Taylor Milo, Cheng Anya Brooke, Hodkinson Duncan Jack, Afacan Onur, Zurakowski David, Bajic Dusica
Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States.
Harvard College, Massachusetts Hall, Cambridge, MA, United States.
Front Pain Res (Lausanne). 2023 Feb 27;4:962783. doi: 10.3389/fpain.2023.962783. eCollection 2023.
Prolonged morphine treatment in infancy is associated with a high incidence of opioid tolerance and dependence, but our knowledge of the long-term consequences of this treatment is sparse. Using a rodent model, we examined the (1) short- and (2) long-term effects of prolonged morphine administration in infancy on body weight and brain volume, and (3) we evaluated if subsequent dosing in adulthood poses an increased brain vulnerability.
Newborn rats received subcutaneous injections of either morphine or equal volume of saline twice daily for the first two weeks of life. In adulthood, animals received an additional two weeks of saline or morphine injections before undergoing structural brain MRI. After completion of treatment, structural T2-weigthed MRI images were acquired on a 7 T preclinical scanner (Bruker) using a RARE FSE sequence. Total and regional brain volumes were manually extracted from the MRI images using ITK-SNAP (v.3.6). Regions of interest included the brainstem, the cerebellum, as well as the forebrain and its components: the cerebral cortex, hippocampus, and deep gray matter (including basal ganglia, thalamus, hypothalamus, ventral tegmental area). Absolute (cm) and normalized (as % total brain volume) values were compared using a one-way ANOVA with Tukey HSD post-hoc test.
Prolonged morphine administration in infancy was associated with lower body weight and globally smaller brain volumes, which was not different between the sexes. In adulthood, females had lower body weights than males, but no difference was observed in brain volumes between treatment groups. Our results are suggestive of no long-term effect of prolonged morphine treatment in infancy with respect to body weight and brain size in either sex. Interestingly, prolonged morphine administration in adulthood was associated with smaller brain volumes that differed by sex only in case of previous exposure to morphine in infancy. Specifically, we report significantly smaller total brain volume of female rats on account of decreased volumes of forebrain and cortex.
Our study provides insight into the short- and long-term consequences of prolonged morphine administration in an infant rat model and suggests brain vulnerability to subsequent exposure in adulthood that might differ with sex.
婴儿期长期使用吗啡治疗与阿片类药物耐受性和依赖性的高发生率相关,但我们对这种治疗的长期后果了解甚少。我们使用啮齿动物模型,研究了(1)婴儿期长期给予吗啡对体重和脑容量的短期和(2)长期影响,以及(3)我们评估了成年期后续给药是否会增加脑易损性。
新生大鼠在出生后的前两周每天皮下注射吗啡或等体积的生理盐水两次。成年后,动物在接受结构性脑MRI检查前再接受两周的生理盐水或吗啡注射。治疗完成后,使用RARE FSE序列在7 T临床前扫描仪(布鲁克)上采集结构性T2加权MRI图像。使用ITK-SNAP(v.3.6)从MRI图像中手动提取全脑和区域脑容量。感兴趣的区域包括脑干、小脑以及前脑及其组成部分:大脑皮层、海马体和深部灰质(包括基底神经节、丘脑、下丘脑、腹侧被盖区)。使用单因素方差分析和Tukey HSD事后检验比较绝对值(cm)和归一化值(占全脑体积的百分比)。
婴儿期长期给予吗啡与体重降低和全脑体积总体较小有关,两性之间无差异。成年后,雌性体重低于雄性,但各治疗组之间脑容量无差异。我们的结果表明,婴儿期长期使用吗啡治疗对两性的体重和脑大小均无长期影响。有趣的是,成年期长期给予吗啡与脑容量较小有关,仅在婴儿期曾接触过吗啡的情况下,两性之间存在差异。具体而言,我们报告雌性大鼠的全脑体积显著较小,原因是前脑和皮层体积减小。
我们的研究深入了解了在幼鼠模型中长时间给予吗啡的短期和长期后果,并表明成年期后续接触可能会使大脑产生易损性,且这种易损性可能因性别而异。