Effects of Opioid Dependence on Visuospatial Memory and Its Associations With Depression and Anxiety

Abstract

Introduction: The cognitive impact of opioid dependence is rarely measured systematically in everyday clinical practice even though both patients and clinicians accept that cognitive symptoms often occur in the opioid-dependent population. There are only a few publications which utilized computerized neuropsychological tests to assess possible impairments of visuospatial memory in opioid-dependent individuals either receiving opioid replacement therapy (ORT) or during subsequent short-term abstinence and the effects of anxiety and depression.Methods: We assessed a cohort of 102 participants, comprising i) a stable opioid-dependent group receiving methadone maintenance treatment (MMT) (n = 22), ii) a stable opioid-dependent group receiving buprenorphine (BMT) (n = 20), iii) a current abstinent but previously opioid-dependent group (ABS) (n = 8), and iv) a control group who have never been dependent on opioids. The Cambridge Neuropsychological Automated Test Battery (CANTAB) neuropsychological tasks undertaken by participants included: Delayed Matching to Sample (DMS), Pattern Recognition Memory (PRM), Spatial Recognition Memory (SRM), and Paired Associate Learning (PAL) tasks. Three clinical measures were used to assess the severity of anxiety and depressive illness: Hospital Anxiety Scale-Hospital Anxiety Depression (HADA)-(HADD), Beck Depression Inventory (BDI), and Inventory of Depressive Symptomatology (self-report) (ISD-SR).Results: The methadone- and buprenorphine-treated groups showed significant impairments (p < 0.001) in visuospatial memory tasks but not the abstinent group. Impairments in visuospatial memory strongly correlated with higher mood and anxiety symptom severity scores (p < 0.001).Discussion: These results are broadly consistent with previous studies. Uniquely, though, here we report a strong relationship between visuospatial memory and depression and anxiety scores, which might suggest common illness mechanisms.

Methadone maintenance treatment alters couplings of default mode and salience networks in individuals with heroin use disorder: A longitudinal self-controlled resting-state fMRI study

“…During the one-year follow-up period, 19 of the 37 patients undergoing MMT (51.35%) relapsed. The number of occurrences of relapse within a year was 5.25 ± 2.83 (range, [1][2][3][4][5][6][7][8][9][10][11]. The number of relapses was negatively related to the total methadone dose in 1 year (r = −0.515, p = 0.001, Bonferroni corrected p = 0.05/5 = 0.01; Figure 3).…”

“…The preprocessing was performed using DPABI, 1 SPM12, 2 and MATLAB 8.1 3 for neuroimaging. The resting-state fMRI dates for each participant were corrected for slice timing to eliminate time differences caused by multi-slice interval imaging.…”

An fMRI analysis of verbal and non-verbal working memory in people with a past history of opioid dependence

“…The participants with a history of heroin abuse performed normally on the digit span task but demonstrated impaired verbal WM on the N-back task compared to HC. Additionally, Ersche et al (2006) and Tolomeo et al (2019) found visuospatial memory deficits in opioid-dependent participants, implicating a non-verbal WM impairment as well. These studies included the pattern recognition memory task from the Cambridge Neuropsychological Test Automated Battery (CANTAB) ( Fray et al, 1996 ), which involved participants viewing sets of geometric patterns and later choosing the pattern they recognized from a two-alternative forced choice test of the patterns.…”

Opioid use disorder and the brain: a clinical perspective

“…One meta‐analysis of methadone‐maintained individuals reported neurocognitive deficits in working memory, attention, cognitive flexibility and other areas compared with controls [20]. In another study both methadone and buprenorphine users exhibited deficits in visuospatial working memory, which were strongly correlated with higher mood and anxiety symptom scores [21]. This highlights the potential need to pursue abstinence‐based therapy in OUD.…”