Methadone maintenance is an effective treatment for opioid use disorder, yet many methadone-maintained patients (MMPs) continue to struggle with chronic relapse. The current study evaluated whether functional near-infrared spectroscopy (fNIRS) could identify prefrontal cortex (PFC) markers of ongoing opioid use in MMPs, and whether clinical measures of depression and self-report measures of craving would also be associated with opioid use. MMPs (n = 29) underwent a drug cue reactivity paradigm during fNIRS measurements of PFC reactivity. Self-reported opioid craving (measured by a visual analog scale; 0-100) was collected before and after drug cue reactivity, and depressive symptoms were assessed via the 17-item Hamilton Depression Rating Scale (HAM-D). Hierarchical regression and partial correlations were used to evaluate associations between weekly urine drug screens over a 90-day follow-up period and fNIRS, craving, and HAM-D assessments. Neural response to drug cues in the left lateral PFC, controlling for age, sex, and days in treatment was significantly associated with percent opioid-negative urine screens during follow-up (∆F1, 24 = 13.19, p = 0.001, ∆R2 = 0.30), and correctly classified 86% of MMPs as either using opioids, or abstaining from opioids (χ2(4) = 16.28, p = 0.003). Baseline craving (p < 0.001) and HAM-D assessment (p < 0.01) were also associated with percent opioid-negative urine screens. Combining fNIRS results, baseline craving scores, and HAM-D scores created a robust predictive model (∆F3, 22 = 16.75, p < 0.001, ∆R2 = 0.59). These data provide preliminary evidence that the fNIRS technology may have value as an objective measure of treatment outcomes within outpatient methadone clinics. Depressive symptoms and drug craving were also correlated with opioid use in MMPs.

中文翻译：

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前额皮质对药物提示、渴望和当前抑郁症状的反应与美沙酮维持治疗患者的治疗结果相关。

美沙酮维持治疗是治疗阿片类药物使用障碍的有效方法，但许多美沙酮维持治疗患者 (MMP) 仍在与慢性复发作斗争。目前的研究评估了功能性近红外光谱 (fNIRS) 是否可以识别 MMP 中持续使用阿片类药物的前额皮质 (PFC) 标记，以及抑郁症的临床测量和渴望的自我报告测量是否也与阿片类药物的使用相关。MMP (n = 29) 在 PFC 反应性的 fNIRS 测量过程中经历了药物提示反应性范式。在药物提示反应之前和之后收集自我报告的阿片类药物渴望（通过视觉模拟量表测量；0-100），并通过 17 项汉密尔顿抑郁评定量表（HAM-D）评估抑郁症状。使用分层回归和偏相关来评估 90 天随访期内每周尿液药物筛查与 fNIRS、渴望和 HAM-D 评估之间的关联。控制年龄、性别和治疗天数后，左侧前额皮质对药物信号的神经反应与随访期间阿片类药物阴性尿液筛查百分比显着相关（ΔF1，24 = 13.19，p = 0.001，ΔR2 = 0.30），并将 86% 的 MMP 正确分类为使用阿片类药物或戒除阿片类药物（χ2(4) = 16.28，p = 0.003）。基线渴望 (p < 0.001) 和 HAM-D 评估 (p < 0.01) 也与阿片类药物阴性尿液筛查百分比相关。结合 fNIRS 结果、基线渴望评分和 HAM-D 评分创建了一个稳健的预测模型 (ΔF3, 22 = 16.75, p < 0.001, ΔR2 = 0.59)。这些数据提供了初步证据，表明 fNIRS 技术作为美沙酮门诊治疗结果的客观衡量指标可能具有价值。抑郁症状和药物渴望也与 MMP 中阿片类药物的使用相关。