Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Department of Nuclear Medicine, Tangdu Hospital of Air Force Medical University, Xi'an, PR China.
Department of Radiology, Hospital of Shaannxi Provincial Geology & Mineral Resources Bureau, Xi'an, PR China.
Drug Alcohol Depend. 2021 Feb 1;219:108503. doi: 10.1016/j.drugalcdep.2020.108503. Epub 2021 Jan 2.
The neural substrates underlying the relapse behavior of heroin dependents (HD) who received long-term methadone maintenance treatment (MMT) have yet to be thoroughly expounded. This study investigated the relapse-related intrinsic functional hubs of HD and their functional integration feature at whole brain network level.
57 male HD receiving MMT and 49 matched healthy controls (HC) were enrolled. All of the subjects received resting-state functional magnetic resonance imaging scan. And the 57 patients were assigned a 26-month follow-up for collecting illegal drug use information. Of them, 11 were non-relapsers and 46 relapsers. We analyzed the voxel-based degree centrality (DC) to reveal the differences in nodule centrality between HD and HC, conducted Pearson partial-correlation analysis to confirm the relationship between relapse frequency and DC value of the nodes with significant intergroup differences, and finally compared the functional connectivity (FC) of the relapse-related hubs between non-relapsers and relapsers.
We found the DC values of right insula and left nucleus accumbens (NAc) were negatively correlated with relapse frequency. Compared with the non-relapsers, the relapsers had a significant decreased FC between left NAc and inhibitory control circuitry, including left dorsolateral prefrontal cortex, left inferior frontal gyrus and motor regions.
These findings suggest that the neural substrates of relapse vulnerability in HD undergoing MMT are the intrinsic functional hubs of introceptive and reward systems and the latter modulates relapse behavior via interaction with inhibitory control circuit.
接受长期美沙酮维持治疗（MMT）的海洛因依赖者（HD）的复发行为的神经基础尚未得到充分阐述。本研究调查了 HD 的与复发相关的内在功能中枢及其在全脑网络水平上的功能整合特征。
纳入 57 名接受 MMT 的男性 HD 和 49 名匹配的健康对照（HC）。所有受试者均接受静息态功能磁共振成像扫描。对 57 名患者进行 26 个月的随访，以收集非法药物使用信息。其中 11 名非复发者和 46 名复发者。我们分析了基于体素的度中心度（DC），以揭示 HD 和 HC 之间结节中心度的差异，进行 Pearson 偏相关分析以确认与节点的 DC 值与组间差异显著的复发频率之间的关系，最后比较了非复发者和复发者之间与复发相关的中枢的功能连接（FC）。
我们发现右侧岛叶和左侧伏隔核（NAc）的 DC 值与复发频率呈负相关。与非复发者相比，复发者的左侧 NAc 与抑制控制回路之间的 FC 显著降低，包括左侧背外侧前额叶、左侧额下回和运动区域。
这些发现表明，接受 MMT 的 HD 中复发脆弱性的神经基础是内感受和奖励系统的内在功能中枢，后者通过与抑制控制回路的相互作用来调节复发行为。
