Evaluating the Impact of Heroin Abuse on Cerebral Bioelectrical Activity in Adolescents: A Quantitative Electroencephalography Study

A BSTRACT Background: Heroin use during adolescence is associated with profound and potentially long-term effects on brain function. Quantitative electroencephalography (QEEG) provides a valuable tool to investigate the neurophysiologic alterations caused by substance abuse. This study aimed to evaluate cerebral bioelectrical activity in adolescents with heroin dependence and explore whether these changes were reversible after 1 month of abstinence. Materials and Methods: A total of 29 inpatient adolescents (aged 16–18 years) with heroin addiction according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and 20 age- and sex-matched healthy controls were included. Electroencephalography (EEG) recordings were obtained within 2–7 days after the last heroin use and repeated after 1 month of abstinence. Artifact-free EEG segments were analyzed using the fast Fourier transform to quantify absolute power values in delta, theta, alpha, and beta frequency bands across different brain regions. Statistical comparisons were conducted using nonparametric tests. Relapse was defined as a return to substance use after treatment and was assessed during the 1-month follow-up. Results: Compared with controls, heroin users exhibited significant increases in delta, theta, beta, and alpha absolute power across various brain regions ( P < 0.05), with elevated alpha power in most regions except the parieto-occipital area. After 1 month of abstinence, delta power in the frontal and temporal regions significantly decreased (frontal: Z = −3.041, P < 0.01; temporal: Z = −2.737, P < 0.01), whereas normalization in other frequency bands was limited. A subset of patients ( n = 8, 27.6%) continued to show abnormal EEG patterns after 1 month, particularly elevated theta and alpha power in frontal, central, and temporal areas. Conclusions: Heroin dependence in adolescents is associated with marked alterations in cerebral bioelectrical activity, some of which may persist after short-term abstinence. QEEG appears to be a valuable tool for detecting substance-induced neurophysiologic changes. These findings emphasize the need for early intervention, prolonged monitoring, and targeted neurorehabilitation strategies in adolescents with heroin use disorder.