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Abnormal white matter within brain structural networks is associated with high-impulse behaviour in codeine-containing cough syrup dependent users

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Abstract

Codeine-containing cough syrup (CCS) is considered as one of the most popular drug of dependence among adolescents because of its inexpensiveness and easy availability. However, its relationship with neurobiological effects remains sparsely explored. Herein, we examined how high-impulse behaviours relate to changes in the brain structural networks. Forty codeine-containing cough syrup dependent (CCSD) users and age-, gender-, and number of cigarettes smoked per day -matched forty healthy control (HC) subjects underwent structural brain imaging via MRI. High-impulse behaviour was assessed using the 30-item self-rated Barratt Impulsiveness Scale (BIS-11), and structural networks were constructed using diffusion tensor imaging and AAL-90 template. Between-group topological metrics were compared using nonparametric permutations. Benjamin–Hochberg false discovery rate correction was used to correct for multiple comparisons (P < 0.05). The relationships between abnormal network metrics and clinical characteristics of CCS dependent (BIS-11 total score, CCS- dependent duration and mean dose) were examined by Spearman’s correlation. Structural networks of the CCSD group demonstrated lower small-world properties than those of the HC group. Abnormal changes in nodal properties among CCSD users were located mainly in the frontal gyrus, inferior parietal lobe and olfactory cortex. NBS analysis further indicated disrupted structural connections between the frontal gyrus and multiple brain regions. There were significant correlations between abnormal nodal properties of the frontal gyrus and clinical characteristics (BIS-11 total score, CCS dependent duration and mean dose) in the CCSD group. These findings suggest that the high-impulse behavioural expression in CCS addiction is associated with widespread brain regions, particularly within those in the frontal cortex. Aberrant brain regions and disrupted connectivity of structural network may be the bases of neuropathology for underlying symptoms of high-impulse behaviours in CCSD users, which may provide a novel sight to better treat and prevent codeine dependency in adolescents.

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Abbreviations

CCS:

Codeine-containing cough syrup

CCSD users:

Codeine-containing cough syrup dependent

HC:

Healthy control

HCs:

Healthy control subjects

WM:

White matter

DTI:

Diffusion tensor imaging

FA:

Fractional anisotropy

FN:

Streamline number

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Acknowledgments

We thank the patients for their participation in the study and the medical and nurse staff for their collaboration in the realization of this work.

Funding

This study has received funding by the National Natural Science Foundation of China (Grant Nos. 81901729 and 81771807, 81701111), the Natural Science Foundation of Guangdong (Grant Nos. 2019A1515011314, 2015A030313723).

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Author notes

  1. Yunfan Wu and Zhihua Zhou contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging, Guangdong Second Provincial General Hospital, Shiliugang Rd, Haizhu District, Guangzhou, 510317, People’s Republic of China

    Yunfan Wu, Meng Li, Xiaofen Ma, Jin Fang, Kanghui Yu, Yi Yin, Cuihua Gao, Jianneng Li & Guihua Jiang

  2. Department of Neurology, The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China

    Zhihua Zhou

  3. The Secondly School of Clinical Medicine, Southern Medical University, Guangdong Second Provincial General Hospital, Guangzhou, People’s Republic of China

    Zhihong Lan, Shishun Fu & Guihua Jiang

  4. Department of Radiology, Shenzhen Children’s Hospital, Shenzhen, 518000, People’s Republic of China

    Shoujun Xu

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  1. Yunfan Wu
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Contributions

YW, GJ—study concepts/study design or data acquisition or data analysis/interpretation, study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; project administration—YW, GJ, Supervision—GJ, writing-original draft—YW, writing-review & editing—YW, ZZ, ML; visualization—ZZ, YW; data curation—SF, YY, ZL, SX; investigation—SF, XM; formal analysis—CG, JL, YY; and software—YW, JF, KY.

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Correspondence to Guihua Jiang.

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Communicated by Sebastian Walther.

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Wu, Y., Zhou, Z., Li, M. et al. Abnormal white matter within brain structural networks is associated with high-impulse behaviour in codeine-containing cough syrup dependent users. Eur Arch Psychiatry Clin Neurosci 271, 823–833 (2021). https://doi.org/10.1007/s00406-020-01111-4

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