The aim of this study was to determine the effect of opium on clinical and neuropsychological parameters in multiple sclerosis (MS) patients with substance dependency. A cross-sectional study was conducted on MS patients in Rafsanjan, Iran. Forty opium-addict MS patients (10 males and 30 females) aged between 18 and 50 years were compared with 40 MS patients with no addiction. Word-Pair Learning, Mini-Mental State Examination (MMSE), Wisconsin Card-Sorting Test (WCST), Depression, Anxiety, Expanded Disability Status Scale (EDSS), Fatigue, and the Multiple Sclerosis Functional Composite (MSFC) were measured and compared in the two groups. The comparison of two groups showed a significant increase trait anxiety (P < 0.001), fatigue (P = 0.009) and significant decrease in the executive function (P = 0.003), MMSE (P = 0.003), and working memory (P < 0.001) in addicted MS. It indicates the better efficiency of processing in the non-addicted MS patients. The MSFC z-score also was significantly higher in the non-addicted group (P < 0.001). The opium addiction has a negative impact on the clinical and neuropsychological outcome in MS patients.
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Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis results of an international survey. Neurology 46(4):907–911
Duquette P, Pleines J, Girard M, Charest L, Senecal-Quevillon M, Masse C (1992) The increased susceptibility of women to multiple sclerosis. Can J Neurol Sci 19(4):466–471
Chiaravalloti ND, DeLuca J (2008) Cognitive impairment in multiple sclerosis. Lancet Neurol 7(12):1139–1151
Beatty WW (2004) RBANS analysis of verbal memory in multiple sclerosis. Arch Clin Neuropsychol 19(6):825–834
Litvan I, Grafman J, Vendrell P, Martinez JM (1988) Slowed information processing in multiple sclerosis. Arch Neurol 45(3):281–285
Benedict RH, Ramasamy D, Munschauer F, Weinstock-Guttman B, Zivadinov R (2009) Memory impairment in multiple sclerosis: correlation with deep grey matter and mesial temporal atrophy. J Neurol Neurosurg Psychiatry 80(2):201–206
Benedict RH, Weinstock-Guttman B, Fishman I, Sharma J, Tjoa CW, Bakshi R (2004) Prediction of neuropsychological impairment in multiple sclerosis: comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden. Arch Neurol 61(2):226–230
Peltz G, Südhof TC (2018) The neurobiology of opioid addiction and the potential for prevention strategies. Jama 319(20):2071–2072
Clifford DB, Trotter JL (1984) Pain in multiple sclerosis. Arch Neurol 41(12):1270–1272
Rog DJ, Nurmikko TJ, Friede T, Young CA (2005) Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology 65(6):812–819
Archibald C, McGrath P, Ritvo P, Fisk J, Bhan V, Maxner C, Murray T (1994) Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients. Pain 58(1):89–93
Ballantyne JC, LaForge SK (2007) Opioid dependence and addiction during opioid treatment of chronic pain. Pain 129(3):235–255
Eisenberg E, McNicol ED, Carr DB (2005) Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin: systematic review and meta-analysis of randomized controlled trials. JAMA 293(24):3043–3052
Noble F, Cox BM (1996) Differential desensitization of μ-and δ-opioid receptors in selected neural pathways following chronic morphine treatment. Br J Pharmacol 117(1):161–169
Goldapple K, Segal Z, Garson C, Lau M, Bieling P, Kennedy S, Mayberg H (2004) Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy. Arch Gen Psychiatry 61(1):34–41
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302
Boscarino JA, Hoffman SN, Han JJ (2015) Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates. Subst Abus Rehabil 6:83
Milgram S (1963) Behavioral study of obedience. J Abnorm Psychol 67(4):371–378
Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198
Puente A (1985) Wisconsin Card-Sorting Test. Test Critiques 4:677–682
Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897
Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N (2005) Psychometric properties of a Persian-language version of the Beck Depression Inventory--second edition: BDI-II-PERSIAN. Depress Anxiety 21(4):185–192
Spielberger CD (1970) STAI manual for the state-trait anxiety inventory. Self-Evaluation Questionnaire 6(2):1-24
Kaviani H, Mousavi A (2008) Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J TUMS Publ 66(2):136–140
Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis an expanded disability status scale (EDSS). Neurology 33(11):1444–1452
Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC (1988) Fatigue in multiple sclerosis. Arch Neurol 45(4):435–437
Gronwall D (1977) Paced auditory serial-addition task: a measure of recovery from concussion. Percept Mot Skills 44(2):367–373
Litvan I, Grafman J, Vendrell P, Martinez JM, Junqué C, Vendrell JM, Barraquer-Bordas JL (1988) Multiple memory deficits in patients with multiple sclerosis: exploring the working memory system. Arch Neurol 45(6):607–610
Arnett PA, Higginson CI, Voss WD, Bender WI, Wurst JM, Tippin JM (1999) Depression in multiple sclerosis: relationship to working memory capacity. Neuropsychology 13(4):546–556
Rao SM, Grafman J, DiGiulio D, Mittenberg W, Bernardin L, Leo GJ, Luchetta T, Unverzagt F (1993) Memory dysfunction in multiple sclerosis: its relation to working memory, semantic encoding, and implicit learning. Neuropsychology 7(3):364–374
Ghafari E, Costa H, Júlio E, Portugal A, Durães L (2014) The effect of nanosilica addition on flowability, strength and transport properties of ultra high performance concrete. Mater Des 59:1–9
Sarkaki A, Assaei R, Motamedi F, Badavi M, Pajouhi N (2008) Effect of parental morphine addiction on hippocampal long-term potentiation in rats offspring. Behav Brain Res 186(1):72–77
Sánchez LM, Olivares PT, Nieto BA, Hernández PM, Barroso RJ (2004) Multiple sclerosis and depression. Rev Neurol 38(6):524–529
Chen CC, Tsai SY, Su LW, Yang TW, Tsai CJ, Hwu HG (1999) RESEARCH REPORT Psychiatric co-morbidity among male heroin addicts: differences between hospital and incarcerated subjects in Taiwan. Addiction 94(6):825–832
Karam EG, Yabroudi PF, Melhem NM (2002) Comorbidity of substance abuse and other psychiatric disorders in acute general psychiatric admissions: a study from Lebanon. Compr Psychiatry 43(6):463–468
We thank the patients who participated in the study, the study-site personnel, and members of the Special Medical Center in Ali-Ebn-Abitaleb hospital in Rafsanjan, Iran.
This study was made possible by financial and technical support of the physiology and pharmacology research center of Rafsanjan University of Medical Sciences (grant no: 9/459).
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The authors declare that they have no conflict of interest.
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Ayoobi, F., Bidaki, R., Shamsizadeh, A. et al. Impact of opium dependency on clinical and neuropsychological indices of multiple sclerosis patients. Neurol Sci 40, 2501–2507 (2019). https://doi.org/10.1007/s10072-019-03971-8
- Multiple sclerosis
- Substance dependency