阿片类物质使用障碍个体脑磁共振成像检测到的脑容量及内在静息态功能连接的改变。
Alterations in Volume and Intrinsic Resting-State Functional Connectivity Detected at Brain MRI in Individuals with Opioid Use Disorder.
作者信息
Mehta Saloni, Peterson Hannah, Ye Jean, Ibrahim Ahmad, Saeed Gul, Linsky Sarah, Kreinin Iouri, Tsang Sui, Nwanaji-Enwerem Uzoji, Raso Anthony, Arora Jagriti, Tokoglu Fuyuze, Yip Sarah W, Hahn C Alice, Lacadie Cheryl, Greene Abigail S, Jeon Sangchoon, Constable R Todd, Barry Declan T, Redeker Nancy S, Yaggi Henry, Scheinost Dustin
机构信息
From the Department of Radiology & Biomedical Imaging (S.M., J.A., F.T., C.L., R.T.C., D.S.), Department of Internal Medicine (A.I., H.Y.), Department of Urology (S.L.), Department of Pulmonary, Critical Care & Sleep Medicine (I.K.), Department of Psychiatry (S.W.Y., D.T.B.), Child Study Center (S.W.Y., D.T.B., D.S.), Yale Center for Clinical Investigation (C.A.H.), Department of Neurosurgery (R.T.C.), and Department of Statistics & Data Science (D.S.), Yale School of Medicine, 300 Cedar St, New Haven, CT 06519; Department of Health Policy, Vanderbilt University, Nashville, Tenn (H.P.); Interdepartmental Neuroscience Program, Yale University, New Haven, Conn (J.Y., S.W.Y., R.T.C., D.S.); Department of Internal Medicine, Roger Williams Medical Center, Providence, RI (G.S.); Yale School of Nursing, New Haven, Conn (S.L., U.N.E., S.J.); Yale University Program of Aging, Yale University, New Haven Conn (S.T.); Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, Conn (A.R.); Department of Psychiatry, Brigham and Women's Hospital, Boston, Mass (A.S.G.); Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, Conn (R.T.C., D.S.); Department of Research, APT Foundation, New Haven, Conn (D.T.B.); School of Nursing, University of Connecticut, Mansfield, Conn (N.S.R.); and Clinical Epidemiology Research Center, VA CT Health Care Center, West Haven, Conn (H.Y.).
出版信息
Radiology. 2024 Dec;313(3):e240514. doi: 10.1148/radiol.240514.
Background Structural and functional MRI studies have revealed brain alterations associated with opioid use disorder (OUD). However, previous research has been limited by small sample sizes, few female participants, and single-modality analyses. Purpose To identify structural and functional brain alterations in individuals with OUD using whole-brain data-driven methods to analyze T1-weighted MRI and resting-state functional MRI (rsfMRI). Materials and Methods This secondary analysis of the Collaboration Linking Opioid Use Disorder and Sleep study compared participants with OUD (data collection February 2021 to February 2023) receiving methadone treatment with healthy control participants (data collection February 2018 to May 2023). T1-weighted MRI and rsfMRI were analyzed using tensor-based morphometry and intrinsic connectivity distribution, respectively. Primary outcome measures included regional brain volumes and functional connectivity. Voxel-wise linear regression was used to assess group differences, with family-wise error correction. Pearson partial correlations were used to examine structure-function relationships. Results Compared with healthy control participants ( = 105; median age, 27 years [IQR, 23-37 years]; 58 female), participants with OUD ( = 103; median age, 37 years [IQR, 31.5-46 years]; 62 male) showed smaller volumes (corrected < .05) in the thalamus (β = -17.42 [95% CI: -26.56, -8.27]) and right medial temporal lobe (β = -8.02 [95% CI: -12.25, -3.78]). Larger volumes (corrected < .05) were seen in the brainstem (pons and medulla, β = 15.21 [95% CI: 7.03, 23.40]; midbrain, β = 13.04 [95% CI: 6.61, 19.47]) and cerebellum (right, β = 14.96 [95% CI: 7.25, 22.67]; left, β = 14.88 [95% CI: 7.32, 22.43]). An interaction between sex and group was found for medial prefrontal cortex volume (β = -19.38, corrected < .05), with female participants having smaller volumes than male participants in the OUD group. Increased functional connectivity (corrected < .05) was noted in the thalamus (β = 0.50 [95% CI: 0.25, 0.75]), right medial temporal lobe (β = 0.43 [95% CI: 0.21, 0.66]), right cerebellum (β = 0.46 [95% CI: 0.21, 0.71]), and brainstem (β = 0.48 [95% CI: 0.22, 0.74]) in the OUD group. Structure and function were positively correlated in the cerebellum (Pearson = 0.32 [95% CI: 0.17, 0.44], < .001) and brainstem (Pearson = 0.23 [95% CI: 0.09, 0.37], = .002). Conclusion Individuals with OUD showed overlapping structural and functional brain alterations in opioid receptor-dense regions compared with healthy control participants. © RSNA, 2024 See also the editorial by Filippi and Messina in this issue.
背景
结构和功能磁共振成像（MRI）研究已揭示与阿片类物质使用障碍（OUD）相关的大脑改变。然而，先前的研究受到样本量小、女性参与者少和单模态分析的限制。目的：使用全脑数据驱动方法分析T1加权MRI和静息态功能MRI（rsfMRI），以识别患有OUD的个体的结构和功能大脑改变。材料与方法：这项对“阿片类物质使用障碍与睡眠关联研究协作项目”的二次分析，将接受美沙酮治疗的OUD参与者（数据收集时间为2021年2月至2023年2月）与健康对照参与者（数据收集时间为2018年2月至2023年5月）进行比较。分别使用基于张量的形态测量法和内在连接分布分析T1加权MRI和rsfMRI。主要结局指标包括脑区体积和功能连接性。采用体素线性回归评估组间差异，并进行家族性错误校正。使用Pearson偏相关分析结构-功能关系。结果：与健康对照参与者（n = 105；年龄中位数，27岁[四分位间距，23 - 37岁]；58名女性）相比，OUD参与者（n = 103；年龄中位数，37岁[四分位间距，31.5 - 46岁]；62名男性）丘脑（β = -17.42 [95%可信区间：-26.56，-8.27]）和右侧内侧颞叶（β = -8.02 [95%可信区间：-12.25，-3.78]）体积较小（校正P <.05）。脑干（脑桥和延髓，β = 15.21 [95%可信区间：7.03，23.40]；中脑，β = 13.04 [95%可信区间：6.61，19.47]）和小脑（右侧，β = 14.96 [95%可信区间：7.25，22.67]；左侧，β = 14.88 [95%可信区间：7.32，22.43]）体积较大（校正P <.05）。内侧前额叶皮质体积存在性别与组间的交互作用（β = -19.38，校正P <.05），OUD组中女性参与者的体积小于男性参与者。OUD组丘脑（β = 0.50 [95%可信区间：0.25，0.75]）、右侧内侧颞叶（β = 0.43 [95%可信区间：0.21，0.66]）、右侧小脑（β = 0.46 [95%可信区间：0.21，0.71]）和脑干（β = 0.48 [95%可信区间：0.22，0.74]）的功能连接性增加（校正P <.05）。小脑（Pearson r = 0.32 [95%可信区间：0.17，0.44]，P <.001）和脑干（Pearson r = 0.23 [95%可信区间：0.09，0.37]，P =.002）的结构与功能呈正相关。结论：与健康对照参与者相比，患有OUD的个体在阿片受体密集区域表现出重叠的结构和功能大脑改变。© RSNA，2024 另见本期Filippi和Messina的社论。
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