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By using our site, you agree to our collection of information through the use of cookies. To learn more, view our Privacy Policy. To browse Academia. Progress in Neuro-Psychopharmacology and Biological Psychiatry, Log in with Facebook Log in with Google. Remember me on this computer. Enter the email address you signed up with and we'll email you a reset link. Need an account? Click here to sign up. Related papers Affective temperaments in heroin addiction Anna Romano. Aggressive responding in abstinent heroin addicts: neuroendocrine and personality correlates Francesca Brambilla. Neuroendocrine and behavioural responses to opioid receptor-antagonist during heroin detoxification: relationship with personality traits Gabriele Moi. Drug addiction and choice of drugs: Temperament and personality as risk factors Robert Cloninger. Lesch typology and temperament in opioid dependence: A cross sectional study A. Association between Novelty Seeking of opiate-dependent patients and the catechol-O-methyltransferase ValMet polymorphism Csaba Barta. The aims of the present study were to see whether or not the monoamine functions were impaired in detoxified addicts and whether or not these alterations were correlated with temperament traits, given the possibility that impairment of the biological and temperament parameters might be responsible for the development of addiction. Copyright by Elsevier Science Inc. All rights of reproduction in any form reserved. NS correlated negatively with the DA function in both addicts and controls, and negatively with the 5-HT function only in addicts. HA correlated positively with 5-HT function in controls but not in addicts. Implications: The impairment in 5-HT function observed in heroin addicts and the changes in the biological correlates of temperamental traits could increase the proneness to addiction and possible comorbid psychiatric disorders. While the discrepancies between studies might be due to the influence of interfering factors, the following does not seem to be responsible for the differing results: doses of heroin consumed daily, duration of addiction, contemporary consumption of other drugs of abuse, alcohol, or psychotropic drugs, subjects' state of nutrition, and methodological differences in measures of neurotransmitters and hormones Gerra et al. In previous studies with heroin addicts, we observed significant correlations between impairment of some specific neurotransmitter and hormonal functions, and personality or psychological dimensions, including depression, anxiety, conduct disorders, and higher than normal aggressiveness, but not with consumption of the drug itself. The correlations were present also in mothers and siblings of addicts affected by the psychopathological disturbances mentioned above Gerra et al. This observation suggests that the central and peripheral biochemical impairments observed in some, but not all, studies with heroin addicts might not be linked to abuse of the drug per se, but instead to the presence of specific personality features or psychopathologies. At best, heroin addiction may have unveiled latent impairments present in some of the subjects with temperament alterations or mental disorders. Nevertheless, there is some evidence that genetic factors may underlie addictive behavior and that specific gene polymorphisms are contributing to addiction Kotler et al. But few data have been reported in the literature regarding the existence in heroin addicts of brain biochemical alterations possibly linked to pathological temperament traits and parallel to the development and maintenance of addiction. The dimensions of human temperament proposed by the Cloninger model are defined as those components of personality that are heritable, developmentally stable, emotionally based, uninfluenced by sociocultural learning, and linked to specific brain biological features as revealed by genetic, neuroanatomic, and neurophysiological studies Cloninger et al. It has been suggested that mesolimbic and mesofrontal dopaminergic DA projections might be involved in incentive activation of NS. In contrast, the data of Netter et al. HA, or behavioral inhibition, seems to be associated with 5-HT function, high HA scores being related to high 5-HT release from presynaptic neurons and with postsynaptic 5-HT receptor down-regulation Ruegg et al. Human 5-HT transporter gene polymorphism seems to be involved in the biological impairments underlying HA temperament and particularly anxiety-related traits Lesch et al. RD is associated with the formation of conditioned signals of reward Corr et al. This temperament trait seems to be linked to norepinephrine NE function, low levels of urinary 3-methoxyhydroxy-phenylglycol MHPG having been reported in subjects with high RD, while a supersensitivity of aadrenoceptors, deriving from decreased NE secretion, has been observed in low RD individuals Garvey et al. Drug abusers in general, and heroin addicts in particular, seem to be high sensation seekers when studied with the Sensation Seeking Scale of Moorman et al. High NS and low HA seem to be predictive factors for substance abuse among adolescents Cloninger et al. The aim of the present study was to see whether or not heroin abusers have monoaminergic impairments, not necessarily linked to the consumption of the drug per se, but related with NS or HA, both the biological and temperament parameters possibly being of relevance for the development, course, and prognosis of substance abuse. We chose to examine addicts after six to eight weeks of abstinence from heroin consumption to investigate their specific temperament traits and brain biochemical patterns independently of the immediate effects of heroin consumption. The central monoamine functions were indirectly evaluated by measuring hormonal responses to pharmacological challenges acting on central pre- and postsynaptic receptors specific for NE, DA, and 5-HT functions. Endocrine challenge tests do not necessarily reflect functional changes of other relevant brain areas and need to be interpreted with caution. Daily intake of heroin ranged from 1. Previous consumption of other drugs of abuse and psychotropic agents or excessive alcohol intake were anamnestically excluded. Then the patients were included in a long-term, community-based psychosocial rehabilitation program. If a three-time-a-week analysis for urine metabolites of the main substances of abuse excluded their consumption in the first six to eight weeks after admission, the patients were included in the study. Exclusion criteria included severe chronic liver or renal diseases or other chronic physical disorders, recent weight loss or obesity, endocrinopathies, immunopathies, and, in particular, HIV disease. In agreement with the rules of therapeutic communities, the subjects were smoking not more than three to five cigarettes per day and drinking not more than two cups of coffee daily. They abstained from smoke or caffeinated beverages 7 days before our biochemical investigation. Exclusion criteria from the study were the same as those used for the patients. The socioeconomic and educational background of healthy volunteers was not significantly different from patients' background. Volunteers were also controlled by urinary drug screening for 4 weeks before the study and immediately before 2 h the experimental days. They also abstained from smoke or caffeinated beverages 7 days before the biochemical investigations. After complete description of the study to the subjects, written informed consent was obtained. A second clinical interview in the presence of a family member was performed by the same psychiatrist to avoid denial of symptoms. The temperament traits of the subjects were studied clinically and with psychometric measures. Fourteen of the heroin addicts had psychiatric symptoms, although only two subjects showed all the criteria for the DSM diagnoses: four had antisocial personality symptoms, two generalized anxiety symptoms, and eight depressive symptomatology; two subjects out of eight were affected by major depression. Neuroendocrine Challenges Addicts and controls were off any medication for at least two months before the study. They consumed a low monoamine diet and avoided smoking during the 7 days prior to the neuroendocrine tests. The three neuroendocrine challenges intravenous clon test, oral D-fen test, and oral brom test were administered 4 days apart from one another days 1, 6, and 11 at the day hospital of our institute after an overnight fast and 1 h of bed-rest in recumbent position. The clon challenge started at A. At A. Blood specimen for GH assays were drawn into EDTA-containing tubes immediately before the clon injection, and 15, 30, 45, 60, and 90 min afterwards. The Dfen challenge started at A. The bromocriptine brom challenge was done on day 11, with a catheter inserted at A. The sensitivity of the method for GH was 0. Correlations between variables were determined by Pearson's correlation coefficients. The hormonal responses obtained in heroin addicts during the three challenges were compared with those obtained in control subjects with ANOVA. The relationship between the measures of temperament and personality traits i. Moreover, the subjects were submitted to a three-challenge experiment with three series of blood samples for each individual. Because of ethical reasons, it was not possible to repeat the tests twice. While the sample of subjects included in the study was small, three monoaminergic systems were investigated in the same addicts and healthy subjects. Previous studies, investigating separately DA or 5-HT function with neuroendocrine challenges, have utilized similar or smaller samples Fishbein et al. D-Fen administration induced PRL rises that were significantly lower in heroin addicts than in controls Fig. Clon administration induced GH rises that were not significantly different in addicts and controls Fig. When ANOVA for repeated measures was covaried for basal GH values, there was no effect of time, diagnosis, diagnosis per time, and responses to the stimulus of addicts and controls. The clon challenge was unable to detect a-adrenergic system differences between addicts and control subjects. Brom administration induced GH rises that were not significantly different in addicts and in controls Fig. ANOVA for repeated measures revealed no significant effect of time, diagnosis, and diagnosis per time. PRL plasma levels were suppressed by brom administration in both addicts and controls, the differences being statistically non-significant Fig. ANOVA for repeated measures showed no significant effects of time, diagnosis, and diagnosis per time. The brom challenge did not demonstrate a significant difference between addicts and healthy subjects in the DA system control of pituitary hormones. It is not easy to understand the significance of these results and the links between monoamine states of activity and temperament traits as possible bases for proneness to addiction. These results confirm our previous data obtained in addicts both during heroin consumption and after detoxification Brambilla et al. The contrast between these results might be due to the fact that the models of investigation used in the two studies are different, our test indirectly measuring the hypothalamic NE function and those of Garcia Sevilla et al. In experimental animals, NE function has been involved in opiate consumption and withdrawal, particularly at the level of the locus ceruleus and its projection areas, where NE turnover is blocked by opiate administration and increased by its withdrawal Rasmussen, This is in contrast with experimental animals, where acute or prolonged opiate administration stimulates presynaptic DA secretion in the mesolimbic area, specifically in the nucleus accumbens and in the ventral tegmental area, by taking off a GABA-mediated inhibition on the cell bodies Leone et al. In humans, addiction was found to be associated with decreases of striatal D2 receptors examined by PET scanning Volkow et al. A DAD2 receptor gene polymorphism has been implicated in the vulnerability to substance abuse indicating the DA system impairment as responsible of addictive behavior Berrettini and Persico, Low DA levels, or an increased density of free striatal DA D2 receptors have been reported in relationship with early relapse in alcohol-dependent patients Guardia et al. In comparison with this body of evidence, normal DA function of our patients was unexpected, and we can offer only tentative hypotheses to explain it. First, the failure to detect a difference in DA and NE responses between addicts and controls in our study may be simply due to the fact that challenge design is not relevant to the right brain areas that are affected in addiction. Second, human and animal studies that are carried out over a course of prolonged heroin consumption may result in different findings. In humans, the daily drug dosage may be much lower than those administered in experimental animals, may vary from day to day, and may be mixed with other non-addictive substances for commercial reasons. This would reduce in humans the heroin-induced damages observed in animals. Moreover, we investigated our patients 6 to 8 weeks after detoxification, while the data of the literature refer to either a period of continuous consumption or to that immediately following heroin withdrawal. Many studies demonstrating monoaminergic changes in heroin addicts, that have been performed with human subjects under the effects of opioid drugs, have been found to modify the DA state in experimental animals Manzanedo et al. It may be possible that eventual catecholamine system impairment occurring during consumption would have already disappeared after the long period of detoxification. However, this hypothesis is not supported by our previous findings that show normal catecholaminergic function in addicts during a prolonged phase of heroin consumption Brambilla et al. This is in contrast with our previous observation in a group of heroin addicts where stimulation of PRL and CORT by fenfluramine challenge excluded a pathology of the 5-HT system Gerra et al. Moreover, Fishbein et al. As for the Schmidt data, our study investigated 5-HT function at the hypothalamic level, while Schmidt measured 5HT in platelets, a peripheral compartment that, as mentioned before for NE, only supposedly mimic brain secretion of the amine. Moreover, Fishbein and Schmidt examined their patients during withdrawal or during heroin consumption, while ours were detoxified for many weeks. Our protocol of investigation does not allow us to state whether or not the 5-HT impairment is a result of previous heroin consumption or whether it is a trait of the subjects, independent of the active presence of heroin, and possibly representing a biological basis for the proneness to addiction. Although the washout period was sufficient and the time of the study was consistently far from withdrawal neuroendocrine raging, persistent heroin-induced damage of 5-HT function cannot be excluded. In fact, because of the homogeneous severity of addiction and similar periods of heroin exposure of the subjects included in the study, the correlations between PRL and CORT responses to D-fen and the severity of substance abuse were not allowed. The temperament profile of our addicts was characterized by higher than normal NS scores, in agreement with our previous results and with those of the literature Vukov et al. This result was intriguing, since an association between high NS, low RD, and low HA has been proposed to be highly predictive for substance abuse Cloninger et al. The analysis of the correlations between neurotransmitter functions and temperament traits has shown that NS scores correlate positively with DA postsynaptic receptor sensitivity and probably with a dysfunction in presynaptic DA secretion. This is in agreement with most of the data of the literature Cloninger, ; Cloninger et al. In response to the initial hypothesis concerning DA changes underlying NS trait, the relationship between DA function and NS was true for all the subjects included in the study, but not for the addicts per se. The negative correlation between NS and 5-HT function observed in our patients and not in the controls, agrees with the data of Netter et al. Nevertheless, the expected link between NS and 5-HT deficit was not demonstrated in healthy subjects. HA in heroin addicts did not show the direct correlation with 5-HT secretion that occurs in controls Cloninger, , Since HA correlated with mood and personality disorders, as evidenced by MMPI D scores, it is possible that the relationship between this temperament trait and the 5-HT function was attenuated in the addicts by the development of mood disorders associated with more consistent 5-HT deficiency Ampollini et al. HA scores of addicts correlated positively with the GH responses to the clon test. This could represent a biological character of patients with dependent personality, social anxiety, and poor social skills since in a previous study we found an inverse correlation in abstinent heroin addicts between NE function and opposite comorbidity symptoms, including the history of conduct disorder, attention deficit, and hyperactivity Gerra et al. In sum, the study of central monoamine functions revealed an alteration only of the 5HT system in detoxified heroin abusers, which might be a trait character of these subjects, possibly involved in the pathogenesis of the disorder. However, two points must be taken into consideration for future studies. First, the normal functional correlations between the three monoaminergic systems is absent, and in the case of the inhibitory effect of 5-HT on DA secretion, it is even reversed, suggesting the existence of complex biological impairments in the monoaminergic circuits. Second, the correlations between biological patterns and temperament traits reveal a disruption of the normal relationship observed in healthy subjects. The small sample included in our study and the non-homogeneous psychiatric diagnoses in the protocol are consistent limitations in the definite interpretation of the results. Further studies need to be performed to investigate the relationships among substance abuse, temperament traits, and their biological correlates. Arque JM, Beltri R, Torrubia R: Personality, bioelectric profile, and platelet monoamine oxidase activity in psychophysiological disorders: Headaches, insomnia, and loss of consciousness due to neurocirculatory dystonia. Cloninger CR: A unfitted biosocial theory of personality and its role in the development of anxiety states. Cloninger CR: A systematic method for clinical description and classification of personality variants. Cloninger CR: The psychobiological regulation of social cooperation. Cloninger CR: The genetics and psychobiology of the seven-factor model of personality. In Biology of Personality Disorders, edited by K. Dabbs JM Jr. Miller and M. Gold, New York, Marcel Dekker, pp. In Eight Sardinian Conf Neurosci 6 abstract : 82, a. Four approaches. Hamilton M: A rating scale for depression. Manual, Minneapolis, University of Minnesota, Invernizzi R, Berettera C, Garattini S, Samanin R: D- and L-isomers of fenfluramine differ markedly in their interaction with brain serotonin and catecholamines in the rat. Nutt DJ: The neurochemistry of addiction. Skolnick NJ, Zuckerman M: Personality changes in drug abusers: A comparison of therapeutic community and prison group. Teichman M, Barnea Z, Rahav G: Sensation seeking, state and trait anxiety, and depressive mood in adolescent substance users. Zuckerman M: The psychophysiology of sensation seeking. Zuckerman, Melbrome, Australia, Cambridge Univ. Press, Zuckerman M: The psychobiological model for impulsive unsocialized sensation seeking a comparative approach. Tratamiento acupuntural sacrolumbalgia. CMF 7. Los Sombreros Mislai Segura Mora. Manual de Excel Avanzado Stalk Pendekatan Arsitektur Terapung Muhammar Khamdevi. Correction SLCI lobna boujlib. Roof design Dragos Patrascu. Cooling and cryopreservation of fish embryos Nathalie Ommundsen Pessoa. Memes in digital culture and their role in marketing and communication: A study in India Harshit Sharma. Computational POM evaluation of experimental in vitro Trypanosoma cruzi and Mycobacterium tuberculosis inhibition of heterocycliccarboxylic acid 3-cyano-1,4-di-noxidequinoxalinyl amide derivatives Javed Sheikh. Studying the relationship of immersion duration and characteristics of natural materials FAD to fish aggregation in the sea Najamuddin Najamuddin.

Neuroendocrine Correlates of Temperament Traits in Abstinent Opiate Addicts

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