Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
Int J Neuropsychopharmacol. 2019 Mar 1;22(3):180-185. doi: 10.1093/ijnp/pyz002.
Adherence is a major factor in the effectiveness of the injectable extended-release naltrexone as a relapse prevention treatment in opioid use disorder. We examined the value of a variant of the Go/No-go paradigm in predicting extended-release naltrexone adherence in 27 detoxified opioid use disorder patients who were offered up to 3 monthly extended-release naltrexone injections. Before extended-release naltrexone, participants performed a Go/No-go task that comprised positively valenced Go trials and negatively valenced No-go trials during a functional magnetic resonance imaging scan. Errors of commission and neural responses to the No-go vs Go trials were independent variables. Adherence, operationalized as the completion of all 3 extended-release naltrexone injections, was the outcome variable. Fewer errors of commission and greater left accumbal response during the No-go vs Go trials predicted better adherence. These findings support the clinical potential of the behavioral and neurophysiological correlates of response inhibition in the prediction of extended-release naltrexone treatment outcomes in opioid use disorder.
依从性是注射用纳曲酮作为阿片类物质使用障碍复发预防治疗有效性的一个主要因素。我们研究了 Go/No-go 范式的一个变体在预测 27 名接受最多 3 次每月注射用纳曲酮的已戒毒阿片类物质使用障碍患者的纳曲酮依从性方面的价值。在接受纳曲酮之前，参与者在功能磁共振成像扫描期间执行了一个 Go/No-go 任务，该任务包括积极有价值的 Go 试验和消极有价值的 No-go 试验。错误的承诺和对 No-go 与 Go 试验的神经反应是自变量。依从性，用完成所有 3 次纳曲酮注射来操作，是因变量。在 No-go 与 Go 试验中，错误承诺减少，左侧伏隔核反应增加，预示着更好的依从性。这些发现支持了反应抑制的行为和神经生理学相关性在预测阿片类物质使用障碍中纳曲酮治疗结果方面的临床潜力。
