Background Structural and functional MRI studies have revealed brain alterations associated with opioid use disorder (OUD). However, previous research has been limited by small sample sizes, few female participants, and single-modality analyses. Purpose To identify structural and functional brain alterations in individuals with OUD using whole-brain data-driven methods to analyze T1-weighted MRI and resting-state functional MRI (rsfMRI). Materials and Methods This secondary analysis of the Collaboration Linking Opioid Use Disorder and Sleep study compared participants with OUD (data collection February 2021 to February 2023) receiving methadone treatment with healthy control participants (data collection February 2018 to May 2023). T1-weighted MRI and rsfMRI were analyzed using tensor-based morphometry and intrinsic connectivity distribution, respectively. Primary outcome measures included regional brain volumes and functional connectivity. Voxel-wise linear regression was used to assess group differences, with family-wise error correction. Pearson partial correlations were used to examine structure-function relationships. Results Compared with healthy control participants (n = 105; median age, 27 years [IQR, 23-37 years]; 58 female), participants with OUD (n = 103; median age, 37 years [IQR, 31.5-46 years]; 62 male) showed smaller volumes (corrected P < .05) in the thalamus (β = -17.42 [95% CI: -26.56, -8.27]) and right medial temporal lobe (β = -8.02 [95% CI: -12.25, -3.78]). Larger volumes (corrected P < .05) were seen in the brainstem (pons and medulla, β = 15.21 [95% CI: 7.03, 23.40]; midbrain, β = 13.04 [95% CI: 6.61, 19.47]) and cerebellum (right, β = 14.96 [95% CI: 7.25, 22.67]; left, β = 14.88 [95% CI: 7.32, 22.43]). An interaction between sex and group was found for medial prefrontal cortex volume (β = -19.38, corrected P < .05), with female participants having smaller volumes than male participants in the OUD group. Increased functional connectivity (corrected P < .05) was noted in the thalamus (β = 0.50 [95% CI: 0.25, 0.75]), right medial temporal lobe (β = 0.43 [95% CI: 0.21, 0.66]), right cerebellum (β = 0.46 [95% CI: 0.21, 0.71]), and brainstem (β = 0.48 [95% CI: 0.22, 0.74]) in the OUD group. Structure and function were positively correlated in the cerebellum (Pearson r = 0.32 [95% CI: 0.17, 0.44], P < .001) and brainstem (Pearson r = 0.23 [95% CI: 0.09, 0.37], P = .002). Conclusion Individuals with OUD showed overlapping structural and functional brain alterations in opioid receptor-dense regions compared with healthy control participants. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Filippi and Messina in this issue.

中文翻译：

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在阿片类药物使用障碍个体的脑部 MRI 中检测到体积和内在静息态功能连接的改变。


背景 结构和功能 MRI 研究揭示了与阿片类药物使用障碍 （OUD） 相关的大脑改变。然而，以前的研究受到样本量小、女性参与者少和单模式分析的限制。目的 使用全脑数据驱动方法分析 T1 加权 MRI 和静息态功能 MRI （rsfMRI） 来识别 OUD 个体的大脑结构和功能改变。材料和方法：将阿片类药物使用障碍与睡眠联系起来的合作研究的二次分析将接受美沙酮治疗的 OUD（数据收集：2021 年 2 月至 2023 年 2 月）与健康对照参与者（数据收集：2018 年 2 月至 2023 年 5 月）进行了比较。T1 加权 MRI 和 rsfMRI 分别使用基于张量的形态测量和内在连接分布进行分析。主要结局指标包括区域脑容量和功能连接。体素线性回归用于评估组差异，并进行家庭误差校正。使用 Pearson 偏相关来检查结构-功能关系。结果与健康对照参与者（n = 105;中位年龄，27 岁 [IQR，23-37 岁];58 名女性）相比，患有 OUD 的参与者（n = 103;中位年龄，37 岁 [IQR，31.5-46 岁];62 名男性）丘脑（β = -17.42 [95% CI：-26.56，-8.27]）和右内侧颞叶（β = -8.02 [95% CI： -12.25, -3.78]).在脑干（脑桥和延髓，β = 15.21 [95% CI： 7.03， 23.40];中脑，β = 13.04 [95% CI： 6.61， 19.47]）和小脑 （右，β = 14.96 [95% CI： 7.25， 22.67];左，β = 14.88 [95% CI： 7.32， 22.43]）中观察到更大的体积。 发现内侧前额叶皮层体积 （β = -19.38，校正 P < .05） 存在性别与群体之间的相互作用，女性参与者的体积小于 OUD 组中的男性参与者。OUD 组丘脑 （β = 0.50 [95% CI： 0.25， 0.75]）、右内侧颞叶 （β = 0.43 [95% CI： 0.21， 0.66]）、右小脑 （β = 0.46 [95% CI： 0.21， 0.71]）和脑干 （β = 0.48 [95% CI： 0.22， 0.74]） 的功能连接增加。小脑 （Pearson r = 0.32 [95% CI： 0.17， 0.44]，P < .001） 和脑干 （Pearson r = 0.23 [95% CI： 0.09， 0.37]，P = .002） 的结构和功能呈正相关。结论 与健康对照参与者相比，OUD 个体在阿片受体密集区域表现出重叠的大脑结构和功能改变。© RSNA，2024 年本文提供补充材料。另请参见本期 Filippi 和 Messina 的社论。