Cognitive Control in Heroin Use Disorder Patients after Prolonged Methadone Maintenance Treatment

Abstract Objective Relapse after detoxification remains a major challenge for addiction treatment worldwide. Although cognitive control impairment is common in heroin use disorder (HUD) patients and is considered a major cause of relapse, it remains unclear after long-term detoxification. The aim of the present study was to assess cognitive control and its association with relapse in HUD patients after prolonged periods of drug abstinence. Methods A total of 63 HUD patients (mean abstinence: 12.24 ± 2.92 years), including 41 relapsers and 22 non-relapsers, and 31 healthy volunteers participated in this study. The eye tracking tasks, prospective memory tasks, Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and Prospective and Retrospective Memory Questionnaire (PRMQ) were used to assess cognitive control. Results HUD patients showed worse saccade error rate but no significant impairment in prospective memory. Furthermore, compared to the non-relapsers, the relapsers performed worse in BRIEF-A scores, antisaccade amplitude and velocity. Moreover, the antisaccade amplitude and velocity were negatively correlated with the BRIEF-A subtest scores. Finally, impairment of inhibition, shift and self-monitoring mediated the association between relapse and poor antisaccade performance. Conclusions Even after prolonged methadone treatment, heroin relapse is associated with worse executive function and antisaccade, and antisaccade amplitude and velocity mainly reflect impairment of inhibition, shift and self-monitoring in executive function.