School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710126, China.
Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.
J Psychiatr Res. 2024 Sep;177:1-10. doi: 10.1016/j.jpsychires.2024.06.035. Epub 2024 Jun 26.
The variation in improvement among individuals with addiction after abstinence is a critical issue. Here, we aimed to identify robust multimodal markers associated with high response to 8-month abstinence in the individuals with heroin use disorder (HUD) and explore whether the identified markers could be generalized to the individuals with methamphetamine use disorder (MUD). According to the median of craving changes, 53 individuals with HUD with 8-month abstinence were divided into two groups: higher craving reduction and lower craving reduction. At baseline, clinical variables, cortical thickness and subcortical volume, fractional anisotropy (FA) of fibers and resting-state functional connectivity (RSFC) were extracted. Different strategies (single metric, multimodal neuroimaging fusion and multimodal neuroimaging-clinical data fusion) were used to identify reliable features for discriminating the individuals with HUD with higher craving reduction from those with lower reduction. The generalization ability of the identified features was validated in the 21 individuals with MUD. Multimodal neuroimaging-clinical fusion features with best performance was achieved an 87.1 ± 3.89% average accuracy in individuals with HUD, with a moderate accuracy of 66.7% when generalizing to individuals with MUD. The multimodal neuroimaging features, primarily converging in frontal regions (e.g., the left superior frontal (LSF) thickness, FA of the LSF-occipital tract, and RSFC of left middle frontal-right superior temporal lobe), collectively contributed to prediction alongside dosage and attention impulsiveness. In this study, we identified the validated multimodal frontal neuroimaging markers associated with higher response to long-term abstinence and revealed insights for the neural mechanisms of addiction abstinence, contributing to clinical strategies and treatment for addiction.
个体在戒断后改善程度的差异是一个关键问题。在这里,我们旨在确定与海洛因使用障碍(HUD)个体 8 个月戒断后高反应相关的稳健多模态标志物,并探讨所确定的标志物是否可推广到甲基苯丙胺使用障碍(MUD)个体。根据渴求变化的中位数,将 53 名具有 8 个月戒断史的 HUD 患者分为两组:渴求降低较多组和渴求降低较少组。在基线时,提取了临床变量、皮质厚度和皮质下体积、纤维分数各向异性(FA)和静息态功能连接(RSFC)。采用不同策略(单一指标、多模态神经影像学融合和多模态神经影像学-临床数据融合)来识别可靠特征,以区分渴求降低较多组和渴求降低较少组。在 21 名 MUD 患者中验证了所识别特征的泛化能力。多模态神经影像学-临床融合特征的最佳表现,在 HUD 患者中达到了 87.1±3.89%的平均准确率,当推广到 MUD 患者时,准确率为 66.7%。多模态神经影像学特征主要集中在前额区域(例如,左侧额上回(LSF)厚度、LSF-枕叶束的 FA 和左侧额中回-右侧颞上回的 RSFC),与剂量和注意力冲动性一起共同预测。在这项研究中,我们确定了与长期戒断后高反应相关的经过验证的多模态额神经影像学标志物,并揭示了成瘾戒断的神经机制的见解,为成瘾的临床策略和治疗提供了依据。
Front Neurosci. 2025-2-11