Neural Responses to Monetary Gain and Loss in Individuals Recovering From Opioid Use Disorder Compared with Controls.

Background: The brain's valuation network, including the ventral striatum and ventromedial prefrontal cortex (VMPFC), represents the value of rewards and punishments and underpins decision behavior. These neural signals are not fully characterized in individuals recovering from prescription opioid use disorder (POUD).

Objectives: We tested the hypothesis that neural responses to monetary gain and loss differ in individuals recovering from POUD relative to individuals without prior substance use.

Methods: Twenty-three individuals in an early stage of recovery from POUD (abstinent 2-3 weeks after admission to an inpatient treatment facility, no other substance use disorder), and 21 neurotypical controls group individuals without prior history of substance use completed a card guessing task during functional magnetic resonance imaging (fMRI), gaining or losing small monetary amounts after each guess. Whole-brain and valuation network regions of interest (ROI) analyses compared POUD and control group fMRI signal responses to monetary gain and loss outcomes.

Results: Ventral striatum signal change following gain and loss outcomes differed between the POUD and control groups. Specifically, time series analysis suggested that left ventral striatum responses following monetary losses remained elevated for a longer duration in POUD compared with control group participants.

Conclusions: This exploratory, small sample study suggests brain responses to non-drug incentives may differ in POUD compared with neurotypical controls, which has implications for understanding affective responses in individuals recovering from POUD.