Reduction in Cerebral Perfusion after Heroin Administration: A Resting State Arterial Spin Labeling StudyReportar como inadecuado

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Heroin dependence is a chronic relapsing brain disorder, characterized by the compulsion to seek and use heroin. Heroin itself has a strong potential to produce subjective experiences characterized by intense euphoria, relaxation and release from craving. The neurofunctional foundations of these perceived effects are not well known. In this study, we have used pharmacological magnetic resonance imaging phMRI in 15 heroin-dependent patients from a stable heroin-assisted treatment program to observe the steady state effects of heroin 60 min after administration. Patients were scanned in a cross-over and placebo controlled design. They received an injection of their regular dose of heroin or saline placebo before or after the scan. As phMRI method, we used a pulsed arterial spin labeling ASL sequence based on a flow-sensitive alternating inversion recovery FAIR spin labeling scheme combined with a single-shot 3D GRASE gradient-spin echo readout on a 3 Tesla scanner. Analysis was performed with Statistical Parametric Mapping SPM 8, using a general linear model for whole brain comparison between the heroin and placebo conditions. We found that compared to placebo, heroin was associated with reduced perfusion in the left anterior cingulate cortex ACC, the left medial prefrontal cortex mPFC and in the insula both hemispheres. Analysis of extracted perfusion values indicate strong effect sizes and no gender related differences. Reduced perfusion in these brain areas may indicate self- and emotional regulation effects of heroin in maintenance treatment.

Autor: Niklaus Denier , Hana Gerber, Marc Vogel, Markus Klarhöfer, Anita Riecher-Rossler, Gerhard A. Wiesbeck, Undine E. Lang, Stefan B



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