رضا آرزومندان

Objectives:

 Cannabis is the most commonly used illicit substance in the world.  Craving is one of the most important treatment challenges in people with cannabis use disorder. The study aims to evaluate the relationship between brain activity and craving among people with cannabis use disorder.

Methods :

This is a descriptive-analytical study. Participants were 20 patients with cannabis use disorder, who were selected by a convenience sampling method. Resting-state quantitative electroencephalography (QEEG) data were recorded in resting state with eyes closed and eyes open, and their craving was measured by the marijuana craving questionnaire-short form. The data were analyzed in MATLAB software, version 22.

Results :

In open eyes conditions, a significant negative correlation was observed between craving and relative power in the theta band, particularly in the frontal and temporal regions (P<0.05). Additionally, in both open and closed eye conditions, a significant positive correlation was identified between craving and relative power in the beta and gamma bands, specifically in the frontal, occipital, and central regions (P<0.05). 

Conclusion :

There is a significant relationship between craving and changes in the activity of different brain regions in people with cannabis use disorder. It is necessary to pay attention to the neurobiological aspects of addiction to cannabis during the treatment process.

Addiction is recognized as a serious societal problem with potentially severe and undesirable consequences, including social and health problems. Individuals addicted to drugs such as opioids experience impaired natural brain function, leading to compromised executive functions, ultimately affecting their quality of life and interpersonal and occupational capabilities. In addition, ample evidence indicates that opioid consumption induces changes in oxidative stress levels, typically resulting in negative alterations and an exacerbation of oxidative stress in the body. Methadone and buprenorphine are widely used as maintenance treatments for opioids in treatment centers. Methadone, a full μ-opioid receptor agonist, is the most widely used substitution treatment in Europe and the United States, as well as in Iran, and its effectiveness in the reduction of drug-associated harm and improvement of abstinence rate is clearly proven. Buprenorphine, a partial μ-receptor agonist and k-receptor antagonist, compared to methadone, causes less analgesia due to being a partial agonist of μ receptor.Several lines of evidence have shown the impact of methadone and buprenorphine on oxidative stress levels. In addition, long-term use of opioids can affect neuronal functions and neural connectivity and subsequently affect normal brain functioning and cognitive functions, including executive functions, learning, memory, and attention. Impairment in cognitive function can significantly affect the routine daily life of individuals. Accordingly, this study aimed to investigate executive functions and inflammatory factors, including malondialdehyde (MDA) levels, total antioxidant capacity (TAC), and ferritin patients undergoing maintenance treatment with methadone and buprenorphine, and compare them with healthy individuals.

This cross-sectional study investigated oxidative/antioxidant activity, inflammatory factors, and cognitive ‎functions in patients under maintenance treatment and healthy control participants. The participants were selected from individuals actively pursuing addiction treatment in South Khorasan, Iran. Participants were categorized into three distinct groups, each comprising 30 members. The groups included the buprenorphine treatment group, the methadone treatment group, and a control group consisting of healthy, demographically matched individuals. All groups were matched based on age, sex, and education level. The methadone and buprenorphine groups had been under treatment for at least 12 months, and healthy subjects ‎had no history of drug use.Executive function was measured using the Wisconsin Card Sorting Test (WCST). The WCST is a gold standard instrument used to assess executive functions. The test requires respondents to match a total of 128 response cards to one of four key cards representing different perceptual sorting dimensions. Once respondents find the correct sorting rule, they need to ignore other sorting dimensions and follow this rule across other changing stimuli. After correctly matching ten cards in a row, the sorting criterion shifts to a new dimension without warning, prompting participants to adapt by devising a fresh sorting strategy. Furthermore, to delve into the biochemical aspects associated with addiction treatment, blood samples were systematically collected for the comprehensive evaluation of serum levels. In brief, for each participant, a 10 ml blood sample was collected from a forearm vein. Each blood sample was drawn after neuropsychological assessments. The serum samples were immediately separated by centrifugation at 3000 g for 10 min and were stored at -80 °C for further analysis. The concentrations of MDA, an indicator of oxidative stress, and TAC were measured. Additionally, the study examined the serum levels of ferritin, a marker of inflammatory processes. The thorough analysis of these biochemical markers aimed to provide insights into the potential impact of buprenorphine and methadone treatments on oxidative stress and inflammatory pathways.

The WCST results reveal that healthy participants significantly outperformed the other groups in numerous executive function subscales. Additionally, individuals under buprenorphine treatment demonstrated better performance compared to those under methadone treatment, although these improvements were not statistically significant in some cases. The methadone treatment group exhibited the weakest performance on all subscales compared to healthy and buprenorphine groups.The analysis of inflammatory factors showed variations in serum ferritin levels among the three groups, with higher levels in the healthy and methadone groups compared to the buprenorphine treatment group. The assessment of oxidative stress factors (MDA and TAC) also revealed differences among the study groups. Serum MDA levels were significantly higher in the buprenorphine treatment group compared to both the healthy and methadone treatment groups. Furthermore, serum MDA levels in the methadone treatment group were significantly higher than in the healthy group. Serum TAC levels were significantly higher in methadone treatment groups compared to the buprenorphine treatment group. Additionally, the healthy group exhibited significantly higher serum TAC levels than the buprenorphine treatment group.

The current research suggests that although both methadone and buprenorphine are associated with heightened oxidative stress, inflammation, compromised antioxidant defenses, and cognitive impairments, these adverse effects are significantly less severe than those linked to morphine and heroin use.  Considering the obtained results and comparing them, it can be generally stated that long-term methadone use elevates inflammation in the body. Moreover, the measurement of lipid oxidation indicates that individuals receiving buprenorphine alternative treatment exhibit higher oxidation levels, and the measurement of TAC, representing antioxidant capacity, is significantly lower in the buprenorphine group compared to methadone. However, oxidative stress levels in all patients were worse than those in healthy individuals.Additionally, the WCST and executive functions results revealed that both patient groups performed poorly compared to healthy individuals. Among the methadone and buprenorphine groups, individuals under buprenorphine treatmentexhibited better performance in comparison to those under methadone treatment. However, notably, due to the higher cost of buprenorphine, individuals under buprenorphine treatment likely had a higher quality of life, which could impact their executive functions. It is suggested that oxidative stress can affect normal brain activity and, consequently, cognitive functions. However, concomitant antioxidant administration with buprenorphine or methadone can potentially enhance their beneficial action by regulating blood redox status.

Wikipedia is one of the most important online sources of information that can be edited by any one. About 80% of people in developed countries use the Internet to search for mental health information, which generally includes disease symptoms, illnesses, and treatment methods. Existing studies have reported varying degrees of quality for mental health information on the Wikipedia website. To our knowledge, there is no study on the quality of information on the Persian version of Wikipedia, especially in the field of mental health. Due to the importance of Wikipedia for Internet users, the main purpose of this letter is to present a brief report on the Iranian authors' efforts in improving the quality and quantity of mental health information on the Persian Wikipedia. This can a step to promote the general knowledge of the community about the mental health.

 This study aims to assess the implementation of drug-related harm reduction programs in Iranian prisons and suggest solutions for their improvement.

 This study was conducted in three steps. First, library method was used for collecting data from the central library of Iran’s Prisons, Security and Corrective Measures Organization. In the second step, performance indicators were extracted based on the results of first step and two researcher-made checklists were designed. Finally, a field visit and a semi-structured interview with the authorities involved in the treatment and harm reduction services were carried out.

 In most of prisons, drug-related harm reduction programs were underway. Despite a lack of human resources and budget at the beginning, the quality of measures was gradually increased and the attitude of authorities was improved. Methadone Maintenance Treatment and Triangular Clinics were the most common harm reduction programs, in addition to HIV and tuberculosis screening programs in collaboration with medical sciences universities. The program continued despite the change of officials.

 Harm reduction programs are able to reduce infection diseases, self-harm and violent behaviors in prisons of Iran. Cultural programs along with other harm reduction programs, briefings and seeking support from the authorities can greatly help with continuation of the programs in prisons. By eliminating the shortage of manpower and redefining the security areas for ordinary prisoners, it will be possible to make better use of the facilities of universities and research centers.

 Frontotemporal Dementia (FTD) is an uncommon type of dementia. The hallmark feature of FTD is the presentation with aphasia or behavioral changes which vary in different FTD subtypes. In this study, we propose a quantitative aphasia test as an additive diagnostic tool for differentiation of FTD subtypes.

 The applied study was conducted on 20 patients with FTD (13 men and 7 women) aged 58-78 years (Mean age=63±0.8 years) referred to dementia clinic of Rasul Akram Hospital in Tehran, Iran. Based on clinical diagnosis, patients were divided into three groups of behavioral variant (n=5), semantic dementia (n=4) and non-fluent aphasia (n=11). The Persian Western Aphasia Battery (P-WAB-1) test was performed on the patients to assess their aphasia severity based on its overall score (Aphasia Quotient). The score of each language section of the test was also reported for each study group, separately. After recording data, they were analyzed in SPSS v. 22 software using the whole rock analysis. Significance level of Aphasia Quotient score was measured separately for each study groups.

 Patients with non-fluent aphasia had problems only in the speech fluency domain, and their abilities in other domains remained intact.

 It seems that P-WAB-1 test is a useful tool for assessing the non-fluent aphasia in patients who suffer from progressive dementia. These patients should be referred to speech therapist for rehabilitation.