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Am J Psychiatry. 2008 Mar;165(3):390-4. Epub 2007 Dec 3.

Acute effect of methadone maintenance dose on brain FMRI response to heroin-related cues.

Author information

1
Department of Psychiatry, University of Pennsylvania, Treatment Research Center, Philadelphia, PA 19104, USA. langlebe@upenn.edu

Abstract

OBJECTIVE:

Environmental drug-related cues have been implicated as a cause of illicit heroin use during methadone maintenance treatment of heroin dependence. The authors sought to identify the functional neuroanatomy of the brain response to visual heroin-related stimuli in methadone maintenance patients.

METHOD:

Event-related functional magnetic resonance imaging was used to compare brain responses to heroin-related stimuli and matched neutral stimuli in 25 patients in methadone maintenance treatment. Patients were studied before and after administration of their regular daily methadone dose.

RESULTS:

The heightened responses to heroin-related stimuli in the insula, amygdala, and hippocampal complex, but not the orbitofrontal and ventral anterior cingulate cortices, were acutely reduced after administration of the daily methadone dose.

CONCLUSIONS:

The medial prefrontal cortex and the extended limbic system in methadone maintenance patients with a history of heroin dependence remains responsive to salient drug cues, which suggests a continued vulnerability to relapse. Vulnerability may be highest at the end of the 24-hour interdose interval.

Comment in

PMID:
18056224
DOI:
10.1176/appi.ajp.2007.07010070
[Indexed for MEDLINE]

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