期刊名称：Proceedings of the National Academy of Sciences
印刷版ISSN：0027-8424
电子版ISSN：1091-6490
出版年度：2022
卷号：119
期号：26
DOI：10.1073/pnas.2116703119
语种：English
出版社：The National Academy of Sciences of the United States of America
摘要：Significance
Relapse to addiction presents a global burden for individuals and societies alike, yet the biological mechanisms underlying relapse remain to be determined. We combined diffusion-weighted imaging with tractography to examine the role of brain structure in predicting relapse to stimulant drug use. Reduced diffusion metrics of a tract projecting from the right anterior insula to the nucleus accumbens (NAcc) predicted relapse to stimulant use 6 mo posttreatment but were not associated with previous stimulant use disorder diagnosis. Our findings reveal a structural target for predicting stimulant drug relapse and specifically suggest that, although midbrain connections to the NAcc may be associated with stimulant use disorder diagnosis, cortical connections to the NAcc may instead predict relapse to stimulant use.
Diffusion tractography allows identification and measurement of structural tracts in the human brain previously associated with motivated behavior in animal models. Recent findings indicate that the structural properties of a tract connecting the midbrain to nucleus accumbens (NAcc) are associated with a diagnosis of stimulant use disorder (SUD), but not relapse. In this preregistered study, we used diffusion tractography in a sample of patients treated for SUD (
n = 60) to determine whether qualities of tracts projecting from medial prefrontal, anterior insular, and amygdalar cortices to NAcc might instead foreshadow relapse. As predicted, reduced diffusion metrics of a tract projecting from the right anterior insula to the NAcc were associated with subsequent relapse to stimulant use, but not with previous diagnosis. These findings highlight a structural target for predicting relapse to stimulant use and further suggest that distinct connections to the NAcc may confer risk for relapse versus diagnosis.
