A cholinergic hub in the nucleus accumbens gates opioid-reward learning.

Yousefzadeh, S Aryana; Yan, Haidun; Kwak, Seung-Hwa; Oh, Yunju; Jeong, Pyeonghwa; Pogorelov, Vladimir; Ravenel, J Russell; Lim, Shaun S X et al. · Nature · 2026

basic_science · Level V

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Abstract

Beneficial and maladaptive opioid effects are difficult to dissociate<sup>1-3</sup>, partly because dopamine signalling contributes to both these effect types<sup>4-13</sup>. Here we show that associative opioid-reward learning can be blocked even under conditions that elevate dopamine in the nucleus accumbens. We developed naloxone<sup>DART</sup>, a cell-type-specific analogue of the clinical opioid receptor antagonist naloxone<sup>14,15</sup>, and delivered it to genetically defined accumbal cholinergic interneurons, selectively rendering these cells morphine-insensitive. Acquisition of morphine conditioned place preference was abolished in a target-engagement-dependent manner, without evidence of contextual or locomotor impairment: saline habituation was enhanced between sessions and unchanged within sessions, whereas morphine-evoked hyperlocomotion, sensitization and acute analgesia remained intact. Microdialysis revealed that cholinergic interneuron-specific naloxone<sup>DART</sup> prevented morphine-induced acetylcholine reductions without detectably altering dopamine increases in the accumbens. These findings identify a cholinergic gate for associative opioid-reward learning, support an emerging dopamine-acetylcholine plasticity theory<sup>16,17</sup>, and motivate exploration of opioid-cholinergic strategies that may preserve acute analgesia while limiting early associative reward learning<sup>18-25</sup>.