Structural MRI and functional connectivity features predict current clinical status and persistence behavior in prescription opioid users

Despite their severely impaired episodic memory, individuals with amnesia are able to comprehend ongoing events. Online representations of a current event are thought to be supported by a network of regions centred on the posterior midline cortex (PMC). By contrast, episodic memory is widely believed to be supported by interactions between the hippocampus and these cortical regions. In this MRI study, we investigated the encoding and retrieval of lifelike events (video clips) in a patient with severe amnesia likely resulting from a stroke to the right thalamus, and a group of 20 age-matched controls. Structural MRI revealed grey matter reductions in left hippocampus and left thalamus in comparison to controls. We first characterised the regions activated in the controls while they watched and retrieved the videos. There were no differences in activation between the patient and controls in any of the regions. We then identified a widespread network of brain regions, including the hippocampus, that were functionally connected with the PMC in controls. However, in the patient there was a specific reduction in functional connectivity between the PMC and a region of left hippocampus when both watching and attempting to retrieve the videos. A follow up analysis revealed that in controls the functional connectivity between these regions when watching the videos was correlated with memory performance. Taken together, these findings support the view that the interactions between the PMC and the hippocampus enable the encoding and retrieval of multimodal representations of the contents of an event.

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Peripheral inflammation is associated with micro-structural and functional connectivity changes in depression-related brain networks

Molecular Psychiatry ◽

10.1038/s41380-021-01272-1 ◽

2021 ◽

Author(s):

Manfred G. Kitzbichler ◽

Athina R. Aruldass ◽

Gareth J. Barker ◽

Tobias C. Wood ◽

Nicholas G. Dowell ◽

...

Keyword(s):

Functional Connectivity ◽

Venous Blood ◽

Regional Analysis ◽

Brain Magnetic Resonance Imaging ◽

Structural Mri ◽

Posterior Cingulate Cortex ◽

Proton Density ◽

Peripheral Inflammation ◽

Tissue Water ◽

Weighted Degree

AbstractInflammation is associated with depressive symptoms and innate immune mechanisms are likely causal in some cases of major depression. Systemic inflammation also perturbs brain function and microstructure, though how these are related remains unclear. We recruited N = 46 healthy controls, and N = 83 depressed cases stratified by CRP (> 3 mg/L: N = 33; < 3 mg/L: N = 50). All completed clinical assessment, venous blood sampling for C-reactive protein (CRP) assay, and brain magnetic resonance imaging (MRI). Micro-structural MRI parameters including proton density (PD), a measure of tissue water content, were measured at 360 cortical and 16 subcortical regions. Resting-state fMRI time series were correlated to estimate functional connectivity between individual regions, as well as the sum of connectivity (weighted degree) of each region. Multiple tests for regional analysis were controlled by the false discovery rate (FDR = 5%). We found that CRP was significantly associated with PD in precuneus, posterior cingulate cortex (pC/pCC) and medial prefrontal cortex (mPFC); and with functional connectivity between pC/pCC, mPFC and hippocampus. Depression was associated with reduced weighted degree of pC/pCC, mPFC, and other nodes of the default mode network (DMN). Thus CRP-related increases in proton density—a plausible marker of extracellular oedema—and changes in functional connectivity were anatomically co-localised with DMN nodes that also demonstrated significantly reduced hubness in depression. We suggest that effects of peripheral inflammation on DMN node micro-structure and connectivity may mediate inflammatory effects on depression.

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PDG19 COST-EFFECTIVENESS OF INTRANASAL NALOXONE DISTRIBUTION TO HIGH RISK PRESCRIPTION OPIOID USERS

Value in Health ◽

10.1016/j.jval.2019.04.698 ◽

2019 ◽

Vol 22 ◽

pp. S166

Author(s):

M. Acharya ◽

D. Chopra ◽

C. Hayes ◽

B. Teeter ◽

B. Martin

Keyword(s):

Cost Effectiveness ◽

High Risk ◽

Prescription Opioid ◽

Opioid Users

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The Impact of Medical Cannabis on Intermittent and Chronic Opioid Users with Back Pain: How Cannabis Diminished Prescription Opioid Usage

Cannabis and Cannabinoid Research ◽

10.1089/can.2019.0039 ◽

2020 ◽

Vol 5 (3) ◽

pp. 263-270 ◽

Cited By ~ 1

Author(s):

Kevin M. Takakuwa ◽

Jeffrey Y. Hergenrather ◽

Frances S. Shofer ◽

Raquel M. Schears

Keyword(s):

Back Pain ◽

Prescription Opioid ◽

Medical Cannabis ◽

Opioid Users ◽

The Impact

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Exploring the latent trait of opioid use disorder criteria among frequent nonmedical prescription opioid users

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2016.05.007 ◽

2016 ◽

Vol 80 ◽

pp. 79-86 ◽

Cited By ~ 5

Author(s):

João Mauricio Castaldelli-Maia ◽

Laura H. Andrade ◽

Katherine M. Keyes ◽

Magdalena Cerdá ◽

Daniel J. Pilowsky ◽

...

Keyword(s):

Latent Trait ◽

Opioid Use Disorder ◽

Prescription Opioid ◽

Opioid Use ◽

Opioid Users

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Exploring Drug Sourcing among Regular Prescription Opioid Users in Canada: Data from Toronto and Victoria

Canadian Journal of Criminology and Criminal Justice/La Revue canadienne de criminologie et de justice pénale ◽

10.3138/cjccj.51.1.55 ◽

2009 ◽

Vol 51 (1) ◽

pp. 55-72 ◽

Cited By ~ 3

Author(s):

Benedikt Fischer ◽

Joseph Anthony De Leo ◽

Christiane Allard ◽

Michelle Firestone-Cruz ◽

Jayadeep Patra ◽

...

Keyword(s):

Prescription Opioid ◽

Opioid Users ◽

Canada Data

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Characterisation of concurrent use of prescription opioids and benzodiazepine/Z-drugs in Alberta, Canada: a population-based study

BMJ Open ◽

10.1136/bmjopen-2019-030858 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030858 ◽

Cited By ~ 1

Author(s):

Vishal Sharma ◽

Daniala Weir ◽

Salim Samanani ◽

Scot H Simpson ◽

Fizza Gilani ◽

...

Keyword(s):

Inappropriate Medication ◽

Oral Morphine ◽

Benzodiazepine Receptor ◽

Population Based ◽

Adverse Outcomes ◽

Prescription Opioid ◽

P Value ◽

Concurrent Use ◽

Opioid Users ◽

Receptor Modulators

ObjectiveThe objective of this study is to characterise concurrent use of benzodiazepine receptor modulators and opioids among prescription opioid users in Alberta in 2017.DesignA population based retrospective study.SettingAlberta, Canada, in the year 2017.ParticipantsAll individuals in Alberta, Canada, with at least one dispensation record from a community pharmacy for an opioid in the year 2017.ExposureConcurrent use of a benzodiazepine receptor modulator and opioid, defined as overlap of supply for both drugs for at least 1 day.Main outcome measuresPrevalence of concurrency was estimated among subgroups of patient characteristics that were considered clinically relevant or associated with inappropriate medication use.ResultsAmong the 547 709 Albertans who were dispensed opioid prescriptions in 2017, 132 156 (24%) also received prescriptions for benzodiazepine receptor modulators. There were 96 581 (17.6%) prescription opioid users who concurrently used benzodiazepine receptor modulators with an average of 98 days (SD=114, 95% CI 97 to 99) of total cumulative concurrency and a median of 37 days (IQR 10 to 171). The average longest duration of consecutive days of concurrency was 45 (SD=60, 95% CI 44.6 to 45.4) with a median of 24 days (IQR 8 to 59). Concurrency was more prevalent in females, patients using an average daily oral morphine equivalent >90 mg, opioid dependence therapy patients, chronic opioid users, patients utilising a high number of unique providers, lower median household incomes and those older than 65 (p value<0.001 for all comparisons).ConclusionsConcurrent prescribing of opioids and benzodiazepine receptor modulators is common in Alberta despite the ongoing guidance of many clinical resources. Older patients, those taking higher doses of opioids, and for longer durations may be at particular risk of adverse outcomes and may be worthy of closer follow-up for assessment for dose tapering or discontinuations. As well, those with higher healthcare utilisation (seeking multiple providers) should also be closely monitored. Continued surveillance of concurrent use of these medications is warranted to ensure that safe drug use recommendations are being followed by health providers.

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