Pathological Regional Cerebral Blood Flow in Opiate-Dependent Patients during Withdrawal: A HMPAO-SPECT Study

Abstract

The aims of the present study were to investigate regional cerebral blood flow (rCBF) in heroin-dependent patients during withdrawal and to assess the relation between these changes and duration of heroin consumption and withdrawal data. The rCBF was measured using brain SPECT with ^99mTc-HMPAO in 16 heroin-dependent patients during heroin withdrawal. Thirteen patients received levomethadone at the time of the SPECT scans. The images were analyzed both visually and quantitatively. A total of 21 hypoperfused brain regions were observed in 11 of the 16 patients. The temporal lobes were the most affected area, hypoperfusions of the right and left temporal lobe were observed in 5 and 5 patients, respectively. Three of the patients had a hypoperfusion of the right frontal lobe, 2 patients showed perfusion defects in the left frontal lobe, right parietal lobe and left parietal lobe. The results of the quantitative assessments of the rCBF were consistent with the results of the qualitative findings. The stepwise regression analysis showed a significant positive correlation (r = 0.54) between the dose of levomethadone at the time of the SPECT scan and the rCBF of the right parietal lobe. Other significant correlations between clinical data and rCBF were not found. The present results suggest brain perfusion abnormalities during heroin withdrawal in heroin-dependent patients, which are not due to the conditions of withdrawal.

Augmented Accumbal Serotonin Levels Decrease the Preference for a Morphine Associated Environment During Withdrawal

“…Although a number of reports have shown that fluoxetine in the doses used in this study has no effect on DA levels in the accumbens (Clark et al 1996;Ichikawa and Meltzer 1995;Perry and Fuller 1992), one recent study found that similar doses of fluoxetine significantly increased DA levels in the frontal cortex (Gobert et al 1997). The frontal cortex is one area shown to be hypofunctional during opiate abstinence and withdrawal in human opiate addicts (Danos et al 1998;Gerra et al 1998;Krystal et al 1995) and it is possible that the treatments given in this study may be effective in changing preference by altering activity in this brain region.…”

Cerebral metabolism and mood in remitted opiate dependence

“…The few studies that have investigated brain function in clients receiving MMT involved research participants who did not use illicit drugs (Rose et al, 1996;Krystal et al, 1995;Danos et al, 1998), as well as other that were actively using heroin (Pezawas et al, 2002) or were HIV-positive (Woods et al, 1991). The resultant reports yielded inconsistent findings of cortical and subcortical perfusion defects.…”

Full number: Volume 10, Number 2 / Número completo: Volumen 10, Número 2

“…La mayoría de estos estudios han utilizado la Tomografía Computerizada por Emisión de Fotón Único (SPECT, del inglés Single Photon Emission Computerized Tomography). Todos refieren un menor flujo sanguíneo en el córtex prefrontal, frontal, temporal y parietal (Pezawas, Fischer, Podreka, Schindler, Brucke, Jagsch et al, 2002;Danos, Kasper, Grunwald, Klemm, Krappel, Broich et al, 1998;Gerra, Calbiani, Zaimovic, Sartori, Ugolotti, Ippolito et al, 1998;Krystal, Woods, Kosten, Rosen, Seibyl, van Dyck et al, 1995). Dos estudios refieren asimetrías en cuanto a la actividad, pues ésta era menor en las zonas cerebrales derechas respecto a las izquierdas, alegando que dicha asimetría puede deberse más al estado anímico de los sujetos que a la propia administración crónica.…”