Dejoie Jordan M, Senia Nicole, Konova Anna B, Smith David V, Fareri Dominic S
Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY, United States.
Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States.
Imaging Neurosci (Camb). 2024 Jul 1;2. doi: 10.1162/imag_a_00211. eCollection 2024.
Substance use and substance use disorders represent ongoing major public health crises. Specifically, the use of substances such as cocaine and heroin are responsible for over 50,000 drug-related deaths combined annually. We used a comparative meta-analysis procedure to contrast activation patterns associated with cocaine and heroin cue reactivity, which may reflect substance use risk for these substances. PubMed and Google Scholar were searched for studies with within-subject whole brain analyses comparing drug to neutral cues for users of cocaine and heroin published between 1995 and 2022. A total of 18 studies were included, 9 in each subgroup. Voxel-based meta-analyses were performed using seed-based d mapping with permuted subject images (SDM-PSI) for subgroup mean analyses and a contrast meta-regression comparing the two substances. Results from our mean analysis indicated that users of heroin showed more widespread activation in the nucleus accumbens, right inferior and left middle temporal gyrus, right thalamus, and right cerebellum. Cocaine use was associated with recruitment of dorsolateral prefrontal cortex during cue reactivity. Direct comparison of cue reactivity studies in heroin relative to cocaine users revealed greater activation in dopaminergic targets for users of heroin compared to users of cocaine. Differential activation patterns between substances may underlie differences in the clinical characteristics observed in users of cocaine and heroin, including seeking emotional blunting in users of heroin. More consistent research methodology is needed to provide adequate studies for stringent meta-analyses examining common and distinct neural activation patterns across substances and moderation by clinically relevant factors.
物质使用及物质使用障碍是持续存在的重大公共卫生危机。具体而言，可卡因和海洛因等物质的使用每年合计导致超过50,000例与毒品相关的死亡。我们采用比较性元分析程序，对比与可卡因和海洛因线索反应性相关的激活模式，这可能反映了这些物质的物质使用风险。在PubMed和谷歌学术上搜索了1995年至2022年间发表的、对可卡因和海洛因使用者进行药物与中性线索对比的受试者内全脑分析研究。共纳入18项研究，每个亚组9项。使用基于种子点的排列受试者图像的d映射（SDM-PSI）进行基于体素的元分析，以进行亚组均值分析，并进行对比元回归以比较这两种物质。我们的均值分析结果表明，海洛因使用者在伏隔核、右侧颞下回和左侧颞中回、右侧丘脑和右侧小脑表现出更广泛的激活。可卡因使用与线索反应性期间背外侧前额叶皮质的激活有关。对海洛因使用者与可卡因使用者的线索反应性研究进行直接比较发现，与可卡因使用者相比，海洛因使用者在多巴胺能靶点的激活更强。不同物质之间的差异激活模式可能是可卡因和海洛因使用者所观察到的临床特征差异的基础，包括海洛因使用者寻求情绪迟钝。需要更一致的研究方法，以便为严格的元分析提供充分的研究，从而检验不同物质之间常见和独特的神经激活模式以及临床相关因素的调节作用。
