Skip to content

Research at St Andrews

Abnormal brain activity during a reward and loss task in opiate dependent patients receiving methadone maintenance therapy

Research output: Contribution to journalArticle



Victoria B. Gradin, Alexander Mario Baldacchino, David Balfour, Keith Matthews, J. Douglas Steele

School/Research organisations


A core feature of human drug dependency is persistence in seeking and using drugs at the expense of other life goals. It has been hypothesised that addiction is associated with over-valuation of drug-related rewards and under-valuation of natural, non-drug related rewards. Humans additionally tend to persist in using drugs despite adverse consequences. This suggests that the processing of both rewarding and aversive information may be abnormal in addictions. We used fMRI to examine neural responses to reward and loss events in opiate dependent patients receiving Methadone Maintenance Treatment (MMT, n=30) and healthy controls (n=23) using non-drug related stimuli. Half of the patients were scanned after/before daily methadone intake (ADM/BDM patient groups). During reward trials, patients as a whole exhibited decreased neural discrimination between rewarding and non-rewarding outcomes in the dorsal caudate. Patients also showed reduced neural discrimination in the ventral striatum with regard to aversive and non-aversive outcomes, and failed to encode successful loss-avoidance as a reward signal in the ventral striatum. Patients additionally showed decreased insula activation during the anticipation/decision phase of loss events. ADM patients exhibited increased loss signals in the midbrain/para-hippocampal gyrus, possibly related to a disinhibition of dopamine neurons. This study suggests that patients with opiate dependency on MMT exhibit abnormal brain activations to non-drug related rewarding and loss events. Our findings add support to proposals that treatments for opiate addiction should aim to increase the reward value of non-drug related rewarding events, and highlights the importance of potential abnormalities in aversive information processing.


Original languageEnglish
Pages (from-to)885-894
Number of pages10
Issue number4
StatePublished - 2014

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Chronic tobacco smoking and neuropsychological impairments: a systematic review and meta-analysis

    Conti, A. A., McLean, L., Tolomeo, S., Steele, D. & Baldacchino, A. M. Jan 2019 In : Neuroscience and Biobehavioral Reviews. 96, p. 143-154 12 p.

    Research output: Contribution to journalReview article

  2. Profiles of visuospatial memory dysfunction in opioid exposed and dependent populations

    Baldacchino, A. M., Tolomeo, S., Balfour, D. & Matthews, K. 20 Nov 2018 In : Psychological Medicine. First View, 27 p.

    Research output: Contribution to journalArticle

  3. Alcohol policies in Malawi: inclusion of WHO “best buy” interventions and use of multi-sectoral action

    Mwagomba, B. L. M., Nkhata, M., Baldacchino, A., Wisdom, J. & Ngwira, B. 15 Aug 2018 In : BMC Public Health. 18, Suppl 1, 11 p., 957

    Research output: Contribution to journalArticle

Related by journal

  1. Acute SSRI administration affects the processing of social cues in healthy volunteers

    Harmer, C. J., Bhagwagar, Z., Perrett, D. I., Völlm, B. A., Cowen, P. J. & Goodwin, G. M. Jan 2003 In : Neuropsychopharmacology. 28, 1, p. 148-152 5 p.

    Research output: Contribution to journalArticle

  2. Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers

    Ornstein, T. J., Iddon, J. L., Baldacchino, A. M., Sahakian, B. J., London, M., Everitt, B. J. & Robbins, T. W. 2000 In : Neuropsychopharmacology. 23, 2, p. 113-126 14 p.

    Research output: Contribution to journalArticle

  3. Dissociable deficits in the decision-making cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophan-depleted normal volunteers

    Rogers, R. D., Everitt, B. J., Baldacchino, A., Blackshaw, A. J., Swainson, R., Wynne, K., Baker, N. B., Hunter, J., Carthy, T., Booker, E., London, M., Deakin, J. F. W., Sahakian, B. J. & Robbins, T. W. Apr 1999 In : Neuropsychopharmacology. 20, 4, p. 322-339 18 p.

    Research output: Contribution to journalArticle

ID: 241559801