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| Motta, Antonella |
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| Mohamed, Tarek |
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| Ertürk, Emre |
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| Taccardi, Nicola |
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| Petrov, R. H. | Madrid |
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| Azam, Siraj |
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| Ali, M. A. |
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| Rančić, M. |
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| Ollier, Nadège |
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| Azevedo, Nuno Monteiro |
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Lubman, Dan I.
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article
Time-dependent neuronal changes associated with craving in opioid dependence: an fMRI study.
Abstract
Background: Relapse after initially successful treatment is a significant problem facing the treatment of opioid dependence. Evidence suggests craving elicited by re-exposure to drug cues may precipitate relapse. Attempts to identify neural biomarkers of cue-elicited craving have yielded inconsistent findings. We aimed to apply a novel continuous functional magnetic resonance imaging (fMRI) technique to follow the minute-to-minute evolution of brain responses which correlate with the waxing and waning of craving. Methods:Newly detoxified male opioid-dependent patients and healthy control participants attended two separate, counter-balanced, fMRI scanning sessions during which they viewed a 10-minute video (drug cue or neutral cue) followed by 5-minutes of fixation. Participants rated the intensity of their craving throughout each session.We hypothesised subcortical/ventral prefrontal cortex (PFC) regions and dorsal PFC regions would show different associations with craving reflecting their putative roles in appetitive processing versus cognitive control. Results: Compared with controls, drug cue (minus neutral cue) video recruited the left amygdala and was temporally correlated with craving. In contrast, dorsal anterior cingulate BOLD signal time-course was higher than controls only during a period after cue exposure when craving levels were declining. Against expectations neither the ventral striatum nor ventral PFC were significantly recruited by drug cue exposure. Conclusions: Findings suggest the amygdala has a central role in craving whereas the dorsal anterior cingulate may control craving in treatment-seeking patients.Time-course analysis yielded new insights into the neural substrates of craving that could objectively validate development of psychological and pharmacological approaches to sustained abstinence.