negative affect; and differences in the frequency and intensity of these states between groups. Results Deductive content analysis indicated support for each of the three categories of anhedonia, craving, and negative affect. Consistent with existing substance addiction literature, high-ability climbers recalled more frequent and intense craving states and negative affect during abstinence compared with average-ability climbers. No differences in anhedonic symptoms between high and average-ability participants were found. Conclusions Rock climbing athletes appear to experience withdrawal symptoms when abstinent from their sport comparable to individuals with substance and behavioral addictions. The implications of these findings and suggestions for future research are discussed.
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Affiliation(s)
- Robert M. Heirene
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom,Corresponding author: Robert M. Heirene; School of Psychology, Early Years and Therapeutic Studies, University of South Wales, Pontypridd, Wales CF37 1DL, United Kingdom; Phone: +44 01443 482690; E-mail:
| | - David Shearer
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
| | - Gareth Roderique-Davies
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, United Kingdom
| | - Stephen D. Mellalieu
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom
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31
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Nichols TT, Foulds J, Yingst JM, Veldheer S, Hrabovsky S, Richie J, Eissenberg T, Wilson SJ. Cue-reactivity in experienced electronic cigarette users: Novel stimulus videos and a pilot fMRI study. Brain Res Bull 2015; 123:23-32. [PMID: 26478134 DOI: 10.1016/j.brainresbull.2015.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/19/2015] [Accepted: 10/10/2015] [Indexed: 12/31/2022]
Abstract
Some individuals who try electronic cigarettes (e-cigarettes) continue to use long-term. Previous research has investigated the safety of e-cigarettes and their potential for use in smoking cessation, but comparatively little research has explored chronic or habitual e-cigarette use. In particular, the relationship between e-cigarette cues and craving is unknown. We sought to bridge this gap by developing a novel set of e-cigarette (salient) and electronic toothbrush (neutral) videos for use in cue-reactivity paradigms. Additionally, we demonstrate the utility of this approach in a pilot fMRI study of 7 experienced e-cigarette users. Participants were scanned while viewing the cue videos before and after 10min use of their own e-cigarettes (producing an 11.7ng/ml increase in plasma nicotine concentration). A significant session (pre- and post-use) by video type (salient and neutral) interaction was exhibited in many sensorimotor areas commonly activated in other cue-reactivity paradigms. We did not detect significant cue-related activity in other brain regions notable in the craving literature. Possible reasons for this discrepancy are discussed, including the importance of matching cue stimuli to participants' experiences.
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Affiliation(s)
- Travis T Nichols
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States.
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Jessica M Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Susan Veldheer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Shari Hrabovsky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - John Richie
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Thomas Eissenberg
- Center for The Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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Blum K, Thompson B, Demotrovics Z, Femino J, Giordano J, Oscar-Berman M, Teitelbaum S, Smith DE, Roy AK, Agan G, Fratantonio J, Badgaiyan RD, Gold MS. The Molecular Neurobiology of Twelve Steps Program & Fellowship: Connecting the Dots for Recovery. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:46-64. [PMID: 26306329 PMCID: PMC4545669 DOI: 10.17756/jrds.2015-008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There are some who suggest that alcoholism and drug abuse are not diseases at all and that they are not consequences of a brain disorder as espoused recently by the American Society of Addiction Medicine (ASAM). Some would argue that addicts can quit on their own and moderate their alcohol and drug intake. When they present to a treatment program or enter the 12 Step Program & Fellowship, many addicts finally achieve complete abstinence. However, when controlled drinking fails, there may be successful alternatives that fit particular groups of individuals. In this expert opinion, we attempt to identify personal differences in recovery, by clarifying the molecular neurobiological basis of each step of the 12 Step Program. We explore the impact that the molecular neurobiological basis of the 12 steps can have on Reward Deficiency Syndrome (RDS) despite addiction risk gene polymorphisms. This exploration has already been accomplished in part by Blum and others in a 2013 Springer Neuroscience Brief. The purpose of this expert opinion is to briefly, outline the molecular neurobiological and genetic links, especially as they relate to the role of epigenetic changes that are possible in individuals who regularly attend AA meetings. It begs the question as to whether "12 steps programs and fellowship" does induce neuroplasticity and continued dopamine D2 receptor proliferation despite carrying hypodopaminergic type polymorphisms such as DRD2 A1 allele. "Like-minded" doctors of ASAM are cognizant that patients in treatment without the "psycho-social-spiritual trio," may not be obtaining the important benefits afforded by adopting 12-step doctrines. Are we better off with coupling medical assisted treatment (MAT) that favors combining dopamine agonist modalities (DAM) as possible histone-deacetylase activators with the 12 steps followed by a program that embraces either one or the other? While there are many unanswered questions, at least we have reached a time when "science meets recovery," and in doing so, can further redeem joy in recovery.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- IGENE, LLC., Austin, TX, USA
- RDSolutions, Del Mar, CA, USA
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Benjamin Thompson
- Behavioral Neuroscience Program, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Zsolt Demotrovics
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
| | - John Femino
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Meadows Edge Recovery Center, North Kingstown, RI, USA
| | - John Giordano
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Scott Teitelbaum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - David E. Smith
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Institute of Health & Aging, University of California at San Francisco, San Francisco, CA, USA
| | | | - Gozde Agan
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
| | | | - Rajendra D. Badgaiyan
- Department of Psychiatry, University of Minnesota College of Medicine, Minneapolis, MN, USA
| | - Mark S. Gold
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
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Levran O, Peles E, Randesi M, Correa da Rosa J, Ott J, Rotrosen J, Adelson M, Kreek MJ. Dopaminergic pathway polymorphisms and heroin addiction: further support for association of CSNK1E variants. Pharmacogenomics 2015; 15:2001-9. [PMID: 25521358 DOI: 10.2217/pgs.14.145] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND & AIM The dopaminergic pathways have been implicated in the etiology of drug addictions. The aim of this study was to determine if variants in dopaminergic genes are associated with heroin addiction. MATERIALS & METHODS The study includes 828 former heroin addicts and 232 healthy controls, of predominantly European ancestry. Ninety seven SNPs (13 genes) were analyzed. RESULTS Nine nominally significant associations were observed at CSNK1E, ANKK1, DRD2 and DRD3. CONCLUSION The results support our previous report of association of CSNK1E SNP rs1534891 with protection from heroin addiction. CSNK1E interacts with circadian rhythms and DARPP-32 and has been implicated in negative regulation of sensitivity to opioids in rodents. It may be a target for drug addiction treatment. Original submitted 8 August 2014; Revision submitted 8 October 2014.
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Affiliation(s)
- Orna Levran
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA
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Zaaijer ER, van Dijk L, de Bruin K, Goudriaan AE, Lammers LA, Koeter MWJ, van den Brink W, Booij J. Effect of extended-release naltrexone on striatal dopamine transporter availability, depression and anhedonia in heroin-dependent patients. Psychopharmacology (Berl) 2015; 232:2597-607. [PMID: 25757673 PMCID: PMC4480848 DOI: 10.1007/s00213-015-3891-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/14/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE Extended-release naltrexone (XRNT), an opioid receptor antagonist, is successfully used in the treatment of opioid dependence. However, naltrexone treatment of opioid-dependent patients may reduce striatal dopamine transporter (DAT) availability and cause depression and anhedonia. OBJECTIVES The aim of this study is to investigate changes in striatal DAT availability and symptoms of depression (Beck Depression Inventory (BDI)) and anhedonia (Snaith Hamilton Pleasure Scale (SHAPS)) before and during XRNT treatment. METHODS At baseline, ten detoxified heroin-dependent patients and 11 matched healthy controls underwent [(123)I]FP-CIT single photon emission computed tomography (SPECT) imaging to assess striatal DAT binding. Patients underwent a second SPECT scan 2 weeks after an intramuscular injection with XRNT. RESULTS At baseline, the mean binding potential (BPND) in the putamen was at a trend level lower and the mean BDI score was significantly higher in heroin patients (n = 10) than in controls (n = 11) (3.45 ± 0.88 vs. 3.80 ± 0.61, p = 0.067, d = -0.48 and 12.75 ± 7.40 vs. 5.20 ± 4.83, p = 0.019, d = 1.24, respectively). Post hoc analyses in subgroups with negative urine analyses for opioids and cocaine showed significantly lower baseline putamen BPND in heroin patients (n = 8) than controls (n = 10) (3.19 ± 0.43 vs. 3.80 ± 0.64, p = 0.049, d = -1.03). XRNT treatment in heroin patients was not significantly associated with changes in striatal DAT availability (p = 0.348, d = 0.48), but the mean BDI score after XRNT treatment was significantly lower than before treatment (7.75 ± 7.21 vs. 12.75 ± 7.40, p = 0.004, d = -0.68). CONCLUSIONS The results of this study suggest that XRNT treatment does not reduce striatal DAT availability and has no significant effect on anhedonia, but is associated with a significant reduction of depressive symptoms.
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Affiliation(s)
- Eline R Zaaijer
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands,
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Nutt DJ, Lingford-Hughes A, Erritzoe D, Stokes PRA. The dopamine theory of addiction: 40 years of highs and lows. Nat Rev Neurosci 2015; 16:305-12. [PMID: 25873042 DOI: 10.1038/nrn3939] [Citation(s) in RCA: 350] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
For several decades, addiction has come to be viewed as a disorder of the dopamine neurotransmitter system; however, this view has not led to new treatments. In this Opinion article, we review the origins of the dopamine theory of addiction and discuss the ability of addictive drugs to elicit the release of dopamine in the human striatum. There is robust evidence that stimulants increase striatal dopamine levels and some evidence that alcohol may have such an effect, but little evidence, if any, that cannabis and opiates increase dopamine levels. Moreover, there is good evidence that striatal dopamine receptor availability and dopamine release are diminished in individuals with stimulant or alcohol dependence but not in individuals with opiate, nicotine or cannabis dependence. These observations have implications for understanding reward and treatment responses in various addictions.
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Affiliation(s)
- David J Nutt
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Burlington Danes Building, Imperial College London, London W12 0NN, UK
| | - Anne Lingford-Hughes
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Burlington Danes Building, Imperial College London, London W12 0NN, UK
| | - David Erritzoe
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Burlington Danes Building, Imperial College London, London W12 0NN, UK
| | - Paul R A Stokes
- 1] Centre for Neuropsychopharmacology, Division of Brain Sciences, Burlington Danes Building, Imperial College London, London W12 0NN, UK. [2] Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
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36
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Miller DK, Bowirrat A, Manka M, Miller M, Stokes S, Manka D, Allen C, Gant C, Downs BW, Smolen A, Stevens E, Yeldandi S, Blum K. Acute Intravenous Synaptamine Complex Variant KB220™ “Normalizes” Neurological Dysregulation in Patients during Protracted Abstinence from Alcohol and Opiates as Observed Using Quantitative Electroencephalographic and Genetic Analysis for Reward Polymorphisms: Part 1, Pilot Study with 2 Case Reports. Postgrad Med 2015; 122:188-213. [DOI: 10.3810/pgm.2010.11.2236] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Increased functional connectivity in the resting-state basal ganglia network after acute heroin substitution. Transl Psychiatry 2015; 5:e533. [PMID: 25803496 PMCID: PMC4354356 DOI: 10.1038/tp.2015.28] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/06/2015] [Accepted: 01/20/2015] [Indexed: 01/17/2023] Open
Abstract
Reinforcement signals in the striatum are known to be crucial for mediating the subjective rewarding effects of acute drug intake. It is proposed that these effects may be more involved in early phases of drug addiction, whereas negative reinforcement effects may occur more in later stages of the illness. This study used resting-state functional magnetic resonance imaging to explore whether acute heroin substitution also induced positive reinforcement effects in striatal brain regions of protracted heroin-maintained patients. Using independent component analysis and a dual regression approach, we compared resting-state functional connectivity (rsFC) strengths within the basal ganglia/limbic network across a group of heroin-dependent patients receiving both an acute infusion of heroin and placebo and 20 healthy subjects who received placebo only. Subsequent correlation analyses were performed to test whether the rsFC strength under heroin exposure correlated with the subjective rewarding effect and with plasma concentrations of heroin and its main metabolites morphine. Relative to the placebo treatment in patients, heroin significantly increased rsFC of the left putamen within the basal ganglia/limbic network, the extent of which correlated positively with patients' feelings of rush and with the plasma level of morphine. Furthermore, healthy controls revealed increased rsFC of the posterior cingulate cortex/precuneus in this network relative to the placebo treatment in patients. Our results indicate that acute heroin substitution induces a subjective rewarding effect via increased striatal connectivity in heroin-dependent patients, suggesting that positive reinforcement effects in the striatum still occur after protracted maintenance therapy.
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38
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Zhou Y, Leri F, Cummins E, Kreek MJ. Individual differences in gene expression of vasopressin, D2 receptor, POMC and orexin: vulnerability to relapse to heroin-seeking in rats. Physiol Behav 2015; 139:127-35. [PMID: 25446223 PMCID: PMC4275356 DOI: 10.1016/j.physbeh.2014.11.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
Individual vulnerability to stress-induced relapse during abstinence from chronic heroin exposure is a key feature of opiate addiction, with limited studies on this topic. Arginine vasopressin (AVP) and its V1b receptor, components of the brain stress responsive systems, play a role in heroin-seeking behavior triggered by foot shock (FS) stress in rats. In this study, we tested whether individual differences in the FS-induced heroin-seeking were associated with alterations of AVP and V1b, as well as other stress responsive systems, including pro-opiomelanocortin (POMC), orexin, plasma ACTH and corticosterone, as well as dopamine D2 receptor (D2) and plasma prolactin. Sprague-Dawley rats were subjected to 3-hour intravenous heroin self-administration (SA) and then tested in extinction, and FS-induced and heroin priming-induced reinstatements. The rats that self-administered heroin were divided into high and low reinstatement responders induced by FS (H-RI; L-RI). Over SA sessions, both the H-RI and L-RI displayed similar active lever responding, heroin infusion and total heroin intake. Compared to the L-RI, however, the H-RI showed greater active lever responses during stress-induced reinstatement, with higher AVP mRNA levels in medial/basolateral amygdala and lower D2 mRNA levels in caudate putamen. However, heroin priming resulted in similar reinstatement in both groups and produced similarly low POMC and high orexin mRNA levels in hypothalamus. Our results indicate that: 1) enhanced amygdalar AVP and reduced striatal D2 expression may be related to individual vulnerability to stress-induced reinstatement of heroin- seeking; and 2) heroin abstinence-associated alterations of hypothalamic orexin and POMC expression may be involved in drug priming-induced heroin-seeking.
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MESH Headings
- Adrenocorticotropic Hormone/blood
- Analgesics, Opioid/administration & dosage
- Analgesics, Opioid/pharmacology
- Animals
- Brain/drug effects
- Brain/metabolism
- Conditioning, Classical/drug effects
- Corticosterone/blood
- Electroshock/adverse effects
- Extinction, Psychological/drug effects
- Gene Expression/drug effects
- Heroin/administration & dosage
- Individuality
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/metabolism
- Male
- Neuropeptides/genetics
- Neuropeptides/metabolism
- Orexins
- Pro-Opiomelanocortin/genetics
- Pro-Opiomelanocortin/metabolism
- Prolactin/blood
- Rats
- Rats, Sprague-Dawley
- Receptors, Dopamine D2/genetics
- Receptors, Dopamine D2/metabolism
- Receptors, Vasopressin/genetics
- Receptors, Vasopressin/metabolism
- Reinforcement, Psychology
- Self Administration
- Vasopressins/genetics
- Vasopressins/metabolism
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Affiliation(s)
- Yan Zhou
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA.
| | - Francesco Leri
- Department of Psychology, University of Guelph, Guelph, Canada
| | - Erin Cummins
- Department of Psychology, University of Guelph, Guelph, Canada
| | - Mary Jeanne Kreek
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA
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Blum K, Liu Y, Wang W, Wang Y, Zhang Y, Oscar-Berman M, Smolen A, Febo M, Han D, Simpatico T, Cronjé FJ, Demetrovics Z, Gold MS. rsfMRI effects of KB220Z™ on neural pathways in reward circuitry of abstinent genotyped heroin addicts. Postgrad Med 2014; 127:232-41. [PMID: 25526228 DOI: 10.1080/00325481.2015.994879] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Recently, Willuhn et al. reported that cocaine use and even non-substance-related addictive behavior increases as dopaminergic function is reduced. Chronic cocaine exposure has been associated with decreases in D2/D3 receptors and was also associated with lower activation of cues in occipital cortex and cerebellum, in a recent PET study by Volkow's et al. Therefore, treatment strategies, like dopamine agonist therapy, that might conserve dopamine function may be an interesting approach to relapse prevention in psychoactive drug and behavioral addictions. To this aim, we evaluated the effect of KB220Z™ on reward circuitry of 10 heroin addicts undergoing protracted abstinence (average 16.9 months). In a randomized placebo-controlled crossover study of KB220Z, five subjects completed a triple-blinded experiment in which the subject, the person administering the treatment, and the person evaluating the response to treatment were blinded to the treatment that any particular subject was receiving. In addition, nine subjects were genotyped utilizing the GARSDX™ test. We preliminarily report that KB220Z induced an increase in BOLD activation in caudate-accumbens-dopaminergic pathways compared to placebo following 1-hour acute administration. Furthermore, KB220Z also reduced resting-state activity in the putamen of abstinent heroin addicts. In the second phase of this pilot study of all 10 abstinent heroin-dependent subjects, we observed that three brain regions of interest were significantly activated from resting state by KB220Z compared to placebo (p < 0.05). Increased functional connectivity was observed in a putative network that included the dorsal anterior cingulate, medial frontal gyrus, nucleus accumbens, posterior cingulate, occipital cortical areas, and cerebellum. These results and other quantitative electroencephalogy (qEEG) study results suggest a putative anti-craving/anti-relapse role of KB220Z in addiction by direct or indirect dopaminergic interaction. Due to small sample size, we caution definitive interpretation of these preliminary results, and confirmation with additional research and ongoing rodent and human studies of KB220Z is required.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine , Gainesville, FL , USA
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40
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Watson BJ, Taylor LG, Reid AG, Wilson SJ, Stokes PR, Brooks DJ, Myers JF, Turkheimer FE, Nutt DJ, Lingford‐Hughes AR. Investigating expectation and reward in human opioid addiction with [(11) C]raclopride PET. Addict Biol 2014; 19:1032-40. [PMID: 23829344 PMCID: PMC4282066 DOI: 10.1111/adb.12073] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The rewarding properties of some abused drugs are thought to reside in their ability to increase striatal dopamine levels. Similar increases have been shown in response to expectation of a positive drug effect. The actions of opioid drugs on striatal dopamine release are less well characterized. We examined whether heroin and the expectation of heroin reward increases striatal dopamine levels in human opioid addiction. Ten opioid-dependent participants maintained on either methadone or buprenorphine underwent [11C]raclopride positron emission tomography imaging. Opioid-dependent participants were scanned three times, receiving reward from 50-mg intravenous heroin (diamorphine; pharmaceutical heroin) during the first scan to generate expectation of the same reward at the second scan, during which they only received 0.1-mg intravenous heroin. There was no heroin injection during the third scan. Intravenous 50-mg heroin during the first scan induced pronounced effects leading to high levels of expectation at the second scan. There was no detectable increase in striatal dopamine levels to either heroin reward or expectation of reward. We believe this is the first human study to examine whether expectation of heroin reward increases striatal dopamine levels in opioid addiction. The absence of detectable increased dopamine levels to both the expectation and delivery of a heroin-related reward may have been due to the impact of substitute medication. It does however contrast with the changes seen in abstinent stimulant users, suggesting that striatal dopamine release alone may not play such a pivotal role in opioid-maintained individuals.
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Affiliation(s)
- Ben J. Watson
- Psychopharmacology Unit University of Bristol Bristol UK
| | | | | | - Sue J. Wilson
- Imperial College London Centre for Neuropsychopharmacology London UK
| | - Paul R. Stokes
- Imperial College London Centre for Neuropsychopharmacology London UK
| | - David J. Brooks
- Department of Medicine, Division of Brain Sciences Imperial College London London UK
| | - James F. Myers
- Psychopharmacology Unit University of Bristol Bristol UK
| | | | - David J. Nutt
- Imperial College London Centre for Neuropsychopharmacology London UK
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41
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Taepavarapruk P, Butts KA, Phillips AG. Dopamine and glutamate interaction mediates reinstatement of drug-seeking behavior by stimulation of the ventral subiculum. Int J Neuropsychopharmacol 2014; 18:pyu008. [PMID: 25539503 PMCID: PMC4368862 DOI: 10.1093/ijnp/pyu008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 12/13/2013] [Accepted: 12/16/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Drug addiction is a chronic brain disease characterized by recurrent episodes of relapse to drug-seeking/-taking behaviors. The ventral subiculum, the primary output of the hippocampus, plays a critical role in mediating drug-seeking behavior. METHODS A d-amphetamine intravenous self-administration rat model was employed along with focal electrical stimulation of the ventral subiculum (20 Hz/200 pulses) to examine its role in reinstatement of drug-seeking behavior. Dopamine efflux in the nucleus accumbens was measured by in vivo microdialysis and subsequent HPLC-ED analyses. Pharmacological antagonism of dopamine and ionotropic glutamate receptors locally within the nucleus accumbens was employed to assess the role of glutamate and dopamine in reinstatement of drug-seeking behavior induced by stimulation of the ventral subiculum. RESULTS Here, we demonstrate that reinstatement of drug-seeking behavior following extinction of d-amphetamine self-administration by rats was induced by electrical stimulation in the ventral subiculum but not the cortex. This reinstatement was accompanied by a significant increase in dopamine efflux in the nucleus accumbens and was disrupted by microinfusion of a dopamine D1 or D2 antagonist into the nucleus accumbens. Inhibition of N-methyl-D-aspartate or non- N-methyl-D-aspartate receptors had no effect on the reinstatement induced by ventral subiculum stimulation, whereas co-infusion of D1 and N-methyl-D-aspartate antagonists at formerly ineffective doses prevented drug-seeking behavior. CONCLUSIONS These data support the hypothesis that dopamine/glutamate interactions within the ventral striatum related to memory processes are involved in relapse to addictive behavior.
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Affiliation(s)
- Pornnarin Taepavarapruk
- Department of Physiology, Naresuan University, Phitsanulok, Thailand (Dr Taepavarapruk); Department of Psychiatry, University of British Columbia, Vancouver, Canada (Drs Butts and Phillips)
| | - Kelly A Butts
- Department of Physiology, Naresuan University, Phitsanulok, Thailand (Dr Taepavarapruk); Department of Psychiatry, University of British Columbia, Vancouver, Canada (Drs Butts and Phillips)
| | - Anthony G Phillips
- Department of Physiology, Naresuan University, Phitsanulok, Thailand (Dr Taepavarapruk); Department of Psychiatry, University of British Columbia, Vancouver, Canada (Drs Butts and Phillips).
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42
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Gorzelańczyk EJ, Fareed A, Walecki P, Feit J, Kunc M. Risk behavior in opioid-dependent individuals after the administration of a therapeutic dose of methadone. Am J Addict 2014; 23:608-12. [PMID: 25251600 DOI: 10.1111/j.1521-0391.2014.12154.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 05/18/2014] [Accepted: 06/16/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence suggests that methadone may play a protective role in the faulty decision-making in heroin-addicted individuals. This may reduce craving for opioids and the risky decisions associated with active opioid use. METHODS We tested the effect of a daily therapeutic dose of methadone on faulty decision-making in eighty (n = 80) individuals with a history of opioid addiction. We used the Iowa Gambling Task (IGT) and compared the score and response time before and after the daily methadone dosing. RESULTS The mean net IGT score before methadone dose was 10 (±22) and 22 (±23) after methadone dose (t = 4.23, p = .00006). These results reflect statistically significant improvement in faulty decisions after the administration of the daily methadone dose. The mean response time for the reward cards before methadone dose were 1,856 ms (±871) and 1,465 ms (±851) after methadone dose (t = 2.55, p = .012). The mean response time for the punishment cards before methadone dose were 1,688 ms (±911) and 1,399 ms (±827) after methadone dose (t = 1.86, p = .065). These results reflect statistically significant improvement in response time to a rewarding healthy decisions after the administration of the daily methadone dose. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This is the first study to report the effect of a therapeutic dose of methadone on improving faulty decisions for individuals with a long history of opioids addiction. This study demonstrated that the time to making a healthy decision was significantly shorter as a result of administration of methadone.
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Affiliation(s)
- Edward Jacek Gorzelańczyk
- Department of Theoretical Basis of Bio-Medical Sciences and Medical Informatics, Nicolaus Copernicus University Collegium Medicum, Bydgoszcz, Poland; Institute of Philosophy, Kazimierz Wielki University, Bydgoszcz, Poland; Non-Public Health Care Center Sue Ryder Home, Bydgoszcz, Poland; Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland; Medseven-Outpatient Addiction Treatment, Bydgoszcz, Poland
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43
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Tomasi D, Wang GJ, Wang R, Caparelli EC, Logan J, Volkow ND. Overlapping patterns of brain activation to food and cocaine cues in cocaine abusers: association to striatal D2/D3 receptors. Hum Brain Mapp 2014; 36:120-36. [PMID: 25142207 DOI: 10.1002/hbm.22617] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/16/2014] [Accepted: 08/08/2014] [Indexed: 02/05/2023] Open
Abstract
Cocaine, through its activation of dopamine (DA) signaling, usurps pathways that process natural rewards. However, the extent to which there is overlap between the networks that process natural and drug rewards and whether DA signaling associated with cocaine abuse influences these networks have not been investigated in humans. We measured brain activation responses to food and cocaine cues with fMRI, and D2/D3 receptors in the striatum with [11C]raclopride and Positron emission tomography in 20 active cocaine abusers. Compared to neutral cues, food and cocaine cues increasingly engaged cerebellum, orbitofrontal, inferior frontal, and premotor cortices and insula and disengaged cuneus and default mode network (DMN). These fMRI signals were proportional to striatal D2/D3 receptors. Surprisingly cocaine and food cues also deactivated ventral striatum and hypothalamus. Compared to food cues, cocaine cues produced lower activation in insula and postcentral gyrus, and less deactivation in hypothalamus and DMN regions. Activation in cortical regions and cerebellum increased in proportion to the valence of the cues, and activation to food cues in somatosensory and orbitofrontal cortices also increased in proportion to body mass. Longer exposure to cocaine was associated with lower activation to both cues in occipital cortex and cerebellum, which could reflect the decreases in D2/D3 receptors associated with chronicity. These findings show that cocaine cues activate similar, though not identical, pathways to those activated by food cues and that striatal D2/D3 receptors modulate these responses, suggesting that chronic cocaine exposure might influence brain sensitivity not just to drugs but also to food cues.
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Affiliation(s)
- Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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44
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Abstract
Attentional bias in substance-dependent patients is the tendency to automatically direct attention to substance-related cues in the environment. Preclinical models suggest that attentional bias emerges as a consequence of dopaminergic activity evoked by substance-related cues. The aim of the current review is to describe pharmacological mechanisms underlying attentional bias in humans and to critically review empirical studies that aimed to modulate attentional bias in substance-dependent patients by using pharmacological agents. The findings of the reviewed studies suggest that attentional bias and related brain activation may be modulated by dopamine. All of the reviewed studies investigated acute effects of pharmacological agents, while measurements of chronic pharmacological treatments on attentional bias and clinically relevant measures such as relapse are yet lacking. Therefore, the current findings should be interpreted as a proof of principle concerning the role of dopamine in attentional bias. At the moment, there is too little evidence for clinical applications. While the literature search was not limited to dopamine, there is a lack of studies investigating the role of non-dopaminergic neurotransmitter systems in substance-related attentional bias. A focus on neurotransmitter systems such as acetylcholine and noradrenaline could provide new insights regarding the pharmacology of substance-related attentional bias.
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45
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Ravan S, Martinez D, Slifstein M, Abi-Dargham A. Molecular imaging in alcohol dependence. HANDBOOK OF CLINICAL NEUROLOGY 2014; 125:293-311. [PMID: 25307582 DOI: 10.1016/b978-0-444-62619-6.00018-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The cellular mechanisms of alcohol's effects in the brain are complex, targeting multiple transmitter systems. Molecular imaging has been used to study the effects of alcohol and alcohol use disorders on these various systems. Studies of dopaminergic indices have provided robust evidence for deficits in D2-mediated transmission in the striatum of chronic recently detoxified alcoholics. Their presence in the at-risk state prior to excessive drinking, and their recovery after long-term sobriety, are unclear and represent an active area of current research. Investigations of the GABAergic system have shown generalized deficits in various brain regions in the chronic abstinence phase. Studies of the opiate system have suggested alterations in some subtypes in discrete brain regions, including the ventral striatum, while studies of serotonin have been negative and those of the cannabinoid system have been inconclusive. Future investigations should target the glutamatergic system, which plays an important role both in the acute intoxicating effects of alcohol as well as in the long-term effects associated with dependence.
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Affiliation(s)
- Shervin Ravan
- Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Diana Martinez
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Mark Slifstein
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Anissa Abi-Dargham
- Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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Garfield JBB, Lubman DI, Yücel M. Anhedonia in substance use disorders: a systematic review of its nature, course and clinical correlates. Aust N Z J Psychiatry 2014; 48:36-51. [PMID: 24270310 DOI: 10.1177/0004867413508455] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE There is growing evidence that anhedonia is a commonly experienced symptom among substance-using populations. This systematic review synthesises findings across a range of substances to address questions regarding the time course of anhedonia, how anhedonia relates to other symptoms of substance dependence and whether it is similarly prevalent across all addictive drugs. METHOD A literature search was conducted on PubMed, PsycINFO and MEDLINE, yielding 32 studies that used self-report measures of anhedonia among participants with a history of a substance abuse, dependence or long-term daily use of addictive substances. RESULTS Findings from these studies indicate that anhedonia (1) is elevated in samples dependent on a range of substances; (2) typically appears as a consequence of substance abuse or dependence, and diminishes with abstinence; and (3) predicts increased drug cravings and the likelihood of relapse in those attempting abstinence. CONCLUSIONS The common experience of anhedonia in substance-dependent populations, and its relationship to relapse, emphasises the importance of developing therapeutic interventions that specifically target anhedonia in the treatment of all substance use disorders.
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Affiliation(s)
- Joshua B B Garfield
- 1Turning Point Alcohol & Drug Centre, Eastern Health and Monash University, Melbourne, Australia
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47
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Abstract
Opioid use disorder (OUD) is a major public health problem in the United States. It has resulted in devastating consequences for people with this condition, including psychosocial and legal problems, in addition to contraction of infectious diseases such as HIV and hepatitis B and C. Furthermore, this disease can cause fatalities from drug overdoses and drug-drug interactions. OUD shatters families and destroys relationships. Effective treatment is crucial in order to curtail the consequences of this condition. The objective of this article is to provide a review of the pharmacotherapies currently being used to treat OUD.
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48
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Leyton M, Vezina P. Striatal ups and downs: their roles in vulnerability to addictions in humans. Neurosci Biobehav Rev 2013; 37:1999-2014. [PMID: 23333263 PMCID: PMC3743927 DOI: 10.1016/j.neubiorev.2013.01.018] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 01/03/2013] [Accepted: 01/07/2013] [Indexed: 01/05/2023]
Abstract
Susceptibility to addictive behaviors has been related to both increases and decreases in striatal function. Both profiles have been reported in humans as well as in animal models. Yet, the mechanisms underlying these opposing effects and the manner in which they relate to the behavioral development and expression of addiction remain unclear. In the present review of human studies, we describe a number of factors that could influence whether striatal hyper- or hypo-function is observed and propose a model that integrates the influence of these opposite responses on the expression of addiction related behaviors. Central to this model is the role played by the presence versus absence of addiction related cues and their ability to regulate responding to abused drugs and other rewards. Striatal function and incentive motivational states are increased in the presence of these cues and decreased in their absence. Alternations between these states might account for the progressive narrowing of interests as addictions develop and point to relevant processes to target in treatment.
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Affiliation(s)
- Marco Leyton
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, H3A 1A1 Canada.
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Saunders BT, Robinson TE. Individual variation in resisting temptation: implications for addiction. Neurosci Biobehav Rev 2013; 37:1955-75. [PMID: 23438893 PMCID: PMC3732519 DOI: 10.1016/j.neubiorev.2013.02.008] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/28/2013] [Accepted: 02/12/2013] [Indexed: 11/29/2022]
Abstract
When exposed to the sights, sounds, smells and/or places that have been associated with rewards, such as food or drugs, some individuals have difficulty resisting the temptation to seek out and consume them. Others have less difficulty restraining themselves. Thus, Pavlovian reward cues may motivate maladaptive patterns of behavior to a greater extent in some individuals than in others. We are just beginning to understand the factors underlying individual differences in the extent to which reward cues acquire powerful motivational properties, and therefore, the ability to act as incentive stimuli. Here we review converging evidence from studies in both human and non-human animals suggesting that a subset of individuals are more "cue reactive", in that certain reward cues are more likely to attract these individuals to them and motivate actions to get them. We suggest that those individuals for whom Pavlovian reward cues become especially powerful incentives may be more vulnerable to impulse control disorders, such as binge eating and addiction.
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Affiliation(s)
| | - Terry E. Robinson
- Department of Psychology (Biopsychology Program), University of Michigan
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Dopamine transporter availability in heroin-dependent subjects and controls: longitudinal changes during abstinence and the effects of Jitai tablets treatment. Psychopharmacology (Berl) 2013; 230:235-44. [PMID: 23715641 DOI: 10.1007/s00213-013-3148-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 05/09/2013] [Indexed: 10/26/2022]
Abstract
RATIONALE Previous imaging studies have indicated that the levels of the dopamine transporter (DAT) are reduced in the brains of heroin users. However, whether these changes can be reversed by abstinence and/or treatment remains unclear. OBJECTIVES This study aims to investigate DAT availability in heroin users and changes in DAT availability after abstinence and treatment with the Jitai tablets, a traditional Chinese medicinal product that is approved for the treatment of opioid addiction. METHODS Single-photon emission computed tomography (SPECT) with [(99m)Tc] TRODAT-1 was performed on heroin-dependent patients (n = 64) and healthy controls (n = 15). The patients were randomly assigned to treatment with either placebo or the Jitai. All patients underwent SPECT imaging both at baseline and after 6 months of treatment. DAT availability was assessed in the caudate and putamen. Depression and anxiety were evaluated at baseline. RESULTS DAT availability remained at low levels during a 6-month period in the placebo-treated group but was increased (14-17 %) in the Jitai-treated group. The ratio of DAT availability at month 6 to that at baseline in the Jitai-treated group was significantly higher than that in the placebo-treated group in both the bilateral caudate and putamen. DAT uptake in the striatum was significantly correlated with daily heroin dose, years of heroin use, and depression. CONCLUSIONS These findings suggest that chronic heroin use induces long-lasting striatal DAT reductions. DAT availability remained unchanged during a 6-month period of abstinence. Treatment with Jitai appears to be effective at increasing striatal DAT availability.
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