A hypo‐status in drug‐dependent brain revealed by multi‐modal MRI

Abstract

Drug addiction is a chronic brain disorder with no proven effective cure. Assessing both structural and functional brain alterations using multimodal, rather than purely unimodal imaging techniques, may provide a more comprehensive understanding of the brain mechanisms underlying addiction, which in turn may facilitate future treatment strategies. However, this type of research remains scarce in the literature. We acquired multi-modal MRI from 20 cocaine-addicted individuals and 19 age-matched controls. Compared to controls, cocaine addicts showed a multi-modal hypo-status with 1) decreased brain tissue volume in the medial and lateral orbitofrontal cortex (OFC), 2) hypo-perfusion in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), insula, right temporal cortex, and dorsolateral prefrontal cortex (DLPFC), and 3) reduced irregularity of resting state activity in the OFC and limbic areas, as well as the cingulate, visual, and parietal cortices. In the cocaine-addicted brain, larger tissue volume in the medial OFC, ACC, and VS, and smaller insular tissue volume were associated with higher cocaine dependence levels. Decreased perfusion in the amygdala and insula were also correlated with higher cocaine dependence levels. Tissue volume, perfusion, as well as brain entropy in the insula and PFC, all showed a trend of negative correlation with drug craving scores. The three modalities showed voxel-wise correlation in various brain regions, and combining them improved patient vs control brain classification accuracy. These results, for the first time, demonstrate a comprehensive cocaine-dependence and craving-related hypo-status regarding the tissue volume, perfusion, and resting brain irregularity in the cocaine-addicted brain.

Functional Connectivity of Chronic Cocaine Use Reveals Progressive Neuroadaptations in Neocortical, Striatal, and Limbic Networks

“…Another region affected by chronic cocaine SA that has been implicated in reward-related behavior is the amygdala. Prior neuroimaging studies have demonstrated that amygdala volume in cocaine users is significantly smaller than that of matched control subjects ( Makris et al, 2004 ) and that reductions in amygdala cerebral blood flow are correlated with greater cocaine dependence ( Wang et al, 2017 ). Consistent with these findings in humans, cocaine self-administration causes a decrease in amygdala glucose metabolism in both rats and nonhuman primates ( Macey et al, 2004 ; Beveridge et al, 2006 ; Calipari et al, 2013 ).…”

Lifestyle and neurodegeneration in midlife as expressed on functional magnetic resonance imaging: A systematic review

“… Moderate Neurodegeneration Wang et al. [38] Substance misuse 39 (cocaine addict 20/healthy controls 19). Cocaine addict: 42.15 (4.3)/NA.…”

“…In a multimodal MRI study, Wang et al. [38] identified hypoperfusion in the prefrontal cortex, anterior cingulate cortex, insula, right temporal cortex, and dorsolateral prefrontal cortex in cocaine addicts compared with controls.…”

Decreased Relative Cerebral Blood Flow in Unmedicated Heroin-Dependent Individuals

“…A total of 55.8-80% (2,3) of patients relapsed to heroin use after being abstinent from drug use for 1-3 years at a 12-month follow-up. A major reason for the lack of an effective method for preventing relapse is the lack of a clear picture of heroin addiction-related brain mechanisms (4).…”