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Impaired frontostriatal functional connectivity among chronic opioid using pain patients is associated with dysregulated affect.

Authors
  • McConnell, Patrick A1
  • Garland, Eric L2, 3
  • Zubieta, Jon-Kar4, 5
  • Newman-Norlund, Roger6
  • Powers, Shannon1
  • Froeliger, Brett1, 7, 8
  • 1 Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA.
  • 2 Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, Utah, USA.
  • 3 College of Social Work, University of Utah, Salt Lake City, Utah, USA.
  • 4 Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA.
  • 5 University Neuropsychiatric Institute, University of Utah, Salt Lake City, Utah, USA.
  • 6 Department of Psychology, University of South Carolina, Columbia, South Carolina, USA.
  • 7 Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.
  • 8 Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA.
Type
Published Article
Journal
Addiction Biology
Publisher
Wiley (Blackwell Publishing)
Publication Date
Mar 01, 2020
Volume
25
Issue
2
Identifiers
DOI: 10.1111/adb.12743
PMID: 30945801
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Preclinical studies have shown effects of chronic exposure to addictive drugs on glutamatergic-mediated neuroplasticity in frontostriatal circuitry. These initial findings have been paralleled by human functional magnetic resonance imaging (fMRI) research demonstrating weaker frontostriatal resting-state functional connectivity (rsFC) among individuals with psychostimulant use disorders. However, there is a dearth of human imaging literature describing associations between long-term prescription opioid use, frontostriatal rsFC, and brain morphology among chronic pain patients. We hypothesized that prescription opioid users with chronic pain, as compared with healthy control subjects, would evidence weaker frontostriatal rsFC coupled with less frontostriatal gray matter volume (GMV). Further, those opioid use-related deficits in frontostriatal circuitry would be associated with negative affect and drug misuse. Prescription opioid users with chronic pain (n = 31) and drug-free healthy controls (n = 30) underwent a high-resolution anatomical and an eyes-closed resting-state functional scan. The opioid group, relative to controls, exhibited weaker frontostriatal rsFC, and less frontostriatal GMV in both L.NAc and L.vmPFC. Frontostriatal rsFC partially mediated group differences in negative affect. Within opioid users, L.NAc GMV predicted opioid misuse severity. The current study revealed that prescription opioid use in the context of chronic pain is associated with functional and structural abnormalities in frontostriatal circuitry. These results suggest that opioid use-related abnormalities in frontostriatal circuitry may undergird disturbances in affect that may contribute to the ongoing maintenance of opioid use and misuse. These findings warrant further examination of interventions to treat opioid pathophysiology in frontostriatal circuitry over the course of treatment. © 2019 Society for the Study of Addiction.

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