Efficacy and safety of high-dose baclofen for the treatment of alcohol dependence: A multicentre, randomised, double-blind controlled trial.

Previous randomised placebo-controlled trials with low-to-medium doses of baclofen (30-60mg) showed inconsistent results, but case studies suggested a dose-response effect and positive outcomes in patients on high doses of baclofen (up to 270mg). Its prescription was temporary permitted for the treatment of alcohol dependence (AD) in France, and baclofen is now widely prescribed. Recently, a small RCT found a strong effect of a mean dose of 180mg baclofen.

An Efficient Methodology for the Analysis of Dielectric Shimming Materials in Magnetic Resonance Imaging.

Interference effects in the transmit B field can severely degrade the image quality in high-field Magnetic Resonance Imaging (MRI). High-permittivity pads are increasingly used to counteract these effects, but designing such pads is not trivial. In this paper, we present an efficient solution methodology for this dielectric RF shimming problem.

Childhood trauma exposure in substance use disorder patients with and without ADHD.

Background: Childhood trauma exposure (CTE) is frequently reported by those with substance use disorders (SUDs). SUDs also frequently co-occur with attention deficit hyperactivity disorder (ADHD).

Objective: To investigate the role of childhood trauma exposure (CTE) in the presence and the persistence of ADHD in treatment seeking SUD patients.

Variants of opioid system genes are associated with non-dependent opioid use and heroin dependence.

Background: Heroin addiction is a chronic, relapsing brain disease. Genetic factors are involved in the development of drug addiction. The aim of this study was to determine whether specific variants in genes of the opioid system are associated with non-dependent opioid use and heroin dependence.

Revealing the Neuroendocrine Response After Remoxipride Treatment Using Multi-Biomarker Discovery and Quantifying It by PK/PD Modeling.

To reveal unknown and potentially important mechanisms of drug action, multi-biomarker discovery approaches are increasingly used. Time-course relationships between drug action and multi-biomarker profiles, however, are typically missing, while such relationships will provide increased insight in the underlying body processes. The aim of this study was to investigate the effect of the dopamine D2 antagonist remoxipride on the neuroendocrine system.

Early Nonresponse in the Antipsychotic Treatment of Acute Mania: A Criterion for Reconsidering Treatment? Results From an Individual Patient Data Meta-Analysis.

Objective: To investigate whether early nonresponse to antipsychotic treatment of acute mania predicts treatment failure and, if so, to establish the best definition or criterion of an early nonresponse.

Data Sources: Short-term efficacy studies assessing antipsychotics that were submitted to the Dutch Medicines Evaluation Board during an 11-year period as part of the marketing authorization application for the indication of acute manic episode of bipolar disorder. Pharmaceutical companies provided their raw patient data, which enabled us to perform an individual patient data meta-analysis.

Acceptability of Extended-Release Naltrexone by Heroin-Dependent Patients and Addiction Treatment Providers in the Netherlands.

Background: Extended-release naltrexone (XRNT) was developed to overcome poor treatment compliance with oral naltrexone in alcohol and opioid-dependent patients. XRNT injections are registered in the United States and Russia, but not in The Netherlands. However, XRNT can be obtained for individual patients, but it is expensive and not reimbursed by the health insurance.

Aversive Counterconditioning Attenuates Reward Signaling in the Ventral Striatum.

Appetitive conditioning refers to the process of learning cue-reward associations and is mediated by the mesocorticolimbic system. Appetitive conditioned responses are difficult to extinguish, especially for highly salient reward such as food and drugs. We investigate whether aversive counterconditioning can alter reward reinstatement in the ventral striatum in healthy volunteers using functional magnetic resonance imaging (fMRI).

Regional grey matter volume and concentration in at-risk adolescents: Untangling associations with callous-unemotional traits and conduct disorder symptoms.

Structural Magnetic Resonance Imaging studies have reported volume reductions in several brain regions implicated in social cognition and emotion recognition in juvenile antisocial populations. However, it is unclear whether these structural abnormalities are specifically related to antisocial features, or to co-occurring callous-unemotional (CU) traits. The present study employed voxel-based morphometry to assess both grey matter volume (GMV) and grey matter concentration (GMC) in a large representative at-risk sample of adolescents (n=134; mean age 17.

Practical improvements in the design of high permittivity pads for dielectric shimming in neuroimaging at 7T.

Improvements are proposed for practical design and use of high permittivity materials in high field neuroimaging in three different areas: (i) a simple formula to predict the permittivity of tri-component aqueous-based perovskite suspensions with relative permittivities between 110 and 300, (ii) characterization of addition of a hydroxyethyl-cellulose gelling agent to improve the long-term stability and material properties of "dielectric pads", and (iii) investigation of the integration of, for example, headphones into the dielectric pads to increase patient comfort within tightly-fitting receive coil arrays.

Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder.

Extensive cleaning or checking of patients with obsessive-compulsive disorder (OCD) are often interpreted as strategies to avoid harm and as an expression of the widespread belief that OCD patients are more risk-averse. However, despite its clinical significance, the neural basis of risk attitude in OCD is unknown. Here, we investigated neural activity during risk processing using functional magnetic resonance imaging and simultaneously assessed risk attitude using a separate behavioral paradigm in OCD patients with different symptoms versus healthy controls (HCs).

Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

Background/aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment.

Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period.

Grey Matter Changes Associated with Heavy Cannabis Use: A Longitudinal sMRI Study.

Cannabis is the most frequently used illicit drug worldwide. Cross-sectional neuroimaging studies suggest that chronic cannabis exposure and the development of cannabis use disorders may affect brain morphology. However, cross-sectional studies cannot make a conclusive distinction between cause and consequence and longitudinal neuroimaging studies are lacking.

Efficacy of cocaine contingency management in heroin-assisted treatment: Results of a randomized controlled trial.

Aims: To determine the efficacy of contingency management (CM), targeting cocaine use, as an add-on intervention for heroin dependent patients in supervised heroin-assisted treatment (HAT) with frequent cocaine use.

Design: Multi-center, open-label, parallel group, randomized controlled trial.

Setting: Twelve specialized addiction treatment centers for HAT in The Netherlands; April 2006-January 2011.

Impulsivity and attentional bias as predictors of modafinil treatment outcome for retention and drug use in crack-cocaine dependent patients: Results of a randomised controlled trial.

Background: High impulsivity and attentional bias are common in cocaine-dependent patients and predict poor treatment outcomes. The pharmacological agent modafinil is studied for its cognitive-enhancing capacities and may therefore improve clinical outcomes in crack-cocaine dependent patients. In this study, we investigated first whether pre-treatment impulsivity and attentional bias predict treatment outcome; next whether the drug modafinil given as an add-on treatment to cognitive behavioural therapy (CBT) improves impulsivity and attentional bias; and last, whether changes in impulsivity and attentional bias are related to improvements in treatment outcome.

The two-faceted nature of impulsivity in patients with borderline personality disorder and substance use disorder.

Background: Impulsivity, which has been the subject of extensive debate in psychiatric research, is a clinically important concept, especially with respect to Borderline Personality Disorder (BPD) and Substance Use Disorders (SUD). The current study aims to examine the presence of two aspects of impulsivity (self-reported impulsivity and delay discounting) in patients with BPD, SUD (alcohol use=AUD or drug use=DUD) and the combination of both disorders (BPD+SUD).

Methods: Patients were recruited from eight different mental health treatment service facilities.

Hyperresponsiveness of the Neural Fear Network During Fear Conditioning and Extinction Learning in Male Cocaine Users.

Objective: The authors investigated whether cocaine use disorder is associated with abnormalities in the neural underpinnings of aversive conditioning and extinction learning, as these processes may play an important role in the development and persistence of drug abuse.

Method: Forty male regular cocaine users and 51 male control subjects underwent a fear conditioning and extinction protocol during functional MRI. Skin conductance response was measured throughout the experiment as an index of conditioned responses.

Sustained-release dexamfetamine in the treatment of chronic cocaine-dependent patients on heroin-assisted treatment: a randomised, double-blind, placebo-controlled trial.

Background: Heroin-assisted treatment is effective for methadone treatment-refractory heroin-dependent patients, but continued comorbid cocaine dependence remains problematic. Sustained-release dexamfetamine is a promising agonist pharmacotherapy for cocaine dependence and we aimed to assess its acceptance, efficacy, and safety.

Methods: In this multicentre, randomised, double-blind, placebo-controlled trial, patients who were treatment-refractory, as indicated by at least two earlier failed treatments aimed at reducing or abstaining from cocaine use, and who regularly (≥8 days/month) used crack-cocaine were enrolled from four heroin-assisted treatment centres in the Netherlands.

Persistence and Subtype Stability of ADHD Among Substance Use Disorder Treatment Seekers.

To examine ADHD symptom persistence and subtype stability among substance use disorder (SUD) treatment seekers. In all, 1,276 adult SUD treatment seekers were assessed for childhood and adult ADHD using Conners' Adult ADHD Diagnostic Interview for (4th ed.; ; CAADID).

White matter alterations in cocaine users are negatively related to the number of additionally (ab)used substances.

Diffusion tensor imaging studies have provided evidence for white matter (WM) alterations in cocaine users. While polysubstance use is a widespread phenomenon among cocaine users, its role in WM alterations in cocaine users is currently unknown. This study examined the relation between the number of substances that are used(cocaine, alcohol and marijuana) and WM alterations in 67 male non-drug users and 67 male regular cocaine users, who were classified into five groups based on the number of used substances.

Burden and Expressed Emotion of Caregivers in Cases of Adult Substance Use Disorder with and Without Attention Deficit/Hyperactivity Disorder or Autism Spectrum Disorder.

Objective: To identify and compare caregiver burden and expressed emotion (EE) in adult substance use disorder (SUD) patients with and without co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). To examine possible differences in correlations between caregiver burden and EE across patient groups.

Design And Methods: Cross-sectional study with measures of perceived burden (Involvement Evaluation Questionnaire: IEQ), subjective stress (General Health Questionnaire: GHQ) and perceptions of expressed emotion (Level of Expressed Emotion: LEE) in informal caregivers for patients with SUD, SUD+ADHD or SUD+ASD.

Compulsivity in obsessive-compulsive disorder and addictions.

Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating.

Loss of brain graph network efficiency in alcohol dependence.

Alcohol dependence (AD) is characterized by corticostriatal impairments in individual brain areas such as the striatum. As yet however, complex brain network topology in AD and its association with disease progression are unknown. We applied graph theory to resting-state functional magnetic resonance imaging (RS-fMRI) to examine weighted global efficiency and local (clustering coefficient, degree and eigenvector centrality) network topology and the functional role of the striatum in 24 AD patients compared with 20 matched healthy controls (HCs), and their association with dependence characteristics.

Passive radiofrequency shimming in the thighs at 3 Tesla using high permittivity materials and body coil receive uniformity correction.

Purpose: To explore the effects of high permittivity dielectric pads on the transmit and receive characteristics of a 3 Tesla body coil centered at the thighs, and their implications on image uniformity in receive array applications.

Theory And Methods: Transmit and receive profiles of the body coil with and without dielectric pads were simulated and measured in healthy volunteers. Parallel imaging was performed using sensitivity encoding (SENSE) with and without pads.