title: Predicting subsequent relapse by drug-related cue-induced brain activation in heroin addiction: an event-related functional magnetic resonance imaging study.
abstract: Abnormal salience attribution is implicated in heroin addiction. Previously, combining functional magnetic resonance imaging (fMRI) and a drug cue-reactivity task, we demonstrated abnormal patterns of subjective response and brain reactivity in heroin-dependent individuals. However, whether the changes in cue-induced brain response were related to relapse was unknown. In a prospective study, we recruited 49 heroin-dependent patients under methadone maintenance treatment, a gold standard treatment (average daily dose 41.8 ± 16.0 mg), and 20 healthy subjects to perform the heroin cue-reactivity task during fMRI. The patients' subjective craving was evaluated. They participated in a follow-up assessment for 3 months, during which heroin use was assessed and relapse was confirmed by self-reported relapse or urine toxicology. Differences between relapsers and non-relapsers were analyzed with respect to the results from heroin-cue responses. Compared with healthy subjects, relapsers and non-relapsers commonly demonstrated significantly increased brain responses during the processing of heroin cues in the mesolimbic system, prefrontal regions and visuospatial-attention regions. However, compared with non-relapsers, relapsers demonstrated significantly greater cue-induced craving and the brain response mainly in the bilateral nucleus accumbens/subcallosal cortex and cerebellum. Although the cue-induced heroin craving was low in absolute measures, the change in craving positively correlated with the activation of the nucleus accumbens/subcallosal cortex among the patients. These findings suggest that in treatment-seeking heroin-dependent individuals, greater cue-induced craving and greater specific regional activations might be related to reward/craving and memory retrieval processes. These responses may predict relapse and represent important targets for the development of new treatment for heroin addiction.
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.|Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Hanyue
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Yarong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: School of Life Science and Technology, Xidian University, Xi'an, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Yongbin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Yan
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Chang
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Min
authors.initials: M
authors.lastname: Fan
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.|School of Life Science and Technology, Xidian University, Xi'an, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Tian
authors.affiliation: Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Gold
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.|Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA.|College of Engineering, Peking University, Beijing, China.
authors.forename: Yijun
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology*; D001931:Brain Mapping; D002681:China; D003463:Cues; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000503:physiopathology* / Q000534:rehabilitation; D049690:History, Ancient; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results
chemical_list: D008691:Methadone
keywords: Craving; fMRI; heroin addiction; relapse