Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
Addict Biol. 2023 Nov;28(11):e13343. doi: 10.1111/adb.13343.
Opioid use disorder (OUD) is a critical problem in China and is accompanied by depression and deficits in cognitive control. In China, the most successful intervention for OUD is the community drug rehabilitation where methadone maintenance treatment (MMT) plays a key role. Even though methadone for the treatment of OUD can be helpful, it can cause severe somatic side-effects, which limit its effectivity. Even worse, it can have detrimental effects on cognitive control, which is crucial to regain control over drug intake. Here, we consider the potential use of auricular transcutaneous vagus nerve stimulation (atVNS) as an addition to MMT for opioid withdrawal treatment. Compared to other non-invasive brain stimulation methods, atVNS also targets the locus coeruleus (LC) important for noradrenaline (NA) synthesis. NA is an essential neurotransmitter impacted in opioid withdrawal and also critically involved in cognitive control processes. Its ADD-ON to MMT might be a useful mean to improve mood and enhance cognitive control processes impacted in OUD. We discuss the translational advantages of atVNS in China such as the cultural acceptance of the modality of treatment similar to electroacupuncture. Additionally, the wearability of the ear electrode and at-home self-administration without intense medical supervision makes of atVNS a useful tool to enhance clinical and cognitive outcomes especially in everyday life situation. We discuss how atVNS can be integrated in tele-medical health approaches allowing that innovative treatments can widely be disseminated and continued even in situations of restricted medical access.
阿片类药物使用障碍（OUD）在中国是一个严重的问题，常伴有抑郁和认知控制缺陷。在中国，社区戒毒康复是治疗 OUD 最成功的方法，美沙酮维持治疗（MMT）发挥着关键作用。尽管美沙酮治疗 OUD 可能有帮助，但它会引起严重的躯体副作用，限制了其疗效。更糟糕的是，它会对认知控制产生不利影响，而认知控制对于恢复对药物摄入的控制至关重要。在这里，我们考虑将耳穴经皮迷走神经刺激（atVNS）作为 MMT 的附加治疗用于阿片类药物戒断治疗。与其他非侵入性脑刺激方法相比，atVNS 还靶向蓝斑（LC），这对去甲肾上腺素（NA）合成很重要。NA 是阿片类药物戒断中受影响的重要神经递质，也严重参与认知控制过程。将其添加到 MMT 中可能是改善情绪和增强受 OUD 影响的认知控制过程的有用手段。我们讨论了 atVNS 在我国的转化优势，例如治疗方式与电针相似的文化接受度。此外，耳电极的可佩戴性和无需强烈医疗监督的家庭自我管理，使 atVNS 成为增强临床和认知结果的有用工具，尤其是在日常生活情况下。我们讨论了如何将 atVNS 整合到远程医疗保健方法中，以便可以广泛传播和继续创新治疗方法，即使在医疗资源有限的情况下也是如此。
