Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Am J Drug Alcohol Abuse. 2023 Mar 4;49(2):180-189. doi: 10.1080/00952990.2023.2169616. Epub 2023 Feb 14.
Cigarette smoking (CS) and opioid use disorder (OUD) significantly alter brain structure. Although OUD and cigarette smoking are highly comorbid, most prior neuroimaging research in OUD did not control for smoking severity. Specifically, the combined effect of smoking and OUD on the brain gray matter volume (GMV) remains unknown. We used structural magnetic resonance imaging (sMRI) to examine: (1) the GMV differences between OUD and non-OUD individuals with comparable smoking severity; and (2) the differential effect of smoking severity on the brain GMV between individuals with and without OUD. We performed a secondary analysis of existing sMRI datasets of 116 individuals who smoked cigarettes daily, among whom 60 had OUD (CS-OUD; 37 male, 23 female) and 56 did not (CS; 31 male, 25 female). Brain GMV was estimated by voxel-based morphometry analysis. Compared to the CS group, the CS-OUD group had a higher GMV in the occipital cortex and lower GMV in the prefrontal and temporal cortex, striatum, and pre/postcentral gyrus (whole-brain corrected- < .05). There was a significant interaction between group and smoking severity on GMV in the medial orbitofrontal cortex (whole-brain corrected- < .05), such that heavier smoking was associated with lower medial orbitofrontal GMV in the CS-OUD but not CS participants (=-0.32 vs. 0.12). Our findings suggest a combination of independent and interactive effects of cigarette smoking and OUD on the brain gray matter. Elucidating the neuroanatomical correlates of comorbid opioid and tobacco use may shed the light on the development of novel interventions for affected individuals.
吸烟（CS）和阿片类药物使用障碍（OUD）显著改变大脑结构。尽管 OUD 和吸烟高度共病，但大多数先前的 OUD 神经影像学研究并未控制吸烟严重程度。具体来说，吸烟和 OUD 对脑灰质体积（GMV）的综合影响尚不清楚。我们使用结构磁共振成像（sMRI）来检查：（1）吸烟严重程度相当的 OUD 和非 OUD 个体之间的 GMV 差异；（2）吸烟严重程度对 OUD 和非 OUD 个体脑 GMV 的差异影响。我们对每天吸烟的 116 名个体的现有 sMRI 数据集进行了二次分析，其中 60 名患有 OUD（CS-OUD；37 名男性，23 名女性），56 名未患有 OUD（CS；31 名男性，25 名女性）。通过基于体素的形态测量分析来估计脑 GMV。与 CS 组相比，CS-OUD 组在枕叶皮层的 GMV 较高，在前额叶和颞叶皮层、纹状体和额/后中央回的 GMV 较低（全脑校正后<0.05）。在大脑中眶额皮质的 GMV 上，存在组间和吸烟严重程度的显著交互作用（全脑校正后<0.05），即 CS-OUD 中的重度吸烟者与 CS-OUD 参与者的中眶额 GMV 降低相关（=-0.32 与 0.12）。我们的研究结果表明，吸烟和 OUD 对大脑灰质的影响既有独立的也有相互作用的。阐明共患阿片类药物和烟草使用的神经解剖学相关性可能为受影响个体的新型干预措施提供启示。
