Exploring the quiet mind of former drug addicts using functional magnetic resonance imaging

Abstract Background Substance use disorder (SUD) is a complex psychiatric disorder characterized by persistent patterns of substance use despite negative consequences on mental and physical health. Evidence indicates the reward pathway of the brain in active drug addicts to be constantly active, even when there are no stimuli present. However, there are limited studies on whether this activation sustains in former drug addicts (FDA). Aim This study aimed to investigate whether the brain areas implicated in drug craving show activation in the absence of drug-related stimuli in FDA following release from rehabilitation centres. Methods In collaboration with the National Anti-Drugs Agency (NADA), 24 FDA were recruited for this cross-sectional study via purposive sampling. The participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans. The functional data were pre-processed and analyzed in Statistical Parametric Mapping version 12 (SPM12). Within-group brain activation pattern was analyzed using the first-level fixed effect analysis (FFX) and second-level random effects analysis (RFX). The significance level was P FWE < 0.05. Results The key finding of this study was that brain regions implicated in reward-seeking and drug cravings were not significantly activated at the stringent threshold of P FWE < 0.05. However, seven brain regions showed increased activity during the resting state: right precentral gyrus (PrG), left middle occipital gyrus (MOG), right superior parietal lobule (SPL), right middle cingulate gyrus (MCgG), bilateral angular gyrus (AnG), left superior frontal gyrus (SFG), and left supramarginal gyrus (SMG). These regions are part of the salience network and are not directly involved in the brain’s reward pathway. Conclusions The FDA neural networks may undergo alteration following a long period of abstinence. The outcome of this study underscores the importance of the abstinent period in the treatment of SUD and provides evidence of neuroplasticity following long-term drug abstinence.