Cingulate Cortex Structural Alterations in Substance Use Disorder Psychiatric Inpatients

Abstract

Background and Objectives: Substance use disorder (SUD) includes maladaptive patterns of substance use despite negative consequences. Previous structural neuroimaging studies showed some structural alterations in SUD, but it remains unknown whether these alterations are specifically associated with SUD or common comorbidities. This study attempts to validate the findings of structural differences between SUD, healthy controls (HC), and psychiatric controls (PC). Methods: We used HC (N = 86) matched for demographics, and PC (N = 86) matched for demographics and psychiatric diagnoses to a group of SUD patients (N = 86). We assessed the group differences of subcortical volumes, cortical volumes, thickness, and surface areas between SUD and HC. We then analyzed the group differences between SUD and PC within regions showing differences between SUD and HC. Results: SUD had smaller left nucleus accumbens, right thalamus, right hippocampus, left caudal anterior cingulate cortex (ACC) volume, and larger right caudal ACC volume, and right caudal ACC, right caudal middle frontal gyrus (MFG), and right posterior cingulate cortex (PCC) surface than HC. Increased right caudal ACC volume and right PCC surface in SUD were the only findings when compared with PC. Several areas showed thickness alterations between SUD and HC, but none survived multiple comparisons vs PC. Discussion and Conclusions: Our findings suggest that cingulate structures may be altered in SUD compared with both HC and PC. Scientific Significance: These results are among the first to indicate that some structural alterations may be SUD-specific, and highlight a cautionary note about using HC in psychiatric biomarker research.

Cortical surface variation in individuals with excessive smartphone use

“…In the present structural MRI study, however, a dimensional recruitment approach was used, in order to target healthy young adults who spent considerably more time on their smartphone versus those who use smartphones but fall below proposed psychometric criteria, as suggested by the SPAI (Y.-H. Lin et al, 2014), SAS, and SAS-SV Kwon, Lee, et al, 2013). Nevertheless, the categorical approach, that is, splitting two groups for the purpose of direct comparison, clearly revealed a neural signature that has been frequently described in addictive drug use (Goldstein et al, 2009;Oh et al, 2021), compulsive internet video-gaming (D. Lee et al, 2018;Meng et al, 2015), and reward-seeking in general (Durazzo et al, 2013(Durazzo et al, , 2011. Interestingly, structural alterations of SFG and ACC are also neuroanatomical markers in UHR subjects (T. Y.…”

“…Second, ACC plays a crucial role in reward anticipation (Bush et al., 2002) and is associated with addictive behavior (Brand et al., 2019; Kühn & Gallinat, 2011; Meng et al., 2015; Volkow et al., 2012) and substance use disorders (SUD) (Navarri et al., 2020). In particular, a recent MRI study showed that patients with SUD have smaller cACC volumes than healthy individuals and psychiatric controls (Oh et al., 2021). In a recent study of our group, we found a decreased activation of the ACC in individuals with SPA (Horvath et al., 2020).…”

“…Although this correlation did not survive the FDR correction for multiple testing, this finding is biologically plausible and highlights the central role of ACC in OCD‐associated symptoms. It is also a hint to a dimensional and transnosologically valid neural signature related to compulsive behavior, an essential mechanism that also drives SUD (Oh et al., 2021) and behavioral addictions (Zhang et al., 2020). Our findings are also in line with a recent review by Kalhan et al.…”

“…Lin et al., 2014), SAS, and SAS‐SV (Kwon, Kim, et al., 2013; Kwon, Lee, et al., 2013). Nevertheless, the categorical approach, that is, splitting two groups for the purpose of direct comparison, clearly revealed a neural signature that has been frequently described in addictive drug use (Goldstein et al., 2009; Y. Li et al., 2015; Oh et al., 2021), compulsive internet video‐gaming (D. Lee et al., 2018; Meng et al., 2015), and reward‐seeking in general (Durazzo et al., 2013, 2011). Interestingly, structural alterations of SFG and ACC are also neuroanatomical markers in UHR subjects (T. Y. Lee et al., 2013; Liloia et al., 2021).…”

Neural substrates of substance use disorders

“…On the other hand, others have been unable to find reliable univariate between-group differences in cortical structure or edgewise resting state functional connectivity in prescription opioid users [10]. Structural neuroimaging approaches have shown that relative to comparison participants, individuals with substance use disorder have smaller left nucleus accumbens, right thalamus, right hippocampus, left caudal anterior cingulate cortex (ACC) volume and larger right caudal ACC volume, and right caudal ACC, right caudal middle frontal gyrus (MFG) and right posterior cingulate cortex (PCC) surface than Healthy Comparison [11]. Some have speculated that these differences are both due to preexisting factors and the influence of recent substance [12].…”