AI Article Synopsis
- * Significant alterations in brain activity were observed in opioid users, with increased activity in the mesocorticolimbic area and decreased in the dorsolateral-prefrontal region, linked to negative emotions.
- * A follow-up after brief opioid abstention indicated changes in brain network dynamics, highlighting withdrawal signs, suggesting careful management of opioid use in chronic pain treatment.
Article Abstract
Chronic pain is commonly treated with long-term opioids, but the neuropsychological outcomes associated with stable long-duration opioid use remain unclear. Here, we contrasted the psychological profiles, brain activity, and brain structure of 70 chronic back pain patients on opioids (CBP+O, average opioid exposure 6.2 years) with 70 patients managing their pain without opioids. CBP+O exhibited moderately worse psychological profiles and small differences in brain morphology. However, CBP+O had starkly different spontaneous brain activity, dominated by increased mesocorticolimbic and decreased dorsolateral-prefrontal activity, even after controlling for pain intensity and duration. These differences strongly reflected cortical opioid and serotonin receptor densities and mapped to two antagonistic resting-state circuits. The circuits' dynamics were explained by mesocorticolimbic activity and reflected negative affect. We reassessed a sub-group of CBP+O after they briefly abstained from taking opioids. Network dynamics, but not spontaneous activity, reflected exacerbated signs of withdrawal. Our results have implications for the management and tapering of opioids in chronic pain.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10871381 | PMC |
| http://dx.doi.org/10.1101/2024.02.07.24302408 | DOI Listing |
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