Prescription opioid misusers exhibit blunted parasympathetic regulation during inhibitory control challenge
Authors: |
Garland, E. L., & Howard, M. O. |
Journal/Source: |
Psychopharmacology, 238(3), 765–774. |
Publication Year: |
2021 (Epub 2021 Jan 7) |
PMID: |
|
PCMID: |
PMC7914222 |
DOI: |
|
Grant Support: |
R01DA042033, R03DA032517 |
Abstract
Rationale:
Among opioid-treated chronic pain patients, response inhibition deficits in emotional contexts may contribute to opioid misuse.
Objectives:
Using high-frequency heart rate variability (HF-HRV) to index-impaired response inhibition, we examined associations between opioid misuse and response inhibition in emotional and neutral contexts in a sample of opioid-treated chronic pain patients.
Method:
Chronic pain patients taking opioid analgesics (N = 97) for ≥ 90 days completed an Emotional Go/NoGo task that presented an inhibitory control challenge in the context of neutral, opioid, negative affective, and positive affective background images while HF-HRV was computed. Opioid misuse and craving were assessed. Using a validated cut-point on the Current Opioid Misuse Measure, participants were classified as opioid misusers or non-misusers. Opioid misuse was examined as a predictor of behavioral and HF-HRV metrics of response inhibition.
Results:
Negative affective and opioid images elicited more errors of commission (p = .002, η2partial = .16) and slowed reaction times (p = .045, η2partial = .09) compared to neutral and positive affective images, respectively. Though no between-group behavioral differences were observed on the task, opioid misusers exhibited significantly blunted phasic HF-HRV during the task relative to non-misusers (p = .027, η2partial = .11). HF-HRV during the task was significantly inversely associated with opioid craving. It was not clear whether these autonomic findings reflected a durable phenotypic difference between groups or between-group differences in opioid dosing and withdrawal.
Conclusion:
Reduced parasympathetic regulation during inhibitory control challenge may indicate heightened opioid misuse risk among opioid-treated chronic pain patients.
Keywords:
Chronic pain; Cognition; Heart rate variability; Inhibitory control; Opioid misuse.
For more information, contact utahpainstudy@utah.edu
Update as of May 7, 2021