Neural correlates of adherence to extended-release naltrexone pharmacotherapy in heroin dependence

Translational Psychiatry
A-L WangDaniel D Langleben

Abstract

Injectable extended-release naltrexone (XRNTX) presents an effective therapeutic strategy for opioid addiction, however its utility could be hampered by poor adherence. To gain a better insight into this phenomenon, we utilized blood oxygenation level-dependent functional magnetic resonance imaging (fMRI) in conjunction with a validated cue-induced craving procedure to examine neural correlates of XRNTX adherence. We operationalized treatment adherence as the number of monthly XRNTX injections (range: 0-3) administered to a group of fully detoxified heroin-dependent subjects (n=32). Additional outcomes included urine toxicology screening and self-reported tobacco use. The presented heroin-related visual cues reliably elicited heroin craving in all tested subjects. Nine, five, three and 15 of the participants, respectively, received zero, one, two and three XRNTX injections, predicted by the individual baseline fMRI signal change in response to the cues in the medial prefrontal cortex, a brain region involved in inhibitory self-control and emotional appraisal. The incidence of opioid-positive urines during the XRNTX therapy was low and remained about half the pre-treatment rate after the XRNTX ended. During the treatment, cigare...Continue Reading

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Citations

Feb 6, 2018·Addiction·Brantley P JarvisKenneth Silverman
Jan 29, 2019·The International Journal of Neuropsychopharmacology·Zhenhao ShiDaniel D Langleben
May 8, 2020·The American Journal of Drug and Alcohol Abuse·An-Li WangDaniel D Langleben
Nov 14, 2019·Molecular Psychiatry·Sarah D LichensteinSarah W Yip
Mar 23, 2019·Frontiers in Psychiatry·Jennifer L StewartJerzy Bodurka
Aug 12, 2016·Clinical Nurse Specialist CNS·Patricia Anne O'Malley
Oct 25, 2020·Addiction Biology·Zhenhao ShiDaniel D Langleben
Mar 23, 2017·Progress in Neuro-psychopharmacology & Biological Psychiatry·Scott J Moeller, Martin P Paulus
May 1, 2021·Journal of Personalized Medicine·Lynn M OswaldCarla L Storr

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Methods Mentioned

BETA
pharmacotherapy

Clinical Trials Mentioned

NCT02032433

Software Mentioned

Brain Extraction Tool
Statistical Package of the Social Sciences ( SPSS
MCFLIRT
fMRI Expert Analysis Tool
FLIRT
FSL ( FMRIB Library

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