Resting State Functional Connectivity of the Default Mode Network During Opioid Use and Cessation in Treatment-Seeking Persons

Resting-state functional connectivity analyses have been used to examine synchrony in neural networks in substance use disorders (SUDs), with the default mode network (DMN) one of the most studied. Prior research has generally found less DMN synchrony during use and greater synchrony during cessation, although little research has utilized this method with opioid use. This study examined resting brain activity in treatment-seeking persons who use opioids at two points—when using opioids and when opioid-free—to determine whether the DMN exhibits different levels of connectivity during opioid use and cessation and whether differences in connectivity predict subsequent relapse. The sample included 11 participants who met DSM-5 criteria for opioid use disorder and initiated buprenorphine treatment following fMRI scans that were approximately 3 days apart. Results showed greater functional connectivity in the DMN and the rIFG of the salience network (SN) when participants were abstaining than when actively using opioids. These changes in connectivity predicted 76.2% of the variance in withdrawal symptom severity, with the DMN nodes accounting for an additional 30.9%. Findings warrant further longitudinal exploration of the role of DMN connectivity and its interactions with other networks in relation to abstinence and withdrawal status and examination of its utility as a prognostic marker of cessation or relapse.