Neuroimaging may help create personalized plans to treat addiction.

When it comes to the effects of illicit substances on brain cognition, not all brains are created equal. In recent years, neuroimaging has helped us begin to understand the most important differences between individual brains on drugs—and brains subjected to prolonged drug use.

There’s a lofty goal behind this particular quest for understanding brain functioning: there’s a strong possibility that if we can pin down the various ways different people’s brains are stimulated by drugs—and ultimately changed by their regular use—we can help addiction-treatment specialists develop highly effective, tailor-made addiction-recovery plans. But we need more research to get there.

Functional neuroimaging generally works by performing Magnetic Resonance Imaging (MRI) sequences to measure while patients are asked to perform certain mental tasks or look at or listen to a particular stimuli. This is called functional MRI, or fMRI. Subtle changes in blood flow are detected and can help determine which brain areas are activated in responses. With the help of this technology, research has revealed that there may be important differences between the brains of people who tend to relapse repeatedly while attempting to kick a drug habit, and those of people who achieve permanent sobriety.

Barry Southers, M.Ed.,Barry Southers, M.Ed., is an associate professor and the MRI Program Director in the University of Cincinnati Advanced Medical Imaging Technology (AMIT) program. He has 24 years of clinical imaging experience in the medical field, including 20 years in Magnetic Resonance Imaging (MRI). He has worked in hospitals, clinics, and research centers, along with medical imaging education.

Editor: Saad Shaheed

More specifically, several studies suggest that people who relapse may have heightened activity in areas of the brain that respond to drug-triggered pleasure, and lower activity in parts of the brain associated with other types of pleasure. One study used neuroimaging to try to predict relapse and abstinence among drug users. The researchers found decreased functional brain connectivity (that is, connections among areas of the brain that tell one another what to do) in those that are addicted, and specifically those who are relapsing.

This is a big deal. These studies suggest that neuroimaging may be able to be used as a diagnostic tool at the beginning of a drug treatment intervention, with the possibility of enhancing the likelihood of success. We may someday be able look into the brains of people plagued by addiction and determine exactly how to make them better.

We may also be able to compare patients’ brain scans with other patients (those who successfully stayed abstinent) and gauge a patient’s chances of successfully staying away from drugs. As research continues to bear out these structural differences among brains, many researchers believe that it could become easier for us to identify individuals who need more thorough or longer treatment plans to beat relapse. People whose chances of full recovery appear especially low can potentially qualify for extra help and more tailored treatment plans.

As I mentioned, treatment plans that are personalized by brain are not here yet, but could be waiting for us in the future, contingent on further research. It’s crucial that researchers continue to use neuroimaging to study brain function and the impact of drug use, both after immediate consumption and after prolonged and repeated use. With the benefit of accumulated research we may be able to customize treatments to meet the needs of individual patients depending on their likelihood of staying abstinent—but we aren’t there yet. This is a bright possibility for the field of addiction treatment, and I am excited to see where neuroimaging research leads us next.

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