title: Progressive white matter impairment as a predictor of outcome in a cohort of opioid-dependent patient's post-detoxification.
abstract: White matter impairment is associated with opioid dependence. However, the specific neuropathology related to opioid dependence is still not fully understood. The main aims of this study were to: (1) assess the association between white matter impairment and duration of dependence; (2) examine whether this impairment correlates with treatment outcome measures in opioid-dependent patients post-detoxification. Fifty-eight opioid-dependent patients participated, 20 females and 38 males, across three groups: less than 10 years use (n = 18), 10-15 years use (n = 26) and 16-25+ years use (n = 14). Diffusion tensor imaging was used to assess white matter impairment; whole brain voxel-wise analysis of fractional anisotropy, mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were performed by Tract-Based-Spatial-Statistics to pinpoint abnormalities in white matter. The longer the subjects were dependent on opioids, the more widespread and severely the white-matter integrity was disrupted. A general linear model was used to examine patients who relapsed compared to those who were abstinent at follow-up. No statistical difference was found between groups (p > 0.05). Partial correlations were performed to investigate the relationship between clinical outcome measures (physical health, psychological well being and quality of life and hope for the future) and white-matter microstructural differences. Significant correlations were found between AD in the posterior corona radiata (L) and MD in the superior longitudinal fasciculus and a clinical measure for HOPE at 9-month follow-up. Nevertheless, it must be noted that the calculation of numerous correlations raises the possibility of a type I error, namely; to incorrectly conclude the occurrence of a significant correlation. The ability to investigate the structure-clinical relationship may improve our understanding of the pathological abnormalities associated with opioid dependence and has promise for use in evaluating future therapeutic outcomes in this population.
authors.affiliation: Department of Public Health and Primary Care, School of Medicine Trinity College Dublin, Ireland.
authors.forename: Jo-Hanna
authors.initials: JH
authors.lastname: Ivers
authors.affiliation: Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland.|Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Fitzgerald
authors.affiliation: Department of Molecular and Cellular Therapeutics Royal College of Surgeons, Dublin, Royal College of Surgeons in Ireland, Ireland.|Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Whelan
authors.affiliation: Tara Trust Edinburgh, United Kingdom.
authors.forename: Brion
authors.initials: B
authors.lastname: Sweeney
authors.affiliation: National Drug Treatment Centre Board, Health Service Executive, Dublin, Ireland.
authors.forename: Eamon
authors.initials: E
authors.lastname: Keenan
authors.affiliation: National Centre for Advanced Medical Imaging (CAMI), St James Hospital, Ireland.|Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Fagan
authors.affiliation: National Centre for Advanced Medical Imaging (CAMI), St James Hospital, Ireland.|Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Jason
authors.initials: J
authors.lastname: McMarrow
authors.affiliation: National Centre for Advanced Medical Imaging (CAMI), St James Hospital, Ireland.|Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Ireland.
authors.forename: Jim
authors.initials: J
authors.lastname: Meany
authors.affiliation: Department of Public Health and Primary Care, School of Medicine Trinity College Dublin, Ireland.
authors.forename: Joe
authors.initials: J
authors.lastname: Barry
authors.affiliation: Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland.|Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland.|Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Frodl
mesh_terms: D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology; D015331:Cohort Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors; D066127:White Matter / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
keywords: Detoxification; diffusion tensor imaging; neuroimaging; opioid dependence; white matter