Acupuncture inhibits cue-induced heroin craving and brain activation

Previous research using functional MRI has shown that specific brain regions associated with drug dependence and cue-elicited heroin craving are activated by environmental cues. Craving is an important trigger of heroin relapse, and acupuncture may inhibit craving. In this study, we performed functional MRI in heroin addicts and control subjects. We compared differences in brain activation between the two groups during heroin cue exposure, heroin cue exposure plus acupuncture at the Zusanli point （ST36） without twirling of the needle, and heroin cue exposure plus acupuncture at the Zusanli point with twirling of the needle. Heroin cue exposure elicited significant activation in craving-related brain regions mainly in the frontal lobes and callosal gyri. Acupuncture without twirling did not significantly affect the range of brain activation induced by heroin cue exposure, but significantly changed the extent of the activation in the heroin addicts group. Acupuncture at the Zusanli point with twirling of the needle significantly decreased both the range and extent of activation induced by heroin cue exposure compared with heroin cue exposure plus acupuncture without twirling of the needle. These experimental findings indicate that presentation of heroin cues can induce activation in craving-related brain regions, which are involved in reward, learning and memory, cognition and emotion. Acupuncture at the Zusanli point can rapidly suppress the activation of specific brain regions related to craving, supporting its potential as an intervention for drug craving.

Assessing the severity of methamphetamine use disorder beyond the subjective craving report: the role of an attention bias test

Background Methamphetamine (MA) is one of the most commonly abused illicit psychostimulant drugs and MA use disorder constitutes a universal health concern across the world. Despite many intervention approaches to MA use disorder, the indicator of addiction severity is mainly limited to subjective craving score to drug-related cues, which is influenced by many factors such as social approval and self-masking. Aim The present study investigates whether self-reported craving for drug use in response to MA cues is a reliable indicator for addiction severity in MA users, and then tests the validity of the cue-induced attention bias test in addiction severity assessment. Methods Fifty-two male MA users completed the cueinduced craving test and attention bias task, and were required to report clinical characteristics of addiction severity. For the attention bias test, subjects were required to discriminate the letter superimposed onto MA userelated or neutral scenes. The reaction time delay during MA-use condition relative to neutral condition was used as an index of the attention bias. Results The results showed that 24 of the 52 MA users rated non-zero in cue-induced craving test, and they showed a significant attention bias to drug-related pictures. However, the other 28 users who rated zero in cue-induced craving evaluation showed a similar attention bias to drug-related cues. In addition, the attention bias to MA use-related cues was significantly and positively correlated with the clinical indexes of addiction severity, but the relationship was absent between subjective craving evaluation and the indexes of addiction severity. Conclusion These results suggest that attention bias to MA cues may be a more reliable indicator than experiential craving report, especially when subjective craving is measured in the compulsory rehabilitation centre.

Effects of acupuncture stimulation on brain activation induced by cue-elicited alcohol craving

Acupuncture has been shown to be effective on alcohol use disorder.However,the underlying mechanism remains poorly understood.To investigate the effects of Shenmen(HT7)acupoint on brain activation induced by cue-elicited alcohol craving,30 right-handed healthy light to moderate alcohol drinkers were recruited from the community.They were randomly assigned to undergo acupuncture either at HT7(experimental acupoint,n=15)or Jingqu(LU8,control acupoint,n=15)acupoints.This randomized controlled study was performed in Daegu Haany University and Daegu-Gyeongbuk Medical Innovation Foundation,Republic of Korea.Recruitment and data collection were conducted from December 2018 to May 2019.The results showed that after acupuncture at HT7 acupoint,the activation of orbitofrontal cortex and dorsolateral prefrontal cortex was greatly increased,while the activation of dorsolateral prefrontal cortex was obviously reduced,and subject's craving for alcohol was reduced when he/she seeing alcohol-related video clips involving various alcohols(beer,wine,or soju)or drinking scenarios.Acupuncture at HT7 more greatly reduced subject's alcohol cravings than acupuncture at LU8 acupoint.These findings suggest that acupuncture can improve the self-control of mild to moderate social drinkers through the activation of the orbitofrontal cortex and dorsolateral prefrontal cortex,thereby reducing the craving for alcohol.The study protocol was approved by the Institutional Review Board of Daegu Haany University Korean Medicine Hospital,Republic of Korea(approval No.DHUMC-D-18026-PRO-02)on November 30,2018.

Circular RNA expression alterations are involved in incubation of morphine craving

OBJECTIVE Cue-induced drug craving progressively increase after prolong abstinence in animal and human beings.A behavioral phenomenon termed incubation of drug craving is considered as a key reason for drug relapse,but the transcriptional mechanisms that contribute to this incubation are unknown.It has been demonstrated that circular RNAs(circR NAs),act as miR NA sponges,play important roles in the regulation of gene expression and the pathogenesis of disease.The present study aims to explore the transcriptional profiles associated with incubation of morphine craving in nucleus accumbens(NAc),an important brain area previously implicated in drug seeking.METHODS The animal model of the incubation of drug craving was induced by CPP paradigms with six morphine(5 mg·kg-1) injections and 14 d drug abstinence in mice.The brain tissues of NAc were collected after the behavioral tests for circRNA-sequencing by Illumina Hiseq X sequencer.We identified differentially expressed genes(DEGs) by qRT-PCR and used bioinformatics methods for further function analysis.RESULTS The progressive increase of CPP scores during the 14 d drug abstinence indicated the establishment of animal model.The data of circRNA-sequencing reported that 16 circRNAs were significantly altered after 28 d drug abstinence in NAc of morphine treated mice(FC≥2 and P<0.05).Among those circRNAs,9 were significantly up-regulated,while 7 were down-regulated.Furthermore,we subsequently tested circRNAs expression using quantitative real-time PCR,and the consistent data were obtained.The results of KEGG pathway analysis indicated that these genes were enriched for several biological processes,including RNA transport,protein ubiquitination and histone methylation,etc.CONCLUSION These findings provide a unique resource of gene expression data for future studies examining transcriptional mechanisms in NAc that mediate opioids seeking after prolonged withdrawal.

Craving variations in patients with substance use disorder and gambling during COVID-19 lockdown:The Italian experience

BACKGROUND Following the development of the coronavirus disease-2019(COVID-19)pandemic in Italy,a strict lockdown was imposed from March 9 to May 5,2020.The risks of self-medication through alcohol or psychoactive substance abuse were increased,as well as the tendency to adopt pathological behaviors,such as gambling and internet addiction.AIM To evaluate the impact of the COVID-19 pandemic and associated containment measures on craving in a group of patients suffering from substance use disorder and/or gambling disorder who were in treatment in outpatient units or in residency programs as inpatients.METHODS One hundred and fifty-three patients completed a structured questionnaire evaluating craving and other behaviors using a visual analogue scale(VAS).Forty-one subjects completed a pencil and paper questionnaire during the interview.The clinician provided an online questionnaire to 112 patients who had virtual assessments due to lockdown restrictions.Statistical analyses were performed using Statistica version 8.0.Quantitative parameters are presented as the mean±SD and qualitative parameters as number and percentage per class.The Kolmogorov-Smirnov test was used to check for normality of distributions.Analysis of variance and Duncan post hoc test were employed to analyze differences among subgroup means.The associations between variables were measured using Pearson's correlation.A P value of<0.05 was considered significant.RESULTS The variation in craving between the present and the month before showed VASrelated reductions of craving in 57%,increases in 24%,and no significant change in 19%of the sample.The level of craving was significantly higher(F=4.36;P<0.05)in outpatients(n=97;mean=3.8±3.1)living in their own home during the quarantine compared with inpatients(n=56;mean=2.8±2.8)in residential programs.Craving for tetrahydrocannabinol was the greatest(4.94,P<0.001)among various preferred substances.CONCLUSION The unexpected result of this study may be explained by a perceived lack of availability of substances and gambling areas and/or decreased social pressure on a subject usually excluded and stigmatized,or the acquisition of a new social identity based on feelings of a shared common danger and fate that overshadowed the sense of exclusion and rejection in the abuser.

Relationship of Food Craving Behavior with Body Mass Index and Body Composition in Reproductive Age Females

Objective: To estimate the relationship of Food Craving (FC) behavior with females’ Body Mass Index (BMI), and body-composition. Design, setting and participants: A cross-sectional study of 302 reproductive-age women from middle-socioeconomic class was conducted at the Health & Occupational-Environmental Laboratory. Variable Measures: A FC behavior questionnaire (FCQ) was designed and validated in 151 female subjects. This questionnaire evaluated five dimensions: FC-leisure, FC-psychological reactance, FC-depression, FC-anxiety/stress, and FC-anger. Dependent variables were Body Mass Index (BMI, kg/m2) and the body fat mass. Interventions: A second group of 151 women completed the FCQ. Anthropometrical variables were recorded using the International Society for the Advancement of Kinanthropometry procedure. Analysis: A multiple regression-analysis using STAT- ISTICS version 7 was performed to determine the relationship of FC behavior with anthropometrical variables described. Results: We demonstrated that 98.7% of women had FC behavior. Women with higher BMI had higher scores of FC-depressions (p = 0.02) and FC-anger (p = 0.007). Food craving behavior (p < 0.0008), and food psychological-reactance (p = 0.006), were positive predictors of BMI;food psychological reactance was also a positive predictor of upper and lower-body fat mass (p = 0.005) and (p = 0.008), respectively. Conclusion and Implications: The food craving behavior is a common problem in the female population. Food psychological reactance, in addition to another affective alteration that present the population of women are predictor variables for the increase in BMI and in body-fat mass. It is important that health professionals are aware of the affective states of their patients.

Psychology of Craving

Craving is a complex psychological condition characterized by impaired dietary intake, sleep disturbance, sexual dysfunction, and drug abuse. Craving may be associated with risk-taking reckless behavior to seek pleasure including cigarette smoking, binge alcohol drinking, and illicit drug abuse (e.g. cocaine, methamphetamine, methylene deoxy meth-amphetamine (MDMA), ecstasy, morphine and heroine). Craving for food, sex and drugs involves the limbic system and prefrontal cortex. Thus, basic understanding of craving is exceedingly important for the better clinical management of major depression, hopelessness, and poor quality of life among young adolescents, as well as morbidity and early mortality among adults. Physical, psychological, nutritional, and medical rehabilitation may be helpful in the effective clinical management of patients with craving of any age, sex and race. Further studies on the psychology of craving will curb the number of hospital admissions as several victims of drug craving develop schizophrenia later in their life, if they remain untreated.

The Effectiveness of Mindfulness Therapy in Controlling under Treatment Addicts’ Drug Cravings

The present study aimed to examine the effectiveness of mindfulness therapy in controlling under treatment addicts’ drug cravings. This was a quasi-experimental study with pretest and posttest. The sample of this study included 30 under treatment male addicts whom were selected through applying random sampling method and were placed in two groups, experimental and control. After holding a preliminary session aiming at aiding the experimental group to become familiar with the procedure, 8 sessions of the mindfulness-based therapy were administered. Assessment tools were Craving Beliefs Questionnaire (CBQ) and the Depression Anxiety Stress Scale (DASS-21). After calculating mean and standard deviation, the obtained data were analyzed using covariance. The results indicated that the mindfulness therapy was significantly effective in controlling drug cravings, decreasing stress, anxiety, and depression of under treatment addicts (p < 0.05).

The Effectiveness of Neurofeedback Therapy in Craving of Methamphetamine Use

Introduction: Relapse in methamphetamine dependency is one of the most difficult parts to treat. Therefore treatment of craving for usage is one of the essential sections of treatment in methamphetamine dependency (addiction). This study evaluates the effect of neurofeedback therapy on craving for use. Methods: In this study 20 male patient with methamphetamine dependency who diagnosed on the basis of DSM-V were selected. None of the patients had any psychiatric and neurologic disorder except addiction of methamphetamine. Patients were divided into 2 groups of 10. The first group has taken real neurofeedback therapy sessions while the second has undergone non-real neurofeedback (sham) therapy. Then the two groups have been compared with t-test. Result: The result shows that in the first group (real neurofeedback), craving for methamphetamine use has been decreased significantly whereas in the second group (non-real or sham), the decrease was not significant. Conclusion: Neurofeedback therapy is effective in treatment of craving for methamphetamine use.

Pregnancy Craving and Pica: 60 Years Later

Purpose: To study pregnancy craving and pica in a cohort of women and compare our findings to a historic study. Methods: Prospective survey of women in the third trimester of pregnancy. Data were collected using the same questionnaire from a study published in Obstetrics and Gynecology in 1957. All surveys were conducted by clinicians at 35 0/7-41 6/7 weeks gestational age. High risk pregnancies were excluded. Results: We included 547 women in the analysis. Of those, 60.8% reported food craving vs 65.7% in the 1957 cohort, p-value 0.09. The most common food craving was fruit, seen in 31.1% vs 13.6%, p-value < 0.00001. In the group of women with craving, 64.6% reported that they craved the food item prior to becoming pregnant, 76.0% could not wait until another day to satisfy their food craving, and 41.7% reported there was something they liked as much. Only 2.9% of women in our cohort had pica vs 9.0%, p-value 0.00001. The cohorts differed in fruit craving, (31.1% vs 13.6%), meat, poultry, fish, dry beans, eggs, and nuts (21.0% vs 5.0%), milk, yogurt, and cheese, (17.0% vs 2.2%) and vegetable, (14.1% vs 6.9%), all with p-value < 0.00001. They did not differ in the category of bread, cereal, rice, and pasta, 17.9% vs 22.3, p-value 0.06. Conclusion: Food craving during the third trimester of pregnancy has remained constant for almost 60 years, although the items craved have changed. Pica was less common in our modern cohort of women.

The smell of high-calorie food can stop cravings for it

Looking for a way to satisfy those highcalorie meal cravings? A new study finds sniffing a burger or a pizza for two minutes can stop cravings for junk food. The study says the scent of food itself can directly satisfy your cravings because the brain doesn't realize the difference in the source of sensory pleasure.

Neuroimaging and neuroendocrine insights into foodcravings and appetite interventions in obesity

This article reviews the previous studies on the distinction between food cravings and appetite,and how they are regulated by hor-mones and reflected in brain activity.Based on existing research,food cravings are defined as individual preferences influenced by hormones and psychological factors,which differ from appetite,as they are not necessarily related to hunger or nutritional needs.The article also evaluates the neuroimaging findings about food cravings,and interventions to reduce food cravings,such as mindfulness training,alternative sweeteners,non-invasive brain stimulation techniques,cognitive-behavioral therapy,and imaginal retraining,and points out their advantages,disadvantages,and limitations.Furthermore,the article delves into the potential future directions in the field,emphasizing the need for a neuroendocrine perspective,considerations for associated psychiatric disorders,innovative clinical interventions,and emerging therapeutic frontiers in obesity management.The article outlines the neuro-endocrine basis of food cravings,including ghrelin,leptin,melanocortin,oxytocin,glucagon-like peptide-1,baclofen,and other hormones and their brain regions of action.The article argues that food cravings are an important target for obesity,and more research is needed to explore their complex characteristics and mechanisms,and how to effectively interact with their neuro-endocrine pathways.The article provides a new perspective and approach to the prevention and treatment of obesity.

Effect of Zhubin(KI9) Acupuncture in Reducing Alcohol Craving in Patients with Alcohol Dependence:A Randomized Placebo-Controlled Trial

Objective： To examine the effect of acupuncture on Zhubin （KI9） in reducing alcohol craving in alcohol-dependent patients. Methods： Twenty male alcohol-dependent patients were randomly assigned to two groups, a treatment group （10 cases, age 43.0 ± 6.8 years） and a placebo group （10 cases, age 44.5 ± 7.9 years）. The treatment group was treated with real needle acupuncture on Zhubin （KI9） twice a week for 4 weeks, and the control group was treated with placebo needle acupuncture. Both groups were given acupuncture treatment using Park Sham Device （PSD）. Alcohol craving was measured by the Visual Analogue Scale （VAS） before treatment to establish a baseline, and after 1, 2, and 4 weeks of treatment. Repeated measures ANOVA was used to determine the main and interaction effects of time and on the outcome measure （VAS）. Results： There was a significant effect of time on VAS score （dr=3, F=13.3, P〈0.01）. Main effect of group on VAS score was significant （df=1, F=10.9, P〈0.01） and the time × group interaction was also significant （df=3, F=4.7, P〈0.01）. Conclusions： Real-needle acupuncture therapy on Zhubin （KI9） showed effectiveness in reducing alcohol craving. These results strongly suggest the usefulness of acupuncture therapy on Zhubin （KI9） in preventing a relapse in alcohol dependent patients.

13例妊娠合并Graves病的临床分析

目的 分析Graves病治疗后妊娠时机及其母儿预后。方法 采用回顾性分析的方法,将13例妊娠前诊断为Graves病患者,按妊娠期间是否服用抗甲状腺药物分两组:甲组:妊娠期未服用抗甲状腺药物;乙组:妊娠期使用了抗甲状腺药物。对比研究其母儿合并症及并发症。结果 甲、乙两组妊娠前甲亢病程无差异,甲组停药至此次妊娠间隔明显短于乙组,乙组早产率,产后出血率及小于胎龄儿发生率明显高于甲组(P<0.05)。结论 Graves病在病情稳定后即可妊娠,妊娠后需严密监测母体及胎儿甲状腺功能;对于应用内基硫嘧啶治疗后需用甲状腺素片部分替代的孕妇.其胎儿甲状腺功能情况需严密监测。

糖胺聚糖在Graves眼病发病学中的作用

本文着重介绍糖胺聚糖在 Graves 眼病发病中的作用及血、尿测定的临床意义。

男性Graves病患者血清生殖激素的测定及其临床意义

男性Graves病(GD)患者常伴性腺功能低下,乳房发育等症状。为此,我们测定厂8例男性GD患者血清总睾酮(T)、雌二醇(E_2)、促黄体素(LH)、促卵泡素(FSH)及泌乳素(PRL)的水平,旨在了解男性GD患者上述激素水平紊乱的情况及其临床意义。 1 对象与方法 1.1对象:受检的男性GD患者8例,均为我院门诊病人,具典型的甲亢临床表现与高甲状腺素血症为依据的初治患者,不伴其它内分泌疾病和慢性病,无长期服药史。年龄22—48岁(35.6±8.8岁)。正常对照组10例,均为男性输血员,年龄24—45岁(34.5±7.4岁)。两组在年龄构成上无显著性差异。

^(131)Ⅰ治疗Graves病剂量探讨

目的 探讨1 31 Ⅰ治疗Graves病时 ,不同的剂量计算方法与治愈率以及治疗后并发症的关系。方法 在计算治疗Graves病所需1 31 Ⅰ时 ,分别采取不同的两种计算方法 ,观察两者治愈率及并发症的发生情况 ,并做多因素对比分析。结果 治疗组较对照组 1次治愈率提高约 12 % ,近期甲状腺功能减退延续为永久性甲状腺功能减退者亦明显减少 ,治疗效果明显优于后者。结论 1 31 Ⅰ治疗剂量计算时 ,既要有公式的规范性 ,又要有根据具体情况调节的灵活性 。