Cerebral metabolism and mood in remitted opiate dependence.
BACKGROUND
Opiate-dependent individuals are prone to dysphoria that may contribute to treatment failure. Methadone-maintenance therapy (MMT) may mitigate this vulnerability, but controversy surrounds its long-term use. Little is known about the neurobiology of mood dysregulation in individuals receiving or removed from MMT.


METHODS
Fifteen opiate-abstinent and 12 methadone-maintained, opiate-dependent subjects, who lacked other Axis I pathology, and 13 control subjects were compared on the Cornell Dysthymia Rating Scale (CDRS) and regional cerebral glucose metabolism (rCMRglc) using [(18)F]fluorodeoxyglucose positron emission tomography.


RESULTS
CDRS scores showed no group differences. Opiate-abstinent subjects had lower rCMRglc than control subjects in the bilateral perigenual anterior cingulate cortex (ACC), left mid-cingulate cortex, left insula and right superior frontal cortex. Methadone-maintained subjects exhibited lower rCMRglc than control subjects in the left insula and thalamus. In opiate-abstinent subjects, rCMRglc in the left perigenual ACC and mid-cingulate cortex correlated positively with CDRS scores.


CONCLUSIONS
In remitted heroin dependence, opiate-abstinence is associated with more widespread patterns of abnormal cortical activity than MMT. Aberrant mood processing in the left perigenual ACC and mid-cingulate cortex, seen in opiate-abstinent individuals, is absent in those receiving MMT, suggesting that methadone may improve mood regulation in this population.
Galynker
Igor I
II
Department of Psychiatry and Behavioral Sciences, Beth Israel Medical Center, Albert Einstein College of Medicine, First Avenue at 16th Street, New York, NY 10003, USA. igalynker@bethisraelny.org
Eisenberg
Daniel
D
Matochik
John A
JA
Gertmenian-King
Enid
E
Cohen
Lisa
L
Kimes
Alane S
AS
Contoreggi
Carlo
C
Kurian
Varughese
V
Ernst
Monique
M
Rosenthal
Richard N
RN
Prosser
James
J
London
Edythe D
ED
D000328:Adult; D000339:Affect / Q000502:physiology*; D001921:Brain / Q000378:metabolism*; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012074:Remission Induction; D011795:Surveys and Questionnaires
D009294:Narcotics; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D008691:Methadone