Metabolic and functional substrates of impulsive decision-making in individuals with heroin addiction after prolonged methadone maintenance treatment
•Subjects receiving MMT exhibit atypical choice bias and noise in decision.•Model-derived impulsivity is associated with the history of drug use.•Impulsive decision results from impaired top-down cognitive control.•Impaired glucose metabolism in addicts is selectively linked to opioid signaling. Ele...
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Published in | NeuroImage (Orlando, Fla.) Vol. 283; p. 120421 |
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Main Authors | , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Amsterdam
Elsevier Inc
01.12.2023
Elsevier Limited Elsevier |
Subjects | |
Online Access | Get full text |
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Summary: | •Subjects receiving MMT exhibit atypical choice bias and noise in decision.•Model-derived impulsivity is associated with the history of drug use.•Impulsive decision results from impaired top-down cognitive control.•Impaired glucose metabolism in addicts is selectively linked to opioid signaling.
Elevated impulsivity has been frequently reported in individuals with opioid addiction receiving methadone maintenance therapy (MMT), but the underlying neural mechanisms and cognitive subprocesses are not fully understood. We acquired functional magnetic resonance imaging (fMRI) data from 37 subjects with heroin addiction receiving long-term MMT and 33 healthy controls who performed a probabilistic reversal learning task, and measured their resting-state brain glucose using fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Subjects receiving MMT exhibited significantly elevated self-reported impulsivity, and computational modeling revealed a marked impulsive decision bias manifested as switching more frequently without available evidence. Moreover, this impulsive decision bias was associated with the dose and duration of methadone use, irrelevant to the duration of heroin use. During the task, the switch-related hypoactivation in the left rostral middle frontal gyrus was correlated with the impulsive decision bias while the function of reward sensitivity was intact in subjects receiving MMT. Using prior brain-wide receptor density data, we found that the highest variance of regional metabolic abnormalities was explained by the spatial distribution of μ-opioid receptors among 10 types of neurotransmitter receptors. Heightened impulsivity in individuals receiving prolonged MMT is manifested as atypical choice bias and noise in decision-making processes, which is further driven by deficits in top-down cognitive control, other than reward sensitivity. Our findings uncover multifaceted mechanisms underlying elevated impulsivity in subjects receiving MMT, which might provide insights for developing complementary therapies to improve retention during MMT. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1053-8119 1095-9572 |
DOI: | 10.1016/j.neuroimage.2023.120421 |