Transcutaneous Cervical Vagus Nerve Stimulation Modulates Prefrontal Cortex Activity During Opioid Withdrawal in Individuals With Opioid Use Disorder.

BACKGROUND

Opioid use disorder (OUD) is associated with considerable morbidity and mortality with limited treatment approaches. Understanding brain mechanisms in response to treatment could be useful in guiding future developments in treatment approaches.

OBJECTIVE

The purpose of this study was to assess the effects of transcutaneous cervical vagus nerve stimulation (tcVNS) on brain response to opioid use cues in patients with OUD in opioid withdrawal.

MATERIALS AND METHODS

Patients with OUD who were in the early stage of recovery and/or on medication underwent brain imaging with positron emission tomography and radiolabeled water in conjunction with stimulation with active tcVNS or sham devices and exposure to opioid-use-related cues.

RESULTS

tcVNS caused a relative increase in function in the anterior cingulate, dorsal anterior cingulate, and left inferior frontal gyrus during exposure to opioid cues. There also was a pattern of increased activation in the ventral striatum and orbitofrontal cortex.

CONCLUSION

tcVNS modulates brain areas implicated in opioid addiction, suggesting a useful role as an adjunctive therapy for OUD.

CLINICAL TRIAL REGISTRATION

The Clinicaltrials.gov registration number for the study is NCT04556552.