title: Reduction in cerebral perfusion after heroin administration: a resting state arterial spin labeling study.
abstract: Heroin dependence is a chronic relapsing brain disorder, characterized by the compulsion to seek and use heroin. Heroin itself has a strong potential to produce subjective experiences characterized by intense euphoria, relaxation and release from craving. The neurofunctional foundations of these perceived effects are not well known. In this study, we have used pharmacological magnetic resonance imaging (phMRI) in 15 heroin-dependent patients from a stable heroin-assisted treatment program to observe the steady state effects of heroin (60 min after administration). Patients were scanned in a cross-over and placebo controlled design. They received an injection of their regular dose of heroin or saline (placebo) before or after the scan. As phMRI method, we used a pulsed arterial spin labeling (ASL) sequence based on a flow-sensitive alternating inversion recovery (FAIR) spin labeling scheme combined with a single-shot 3D GRASE (gradient-spin echo) readout on a 3 Tesla scanner. Analysis was performed with Statistical Parametric Mapping (SPM 8), using a general linear model for whole brain comparison between the heroin and placebo conditions. We found that compared to placebo, heroin was associated with reduced perfusion in the left anterior cingulate cortex (ACC), the left medial prefrontal cortex (mPFC) and in the insula (both hemispheres). Analysis of extracted perfusion values indicate strong effect sizes and no gender related differences. Reduced perfusion in these brain areas may indicate self- and emotional regulation effects of heroin in maintenance treatment.
authors.affiliation: University Hospital of Psychiatry, Basel, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Denier
authors.forename: Hana
authors.initials: H
authors.lastname: Gerber
authors.forename: Marc
authors.initials: M
authors.lastname: Vogel
authors.forename: Markus
authors.initials: M
authors.lastname: Klarhöfer
authors.forename: Anita
authors.initials: A
authors.lastname: Riecher-Rossler
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Wiesbeck
authors.forename: Undine E
authors.initials: UE
authors.lastname: Lang
authors.forename: Stefan
authors.initials: S
authors.lastname: Borgwardt
authors.forename: Marc
authors.initials: M
authors.lastname: Walter
mesh_terms: D000328:Adult; D002536:Cerebral Arteries / Q000187:drug effects / Q000503:physiopathology; D018592:Cross-Over Studies; D005260:Female; D006179:Gyrus Cinguli / Q000098:blood supply / Q000187:drug effects*; D003932:Heroin / Q000008:administration & dosage*; D006556:Heroin Dependence / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009294:Narcotics / Q000008:administration & dosage*; D017397:Prefrontal Cortex / Q000098:blood supply / Q000187:drug effects*; D012039:Regional Blood Flow / Q000187:drug effects; D016037:Single-Blind Method
chemical_list: D009294:Narcotics; D003932:Heroin
references.citation: Proc Natl Acad Sci U S A. 2001 Mar 27;98(7):4259-64
references.pmid: 11259662
references.citation: Curr Clin Pharmacol. 2006 Jan;1(1):109-18
references.pmid: 18666382
references.citation: Eur Neuropsychopharmacol. 2012 Aug;22(8):537-45
references.pmid: 22209360
references.citation: Neuroimage. 2007 Oct 1;37(4):1083-90; discussion 1097-9
references.pmid: 17719799
references.citation: Neuropsychopharmacology. 2011 Jun;36(7):1340-8
references.pmid: 21412224
references.citation: Arch Gen Psychiatry. 1990 Jan;47(1):73-81
references.pmid: 2403775
references.citation: Neuroimage. 2003 Dec;20(4):1964-70
references.pmid: 14683702
references.citation: Eur Neuropsychopharmacol. 2008 Apr;18(4):278-85
references.pmid: 18207374
references.citation: Arch Gen Psychiatry. 2009 Jan;66(1):95-105
references.pmid: 19124693
references.citation: Brain Cogn. 2009 Dec;71(3):223-8
references.pmid: 19775795
references.citation: J Psychiatr Res. 2009 Aug;43(12):1018-24
references.pmid: 19135215
references.citation: J Neuroradiol. 2007 Dec;34(5):322-9
references.pmid: 18022231
references.citation: Arch Gen Psychiatry. 2012 Jan;69(1):27-36
references.pmid: 22213786
references.citation: Eur Neuropsychopharmacol. 2008 May;18(5):390-3
references.pmid: 18299189
references.citation: Mult Scler. 2012 Nov;18(11):1570-6
references.pmid: 22466702
references.citation: Addict Biol. 2013 Jan;18(1):1-7
references.pmid: 21481103
references.citation: Int J Methods Psychiatr Res. 2011 Mar;20(1):10-27
references.pmid: 21574207
references.citation: Clin Exp Pharmacol Physiol. 2003 Apr;30(4):266-72
references.pmid: 12680845
references.citation: Psychiatry Clin Neurosci. 2009 Aug;63(4):563-8
references.pmid: 19531112
references.citation: Am J Addict. 2013 Nov-Dec;22(6):598-604
references.pmid: 24131168
references.citation: Am J Drug Alcohol Abuse. 1986;12(1-2):79-87
references.pmid: 3788901
references.citation: Psychopharmacology (Berl). 2001 Jun;155(4):362-71
references.pmid: 11441425
references.citation: Brain Res Bull. 2012 Jan 4;87(1):109-16
references.pmid: 22040859
references.citation: Eur Addict Res. 2012;18(3):116-23
references.pmid: 22286020
references.citation: Alcohol Res Health. 1999;23(3):215-24
references.pmid: 10890817
references.citation: AAPS J. 2005 Oct 19;7(3):E587-91
references.pmid: 16353937
references.citation: J Pharmacol Exp Ther. 2011 May;337(2):359-66
references.pmid: 21317356
references.citation: Anesth Analg. 2007 Jul;105(1):167-75
references.pmid: 17578972
references.citation: Proc Natl Acad Sci U S A. 2001 Jan 16;98(2):676-82
references.pmid: 11209064
references.citation: Eur Psychiatry. 2007 Sep;22(6):387-94
references.pmid: 17416488
references.citation: Magn Reson Med. 1995 Sep;34(3):293-301
references.pmid: 7500865
references.citation: Ann N Y Acad Sci. 2001 May;935:107-17
references.pmid: 11411161
references.citation: Magn Reson Med. 2000 Sep;44(3):450-6
references.pmid: 10975898
references.citation: Neuroimage. 2006 May 15;31(1):440-57
references.pmid: 16466680
references.citation: Curr Pharm Des. 2012;18(32):5081-92
references.pmid: 22716140
references.citation: Life Sci. 1983;33 Suppl 1:773-6
references.pmid: 6319928
references.citation: Magn Reson Med. 2005 Aug;54(2):491-8
references.pmid: 16032686
references.citation: J Pharmacol Exp Ther. 1999 Jun;289(3):1454-64
references.pmid: 10336539
references.citation: Addiction. 2010 Jan;105(1):29-37
references.pmid: 19922519
references.citation: Neuropsychobiology. 2002;45(2):67-73
references.pmid: 11893862
references.citation: Ann N Y Acad Sci. 2008 Mar;1124:1-38
references.pmid: 18400922
references.citation: J Cereb Blood Flow Metab. 2008 Aug;28(8):1514-22
references.pmid: 18506198
references.citation: Am J Psychiatry. 2008 Mar;165(3):390-4
references.pmid: 18056224
references.citation: Science. 1997 Oct 3;278(5335):52-8
references.pmid: 9311926
references.citation: Philos Trans R Soc Lond B Biol Sci. 1999 Jul 29;354(1387):1261-81
references.pmid: 10466150
references.citation: Proc Natl Acad Sci U S A. 2012 Feb 7;109(6):2138-43
references.pmid: 22308440
references.citation: Curr Opin Neurol. 2009 Aug;22(4):348-55
references.pmid: 19491678
references.citation: Arch Gen Psychiatry. 2009 Apr;66(4):442-51
references.pmid: 19349314
references.citation: Biol Psychiatry. 2008 Dec 1;64(11):966-73
references.pmid: 18589404
references.citation: Psychopharmacology (Berl). 2003 Jan;165(2):188-93
references.pmid: 12404073
references.citation: Addict Biol. 2011 Jan;16(1):145-51
references.pmid: 20331562
references.citation: MAGMA. 2012 Apr;25(2):163-75
references.pmid: 22113518