Sustained attention in patients receiving and abstinent following methadone maintenance treatment for opiate dependence: performance and neuroimaging results.

Abstract

Impairments in the function of attention exacerbate the course of opiate dependence and may play a role in the relapsing nature of the disorder. This study used clinical measures and positron emission tomography (PET) to assess the functioning of sustained attention in subjects with a history of opiate dependence. A test of auditory sustained attention was administered to 10 subjects receiving methadone maintenance treatment, 13 formerly opiate-dependent subjects in protracted abstinence, and 14 healthy Comparison subjects. Simultaneous measurement of regional glucose metabolism was made by [(18)F] flourodeoxyglucose PET. Subjects groups were compared on the measures of sustained attention and regional cerebral glucose metabolism. Healthy Comparison subjects scored significantly better than either methadone-maintained or abstinent former opiate addicts on measures of sustained attention. Formerly opiate-dependent subjects in protracted abstinence scored better than methadone-maintained subjects on sustained attention. Methadone-maintained subjects demonstrated a relative reduction in regional cerebral glucose metabolism in the right supramarginal gyrus, and the thalamus bilaterally. The Comparison subjects without a history of opiate dependence demonstrated a relative increase in regional cerebral glucose metabolism in the right anterior cingulate gyrus, the right medial superior frontal gyrus and the thalamus bilaterally. Subjects with a history of opiate dependence have impairments in the functioning of sustained attention, and abnormalities in brain regions identified as important in attention processing. Impairments in attention performance persist in subjects who enjoy prolonged abstinence from opiates.