Ieong Hada Fong-Ha, Yuan Zhen
Bioimaging Core, Faculty of Health Sciences, University of MacauTaipa, Macau.
Front Hum Neurosci. 2017 Apr 6;11:169. doi: 10.3389/fnhum.2017.00169. eCollection 2017.
Dependence to opiates, including illicit heroin and prescription pain killers, and treatment of the opioid use disorder (OUD) have been longstanding problems over the world. Despite intense efforts to scientific investigation and public health care, treatment outcomes have not significantly improved for the past 50 years. One reason behind the continuing use of heroin worldwide despite such efforts is its highly addictive nature. Brain imaging studies over the past two decades have made significant contribution to the understanding of the addictive properties as to be due in part to biological processes, specifically those in the brain structure and function. Moreover, traditional clinical neuropsychology studies also contribute to the account in part for the treatment-refractory nature of the drug abuse. However, there is a gap between those studies, and the rates of relapse are still high. Thus, a multidisciplinary approach is needed to understand the fundamental neural mechanism of OUD. How does the brain of an OUD patient functionally and cognitively differ from others? This brief review is to compare and contrast the current literature on non-invasive resting state neuroimaging and clinical neuropsychological studies with the focus on the abstinence stage in OUD. The results show as follow: Brain connectivity strength in the reward system, dysregulation of circuits associated with emotion and stress, enhanced beta and alpha power activity, and high impulsivity are induced by OUD.Some recovery signs in cognition are demonstrated in OUD subjects after prolonged abstinence, but not in the subjects undergoing methadone treatment.Normalization in the composition of brain oscillations especially in the temporal region is induced and restored by methadone treatment in roughly 6 months in mean duration for OUDs having a mean opioid-use history of 10 years. We hope that the review provides valuable implications for clinical research and practice and paves a new insight into the future path to the identification of potential biomarkers and clinical outcome predictors in OUD in the domains of brain regions, functions, and behaviors.
对阿片类药物的依赖，包括非法海洛因和处方止痛药，以及阿片类物质使用障碍（OUD）的治疗一直是全球长期存在的问题。尽管在科学研究和公共卫生保健方面付出了巨大努力，但在过去50年里治疗效果并未显著改善。尽管有这些努力，海洛因在全球仍持续被使用的一个原因是其高度成瘾性。过去二十年的脑成像研究为理解成瘾特性做出了重大贡献，部分原因在于生物过程，特别是大脑结构和功能方面的过程。此外，传统临床神经心理学研究也部分解释了药物滥用难以治疗的性质。然而，这些研究之间存在差距，复发率仍然很高。因此，需要一种多学科方法来理解OUD的基本神经机制。OUD患者的大脑在功能和认知上与其他人有何不同？这篇简短综述旨在比较和对比当前关于非侵入性静息态神经成像和临床神经心理学研究的文献，重点关注OUD的戒断阶段。结果如下：OUD会导致奖励系统中的脑连接强度、与情绪和压力相关回路的失调、β和α功率活动增强以及高冲动性。经过长时间戒断的OUD受试者在认知方面表现出一些恢复迹象，但接受美沙酮治疗的受试者则没有。对于平均有10年阿片类药物使用史的OUD患者，美沙酮治疗大约在6个月的平均时间内可诱导并恢复大脑振荡组成的正常化，尤其是在颞叶区域。我们希望这篇综述能为临床研究和实践提供有价值的启示，并为未来在OUD的脑区、功能和行为领域识别潜在生物标志物和临床结果预测指标的道路提供新的见解。
