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Am J Psychiatry 158:1680-1686, October 2001
© 2001 American Psychiatric Association

Article

Changes in Regional Cerebral Blood Flow Elicited by Craving Memories in Abstinent Opiate-Dependent Subjects

Mark R.C. Daglish, M.B.Ch.B., M.R.C.Psych., Aviv Weinstein, Ph.D., Andrea L. Malizia, M.B.B.S., M.R.C.Psych., M.D., Susan Wilson, Ph.D., Jan K. Melichar, M.B.B.S., M.R.C.Psych., Simon Britten, M.B.B.Chir., F.R.C.S., F.R.C.Psych., Colin Brewer, M.B.B.S., M.R.C.S., L.R.C.P., M.R.C.Psych., Anne Lingford-Hughes, Ph.D., B.M.B.Ch., M.R.C.Psych., Judith S. Myles, M.B.B.Ch., B.A.O., F.R.C.Psych., Paul Grasby, M.B.B.S., D.C.H., M.R.C.Psych., M.D., and David J. Nutt, D.M., M.R.C.P., F.R.C.Psych.

OBJECTIVE: The brain circuitry of opiate craving was investigated with positron emission tomography (PET) imaging of regional cerebral blood flow (rCBF). METHOD: Twelve abstinent opiate-dependent subjects listened to audiotaped autobiographical scripts of an episode of craving and a neutral episode while undergoing a PET scan with the tracer [15O]H2O. Statistical parametric mapping was used to analyze the PET images of rCBF changes. RESULTS: Comparison of the drug-related and neutral stimulus conditions revealed activation of rCBF in the left medial prefrontal and left anterior cingulate cortices and deactivation in the occipital cortex in response to the drug-related stimulus. A further statistical parametric mapping analysis with a subjective rating of craving as a covariate showed a positive association of between craving and rCBF in the left orbitofrontal cortex. CONCLUSIONS: The patterns of cerebral activation reflect the different brain regions mediating the salience of opiate-related stimuli and the subjective experience of craving for opiates.




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