Chang Qi1, Xiaobing Fan2, Sean Foxley2, Qiuxia Wu3, Jinsong Tang4,5, Wei Hao3, An Xie6, Jianbin Liu6, Zhijuan Feng3,7, Tieqiao Liu3, Yanhui Liao4,5. 1. Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China. 2. Department of Radiology, The University of Chicago, Chicago, IL, United States. 3. Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China. 4. Department of Psychiatry, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China. 5. Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China. 6. Department of Radiology, The People's Hospital of Hunan Province, Changsha, China. 7. Department of Psychiatry, Weifang Mental Health Center, Weifang, China.
Abstract
Background: Craving is the predictor of relapse, and insula cortex (IC) is a critical neural substrate for craving and drug seeking. This study investigated whether IC abnormalities among MA users can detect craving state and predict relapse susceptibility. Methods: A total of 142 subjects with a history of MA dependence completed structural MRI (sMRI) scans, and 30 subjects (10 subjects relapsed) completed 4-month follow-up scans. MA craving was measured by the Visual Analog Scale for Craving. Abnormalities of IC gray matter volume (GMV) between the subjects with and without craving were investigated by voxel-based morphometry (VBM). The receiver operating characteristic (ROC) analysis was performed for the region-of-interest (ROI) of IC GMV to assess the diagnostic accuracy. Results: By comparing whole-brain volume maps, this study found that subjects without craving (n = 64) had a significantly extensive decrease in IC GMV (family-wise error correction, p < 0.05) than subjects with craving group (n = 78). The ROI of IC GMV had a significantly positive correlation with the craving scores reported by MA users. The ROC analysis showed a good discrimination (area under curve is 0.82/0.80 left/right) for IC GMV between the subjects with and without craving. By selecting Youden index cut-off point from whole model group, calculated sensitivity/specificity was equal to 78/70% and 70/75% for left and right IC, respectively. By applying the above optimal cut-off values to 30 follow-up subjects as validations, the results showed a similar sensitivity (73-80%) and specificity (73-80%) for detecting craving state as model group. For predicting relapse susceptibility, the sensitivity (50-55%) was low and the specificity (80-90%) was high. Conclusions: Our study provides the first evidence that sMRI may be used to diagnosis the craving state in MA users based on optimal cut-off values, which could be served as MRI bio-markers and an objective measure of craving state.
Background: Craving is the predictor of relapse, and insula cortex (IC) is a critical neural substrate for craving and drug seeking. This study investigated whether IC abnormalities among MA users can detect craving state and predict relapse susceptibility. Methods: A total of 142 subjects with a history of MA dependence completed structural MRI (sMRI) scans, and 30 subjects (10 subjects relapsed) completed 4-month follow-up scans. MA craving was measured by the Visual Analog Scale for Craving. Abnormalities of IC gray matter volume (GMV) between the subjects with and without craving were investigated by voxel-based morphometry (VBM). The receiver operating characteristic (ROC) analysis was performed for the region-of-interest (ROI) of IC GMV to assess the diagnostic accuracy. Results: By comparing whole-brain volume maps, this study found that subjects without craving (n = 64) had a significantly extensive decrease in IC GMV (family-wise error correction, p < 0.05) than subjects with craving group (n = 78). The ROI of IC GMV had a significantly positive correlation with the craving scores reported by MA users. The ROC analysis showed a good discrimination (area under curve is 0.82/0.80 left/right) for IC GMV between the subjects with and without craving. By selecting Youden index cut-off point from whole model group, calculated sensitivity/specificity was equal to 78/70% and 70/75% for left and right IC, respectively. By applying the above optimal cut-off values to 30 follow-up subjects as validations, the results showed a similar sensitivity (73-80%) and specificity (73-80%) for detecting craving state as model group. For predicting relapse susceptibility, the sensitivity (50-55%) was low and the specificity (80-90%) was high. Conclusions: Our study provides the first evidence that sMRI may be used to diagnosis the craving state in MA users based on optimal cut-off values, which could be served as MRI bio-markers and an objective measure of craving state.
Authors: N Tzourio-Mazoyer; B Landeau; D Papathanassiou; F Crivello; O Etard; N Delcroix; B Mazoyer; M Joliot Journal: Neuroimage Date: 2002-01 Impact factor: 6.556
Authors: Irene Perini; Robin Kämpe; Theodor Arlestig; Hanna Karlsson; Andreas Löfberg; Michal Pietrzak; Abraham Zangen; Markus Heilig Journal: Neuropsychopharmacology Date: 2019-11-11 Impact factor: 7.853