Acute impairing effects of morphine related to driving: A systematic review of experimental studies to define blood morphine concentrations related to impairment in opioid-naïve subjects

Strand, Maren Cecilie; Arnestad, Marianne; Fjeld, Bente; Mørland, Jörg

doi:10.1080/15389588.2017.1326595

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…When morphine is administered, the diminished pain sensation may reduce the level of activation of the SN, which potentially leads to an attenuation of the DMN deactivation. Second, opioids such as morphine are known to impair cognitive functions (Strand et al, 2017 ). This may be carried out by altering the fronto-parietal and medio-lateral connectivity of the brain cognitive networks (Hudetz, 2012 ; Khalili-Mahani et al, 2012 ), including the DMN which has been seen to be important in the maintenance of a subject’s cognitive performance (Eichele et al, 2008 ; Prado and Weissman, 2011 ; Lin et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Morphine Attenuates fNIRS Signal Associated With Painful Stimuli in the Medial Frontopolar Cortex (medial BA 10)

Peng

Yücel

Steele

et al. 2018

Front. Hum. Neurosci.

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Functional near infrared spectroscopy (fNIRS) is a non-invasive optical imaging method that provides continuous measure of cortical brain functions. One application has been its use in the evaluation of pain. Previous studies have delineated a deoxygenation process associated with pain in the medial anterior prefrontal region, more specifically, the medial Brodmann Area 10 (BA 10). Such response to painful stimuli has been consistently observed in awake, sedated and anesthetized patients. In this study, we administered oral morphine (15 mg) or placebo to 14 healthy male volunteers with no history of pain or opioid abuse in a crossover double blind design, and performed fNIRS scans prior to and after the administration to assess the effect of morphine on the medial BA 10 pain signal. Morphine is the gold standard for inhibiting nociceptive processing, most well described for brain effects on sensory and emotional regions including the insula, the somatosensory cortex (the primary somatosensory cortex, S1, and the secondary somatosensory cortex, S2), and the anterior cingulate cortex (ACC). Our results showed an attenuation effect of morphine on the fNIRS-measured pain signal in the medial BA 10, as well as in the contralateral S1 (although observed in a smaller number of subjects). Notably, the extent of signal attenuation corresponded with the temporal profile of the reported plasma concentration for the drug. No clear attenuation by morphine on the medial BA 10 response to innocuous stimuli was observed. These results provide further evidence for the role of medial BA 10 in the processing of pain, and also suggest that fNIRS may be used as an objective measure of drug-brain profiles independent of subjective reports.

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Section: Discussionmentioning

confidence: 99%

Morphine Attenuates fNIRS Signal Associated With Painful Stimuli in the Medial Frontopolar Cortex (medial BA 10)

Peng

Yücel

Steele

et al. 2018

Front. Hum. Neurosci.

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“…As Figure 2 (left panel) shows, most performance impairments have been reported in studies using high doses of opioid agonists only, although some studies have observed performance decrements at medium doses (of hydrocodone, oxycodone and partial agonists). This suggests that the effect on opioid agonists on coding performance might be dose-related, although a clear link between plasma morphine concentrations and DSST impairments is currently lacking (Strand, Arnestad, Fjeld, & Mørland, 2017).…”

Section: Coding Taskmentioning

confidence: 99%

The role of the opioid system in decision making and cognitive control: A review

Steenbergen¹,

Eikemo²,

Leknes³

2018

Preprint

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The opioid system plays a key role in the regulation of affective processing including pain, pleasure, and reward. However, there is also increasing evidence that this system plays a broader role and can modulate cognitive function. In particular, increasing evidence suggests that the mu-opioid system influences how we choose between actions of different values and how we control our behavior in the face of distracting information. The present paper reviews the available evidence from studies that have used pharmacological manipulations of the mu-opioid system in healthy human volunteers. Our review covers experimental paradigms that have investigated reward-based decision making, impulsivity, neuropsychological tests of executive functioning, attention, inhibition and effort. The reviewed findings provide an emerging picture of how the mu-opioid system influences higher-level cognitive function via modulation of valuation, motivation and control circuits dense in mu-opioid receptors, including orbitofrontal cortex, basal ganglia, amygdalae, anterior cingulate cortex, and prefrontal cortex. The working model we put forward proposes that opioids influence decision making and cognitive control by increasing the subjective value of reward and reducing aversive arousal. The review highlights potential mechanisms that might underlie the effects of mu-opioids on decision making and cognitive control and provides important directions for future research.

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“…As Figure 3 (left panel) shows, most performance impairments have been reported in studies using high doses of opioid agonists only, although some studies have observed performance decrements at medium doses (e.g., hydrocodone, oxycodone, and partial agonists). This suggests that the effect of opioid agonists on coding performance might be dose-related, even though a clear link between plasma concentrations and DSST impairments is currently lacking (Strand, Arnestad, Fjeld, & Mørland, 2017).…”

Section: Review Of Studies On Cognitive Controlmentioning

confidence: 99%

The role of the opioid system in decision making and cognitive control: A review

Steenbergen

Eikemo

Leknes

2019

Cogn Affect Behav Neurosci

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The opioid system regulates affective processing, including pain, pleasure, and reward. Restricting the role of this system to hedonic modulation may be an underestimation, however. Opioid receptors are distributed widely in the human brain, including the more Bcognitive^regions in the frontal and parietal lobes. Nonhuman animal research points to opioid modulation of cognitive and decision-making processes. We review emerging evidence on whether acute opioid drug modulation in healthy humans can influence cognitive function, such as how we choose between actions of different values and how we control our behavior in the face of distracting information. Specifically, we review studies employing opioid agonists or antagonists together with experimental paradigms of reward-based decision making, impulsivity, executive functioning, attention, inhibition, and effort. Although this field is still in its infancy, the emerging picture suggests that the mu-opioid system can influence higher-level cognitive function via modulation of valuation, motivation, and control circuits dense in mu-opioid receptors, including orbitofrontal cortex, basal ganglia, amygdalae, anterior cingulate cortex, and prefrontal cortex. The framework that we put forward proposes that opioids influence decision making and cognitive control by increasing the subjective value of reward and reducing aversive arousal. We highlight potential mechanisms that might underlie the effects of mu-opioid signaling on decision making and cognitive control and provide directions for future research.

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Acute impairing effects of morphine related to driving: A systematic review of experimental studies to define blood morphine concentrations related to impairment in opioid-naïve subjects

Cited by 11 publications

References 36 publications

Morphine Attenuates fNIRS Signal Associated With Painful Stimuli in the Medial Frontopolar Cortex (medial BA 10)

Morphine Attenuates fNIRS Signal Associated With Painful Stimuli in the Medial Frontopolar Cortex (medial BA 10)

The role of the opioid system in decision making and cognitive control: A review

The role of the opioid system in decision making and cognitive control: A review

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