heroin and Cognitive-Dysfunction

The incidence of chronic heroin use disorder, including overdose deaths, has reached epidemic proportions. Here we summarise and evaluate our knowledge of the relationship between chronic heroin use disorder and the brain through a narrative review. A broad range of areas was considered including causal mechanisms, cognitive and neurological consequences of chronic heroin use and novel neuroscience-based clinical interventions. Chronic heroin use is associated with limited or very limited evidence of impairments in memory, cognitive impulsivity, non-planning impulsivity, compulsivity and decision-making. Additionally, there is some evidence for certain neurological disorders being caused by chronic heroin use, including toxic leukoencephalopathy and neurodegeneration. However, there is insufficient evidence on whether these impairments and disorders recover after abstinence. Whilst there is a high prevalence of comorbid psychiatric disorders, there is no clear evidence that chronic heroin use per se causes depression, bipolar disorder, PTSD and/or psychosis. Despite the growing burden on society from heroin use, knowledge of the long-term effects of chronic heroin use disorder on the brain remains limited. Nevertheless, there is evidence for progress in neuroscience-based interventions being made in two areas: assessment (cognitive assessment and neuroimaging) and interventions (cognitive training/remediation and neuromodulation). Longitudinal studies are needed to unravel addiction and neurotoxic mechanisms and clarify the role of pre-existing psychiatric symptoms and cognitive impairments.

Topics: Bipolar Disorder; Brain; Cognitive Dysfunction; Comorbidity; Heroin; Humans; Impulsive Behavior; Neuroimaging; Neurosciences; Opioid-Related Disorders; Psychotic Disorders

To date, the pattern of heroin- and methamphetamine-induced cognitive impairment is unclear, especially in the Chinese population. The aim of this study was to compare the similarity and heterogeneity of cognitive impairment between heroin and methamphetamine-dependent patients and to link cognitive impairment to drug-related variables.. 567 pure methamphetamine patients, 78 pure heroin patients and 201 healthy volunteers participated in this study. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function including immediate memory, visuospatial/constructional index, language, attention, delayed memory, and total scores.. Methamphetamine-dependent and heroin-dependent patients performed significantly worse on all RBANS subtest and total scores (all p < 0.05). Moreover, methamphetamine-dependent patients had more delayed memory impairment than heroin-dependent patients (p = 0.02). In addition, some drug-related variables, such as duration of abstinence, age at first drug use, and duration of drug use, were independently associated with memory and visuospatial/constructional index in methamphetamine patients (all p < 0.05). In contrast, none of the drug-related variables were associated with cognitive performance in heroin patients (all p > 0.05).. Chronic heroin and methamphetamine patients may exhibit different patterns of cognitive deficits.

Topics: Case-Control Studies; China; Cognition; Cognitive Dysfunction; Heroin; Humans; Language; Methamphetamine; Neuropsychological Tests

Chronic abuse of heroin leads to long-lasting and complicated cognitive impairment. Dopamine receptors are critically involved in the impulsive drug-driven behavior and the altered attention, processing speed, and mental flexibility that are associated with higher relapse rates. However, the effects of the different dopamine receptors and their possible involvement in heroin-induced cognitive impairment remain unclear.. The 5-choice serial reaction time task was used to investigate the profiles of heroin-induced cognitive impairment in mice. The expression levels of dopamine D1- and D2-like receptors in the prefrontal cortex, nucleus accumbens, and caudate-putamen were determined. The effects of dopamine receptors on heroin-induced impulsivity in the 5-choice serial reaction time task were examined by agonist/antagonist treatment on D1 or D3 receptor mutant mice.. Systemic heroin administration influences several variables in the 5-choice serial reaction time task, most notably premature responses, a measure of motor impulsivity. These behavioral impairments are associated with increased D1 receptor and decreased D3 receptor mRNA and protein levels in 3 observed brain areas. The heroin-evoked increase in premature responses is mimicked by a D1 agonist and prevented by a D1 antagonist or genetic ablation of the D1 receptor gene. In contrast, a D3 agonist decreases both basal and heroin-evoked premature responses, while genetic ablation of the D3 receptor gene results in increased basal and heroin-evoked premature responses.. Heroin-induced impulsive behavior in the 5-choice serial reaction time task is oppositely modulated by D1 and D3 receptor activation. The D1 receptors in the cortical-mesolimbic region play an indispensable role in modulating such behaviors.

Topics: 2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-benzazepine; Animals; Antibodies; Benzazepines; Benzopyrans; Cognitive Dysfunction; Heroin; Impulsive Behavior; Male; Mice; Mutation; Neostriatum; Nucleus Accumbens; Oxazines; Prefrontal Cortex; Reaction Time; Receptors, Dopamine D1; Receptors, Dopamine D2; Receptors, Dopamine D3