Reduction in Cerebral Perfusion after Heroin Administration: A Resting State Arterial Spin Labeling Study
Niklaus Denier, Hana Gerber, Marc Vogel, Markus Klarhöfer, Anita Riecher‐rössler, Gerhard A. Wiesbeck, Undine E. Lang, Stefan Borgwardt, Marc Walter
PLoS ONE September 10, 2013 DOI: 10.1371/journal.pone.0071461 via OpenAlex
Summary
In 15 heroin-dependent patients receiving stable heroin-assisted treatment, heroin reduced blood flow in the left anterior cingulate cortex, left medial prefrontal cortex, and insula compared to placebo. These brain areas are involved in self-regulation and emotional processing. The findings suggest that heroin's effects on these regions may contribute to its ability to reduce craving and produce relaxation in maintenance therapy.
Study at a glance
| Characteristics | Randomized controlled trial Placebo-controlled Peer reviewed |
|---|---|
| Sample size | 15 |
| Population | Heroin-dependent patients from a stable heroin-assisted treatment program |
| Keywords | Heroin Placebo Insula Prefrontal cortex Anterior cingulate cortex |
| Citations | 32 |
| Key finding | Heroin reduced perfusion in the left anterior cingulate cortex, left medial prefrontal cortex, and insula compared to placebo. |
Abstract
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.