White matter integrity in polydrug users in relation to attachment and personality: a controlled diffusion tensor imaging study

Abstract

The relationship between substance use disorders (SUD) and brain deficits has been studied extensively. However, there is still a lack of research focusing on the structural neural connectivity in long-term polydrug use disorder (PUD). Since a deficiency in white matter integrity has been reported as being related to various parameters of increased psychopathology, it might be considered an aggravating factor in the treatment of SUD. In this study we compared two groups of PUD inpatients (abstinent: n = 18, in maintenance treatment: n = 15) to healthy controls (n = 16) with respect to neural connectivity in white matter, and their relation to behavioral parameters of personality factors/organization and attachment styles. Diffusion Tensor Imaging was used to investigate white matter structure. Compared with healthy controls, the PUD patients showed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) mainly in the superior fasciculus longitudinalis and the superior corona radiata. These findings suggest diminished neural connectivity as a result of myelin pathology in PUD patients. In line with our assumptions, we observed FA in the biggest cluster as negatively correlated with anxious attachment (r = 0.36, p < 0.05), personality dysfunctioning (r = -0.41; p < 0.01) as well positively correlated with personality factors Openness (r = 0.34; p < 0.05) and Agreeableness (r = 0.28; p < 0.05). Correspondingly these findings were inversely mirrored by RD. Further research employing enhanced samples and addressing longitudinally neuronal plastic effects of SUD treatment in relation to changes in personality and attachment is recommended.

Structural brain markers are differentially associated with neurocognitive profiles in socially marginalized people with multimorbid illness.

“…Specifically, dysfunction of the fronto-subcortical circuitry, namely connectivity of prefrontal cortex and ventral striatum, has been consistently linked with the development and maintenance of addiction (Everitt & Robbins, 2013;Koob & Volkow, 2010). Indeed, significant reductions in white matter integrity of major frontal and interhemispheric tracts are reliably observed in stimulant users (London, Kohno, Morales, & Ballard, 2015;Romero, Asensio, Palau, Sanchez, & Romero, 2010), opioid users (Wollman et al, 2015), alcohol users (Fortier et al, 2014), and polysubstance users (Unterrainer et al, 2015) compared to healthy controls. Moreover, longer duration of substance use is correlated with poorer white matter integrity (Ersche et al, 2012;Fortier et al, 2014;Wollman et al, 2015).…”

“…We selected several major white matter tracts that have projections to frontal and temporal regions including the corpus callosum, cingulum, superior longitudinal fasciculus, and anterior corona radiata. These tracts are commonly examined within the DTI literature and consistently implicated in various clinical conditions such as schizophrenia (Samartzis, Dima, Fusar-Poli, & Kyriakopoulos, 2014), HIV (Leite et al, 2013), and polysubstance abuse (Unterrainer et al, 2015;Willi et al, 2016). Our a priori ROI approach was followed by a whole-brain approach using…”

Insecure Attachment Styles and Increased Borderline Personality Organization in Substance Use Disorders

“…Furthermore, substance use disorder (SUD) has been linked with borderline personality organization [4,5] and insecure attachment [5,6] through several studies. More specifically, identity diffusion - one important marker of borderline personality organization [3] - also seems to be present in SUD [5].…”

Sucht als Bindungsstörung

“…Unterrainer et al [28,29] konnte jeweils einunsichererBindungsstil innerhalbder Suchtgruppen im Vergleich zu Kontrollgruppe beobachtet werden.…”

“…Trotz der unsicheren Datenlage kann die Annahme eines gehäuften Auftretens unsicherer Bindung bei Suchtpatienten zumindest als tendenziell bestätigt gelten. Auch mag das Auftreten eines ängstlich-vermeidenden Bindungsstils als spezifisch für die Suchterkrankungen gelten [11,17,20,21,28,29]. Dem entsprechend konnte z.…”