The official journal of
EUROPAD - European Opiate Addiction Treatment Association
WFTOD - World Federation for the Treatment of Opioid Dependence
Editor: Icro Maremmani, MD - Pisa, Italy, EU
Associate Editors:
Thomas Clausen, MD - Oslo, Norway
Pier Paolo Pani, MD - Cagliari, Italy, EU
Marta Torrens, MD - Barcelona, Spain, EU
Statistical Editor:
Mario Miccoli, PhD - Pisa, Italy, EU

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Heroin Addiction and Related Clinical Problems: 2022, 24, N3 (pages: 47 - 55)

P300 Event-Related Potentials as a Marker of Craving in Opioid Use Disorder: a Systematic Literature Review

Skrenes A., Labonté L.E., Muñoz-Violant S., Khehra J., Krigolson O., and Schütz C.

Summary: Background. Drug-related cues have been found to induce craving in individuals with Opioid Use Disorder (OUD), although these cues are seldom reported as a factor in relapse. To explore attentional processes in addiction, studies using electroencephalography (EEG) have turned to examining the amplitude of the P300 component of the human event-related brain potential (ERP) when participants are exposed to drug-related cues and other non-drug cues. Aim: To determine whether there is a relationship between the amplitude of the P300 ERP component and opioid craving in individuals suffering from OUD. Methods. Systematic literature searches for articles using Ovid Medline and Ovid Embase were conducted to identify studies investigating ERPs in opioid craving. Reference harvesting in relevant key articles was also performed to increase search sensitivity. 120 studies were screened, five were deemed to be eligible according to our inclusion and exclusion criteria. Results. All studies made use of drug-cue responses in assessing P300 amplitude. Moreover, two studies used affective cues and two studies used oddball cues. Overall, baseline craving scores had a significant effect on P300 amplitude in the opioid-dependent groups in response to either drug-related cues or positive affective pictures. Conclusions. These findings suggest that individuals with OUD exhibit greater P300 amplitudes to drug-related cues than to positive, negative, or neutral cues. Furthermore, greater P300 amplitudes in response to drug-related cues are associated with greater self-reported craving for opioids. The findings outline a key clinical indicator of OUD, one that may be used in the future to assess relapse risk and treatment outcome.


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