André Schmidt1, Stefan Borgwardt2, Hana Gerber3, Gerhard A Wiesbeck3, Otto Schmid3, Anita Riecher-Rössler4, Renata Smieskova5, Undine E Lang4, Marc Walter6. 1. Department of Psychiatry (Universitäre Psychiatrische Kliniken), University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University Hospital Basel, Basel, Switzerland. Electronic address: andre.schmidt@unibas.ch. 2. Department of Psychiatry (Universitäre Psychiatrische Kliniken), University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University Hospital Basel, Basel, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom. 3. Division of Substance Use Disorders, University Hospital Basel, Basel, Switzerland. 4. Department of Psychiatry (Universitäre Psychiatrische Kliniken), University of Basel, Basel, Switzerland. 5. Department of Psychiatry (Universitäre Psychiatrische Kliniken), University of Basel, Basel, Switzerland; Medical Image Analysis Centre, University Hospital Basel, Basel, Switzerland. 6. Department of Psychiatry (Universitäre Psychiatrische Kliniken), University of Basel, Basel, Switzerland; Division of Substance Use Disorders, University Hospital Basel, Basel, Switzerland.
Abstract
BACKGROUND:Negative emotional states and abnormal stress reactivity are central components in drug addiction. The brain stress system in the amygdala is thought to play a key role in the maintenance of drug dependence through negative reinforcement. Although acute heroin administration was found to reduce anxiety, craving, and stress hormone release, whether these effects are reflected in amygdala activity has not yet been investigated. METHODS: With a randomized, crossover, double-blind design, saline and heroin were administered to 22 heroin-dependent patients, whereas 17 healthy control subjects were included for the placebo administration only. We used functional magnetic resonance imaging to investigate blood oxygen level-dependent responses during fearful faces processing. Stress reactivity was measured by adrenocorticotropic hormone levels and by cortisol concentrations in serum and saliva 60 min after substance administration. Anxiety and craving levels were assessed with self-report ratings. RESULTS:Heroin administration acutely reduced the left amygdala response to fearful faces relative to the saline injection. Patients receiving saline showed a significantly higher left amygdala response to fearful faces than healthy control subjects, whose activity did not differ from patients receiving heroin. The left amygdala activity correlated significantly with scores on state-anxiety and levels of adrenocorticotropic hormone, serum cortisol, and saliva cortisol among all patients and control subjects. CONCLUSIONS: Our results show a direct relation between the acute heroin effects on stress-related emotions, stress reactivity, and left amygdala response to negative facial expressions. These findings provide new insights into the mechanisms underlying negative reinforcement in heroin addiction and the effects of regular heroin substitution.
RCT Entities:
BACKGROUND: Negative emotional states and abnormal stress reactivity are central components in drug addiction. The brain stress system in the amygdala is thought to play a key role in the maintenance of drug dependence through negative reinforcement. Although acute heroin administration was found to reduce anxiety, craving, and stress hormone release, whether these effects are reflected in amygdala activity has not yet been investigated. METHODS: With a randomized, crossover, double-blind design, saline and heroin were administered to 22 heroin-dependent patients, whereas 17 healthy control subjects were included for the placebo administration only. We used functional magnetic resonance imaging to investigate blood oxygen level-dependent responses during fearful faces processing. Stress reactivity was measured by adrenocorticotropic hormone levels and by cortisol concentrations in serum and saliva 60 min after substance administration. Anxiety and craving levels were assessed with self-report ratings. RESULTS:Heroin administration acutely reduced the left amygdala response to fearful faces relative to the saline injection. Patients receiving saline showed a significantly higher left amygdala response to fearful faces than healthy control subjects, whose activity did not differ from patients receiving heroin. The left amygdala activity correlated significantly with scores on state-anxiety and levels of adrenocorticotropic hormone, serum cortisol, and saliva cortisol among all patients and control subjects. CONCLUSIONS: Our results show a direct relation between the acute heroin effects on stress-related emotions, stress reactivity, and left amygdala response to negative facial expressions. These findings provide new insights into the mechanisms underlying negative reinforcement in heroin addiction and the effects of regular heroin substitution.
Authors: Antoine Bechara; Kent C Berridge; Warren K Bickel; Jose A Morón; Sidney B Williams; Jeffrey S Stein Journal: Psychol Sci Public Interest Date: 2019-10
Authors: Christian L Seifert; Stefano Magon; Till Sprenger; Undine E Lang; Christian G Huber; Niklaus Denier; Marc Vogel; André Schmidt; Ernst-Wilhelm Radue; Stefan Borgwardt; Marc Walter Journal: Eur Arch Psychiatry Clin Neurosci Date: 2014-12-03 Impact factor: 5.270
Authors: Niklaus Denier; André Schmidt; Hana Gerber; Marc Vogel; Christian G Huber; Undine E Lang; Anita Riecher-Rossler; Gerhard A Wiesbeck; Ernst-Wilhelm Radue; Marc Walter; Stefan Borgwardt Journal: Hum Brain Mapp Date: 2015-10-06 Impact factor: 5.038
Authors: Kenzie L Preston; William J Kowalczyk; Karran A Phillips; Michelle L Jobes; Massoud Vahabzadeh; Jia-Ling Lin; Mustapha Mezghanni; David H Epstein Journal: Neuropsychopharmacology Date: 2017-11-06 Impact factor: 7.853