Psychiatry research. Neuroimaging · 2026
Early effects of oral naltrexone on craving, resting state and cue-induced brain activation in opioid use disorder: a prospective fMRI study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kullai Malsawmkima, Khanra Sourav, Raj Justin, Roy Chandramouli
Аннотация
BACKGROUND: Opioid use disorder (OUD) is characterized by intense cue-induced craving and high relapse risk. This longitudinal fMRI study investigated whether oral naltrexone (50mg/day) (oral-NTX) modulates neural and behavioral responses to opioid cues, as well as resting-state brain connectivity.
METHODS: Thirty male patients with moderate-severe OUD underwent fMRI during an opioid-versus-neutral image task at baseline and after 2 weeks of oral-NTX treatment. The DDQ and OCDUS were administered for craving assessment. Task fMRI data was analyzed with linear mixed-effects models (3dLME). Resting-state fMRI was analyzed for ROI-to-ROI functional connectivity changes in key craving-related regions.
RESULTS: Oral_NTX significantly reduced both DDQ and OCDUS scores (p<0.01). Task-based fMRI revealed significant reductions in cue-induced activation in the anterior cingulate cortex (ACC) and cerebellum (whole-brain p<0.05, cluster-corrected). ROI analyses confirmed pre-to-post decreases in ACC and cerebellar activation (t>3.5, p<0.05). Larger craving reductions correlated with greater left superior temporal deactivation (t≈1.97, p<0.05). Resting-state connectivity analysis showed significant attenuation of intrinsic functional coupling between ACC-insula, nucleus accumbens (NAc)-amygdala, and cerebellum-hippocampus (p<0.05). These decreases complement task findings, indicating widespread dampening of salience and reward network interactions following oral-NTX.
CONCLUSION: Oral-NTX reduces cue-driven activation in cortical and cerebellar regions while dampening resting-state connectivity within craving circuits.
METHODS: Thirty male patients with moderate-severe OUD underwent fMRI during an opioid-versus-neutral image task at baseline and after 2 weeks of oral-NTX treatment. The DDQ and OCDUS were administered for craving assessment. Task fMRI data was analyzed with linear mixed-effects models (3dLME). Resting-state fMRI was analyzed for ROI-to-ROI functional connectivity changes in key craving-related regions.
RESULTS: Oral_NTX significantly reduced both DDQ and OCDUS scores (p<0.01). Task-based fMRI revealed significant reductions in cue-induced activation in the anterior cingulate cortex (ACC) and cerebellum (whole-brain p<0.05, cluster-corrected). ROI analyses confirmed pre-to-post decreases in ACC and cerebellar activation (t>3.5, p<0.05). Larger craving reductions correlated with greater left superior temporal deactivation (t≈1.97, p<0.05). Resting-state connectivity analysis showed significant attenuation of intrinsic functional coupling between ACC-insula, nucleus accumbens (NAc)-amygdala, and cerebellum-hippocampus (p<0.05). These decreases complement task findings, indicating widespread dampening of salience and reward network interactions following oral-NTX.
CONCLUSION: Oral-NTX reduces cue-driven activation in cortical and cerebellar regions while dampening resting-state connectivity within craving circuits.