Introduction: Quantitative electroencephalograph (qEEG) and low-resolution electromagnetic brain tomography (LORETA) methods are undervalued and underused for determining the effects of medications on the brain, especially concerning substance use disorders (Cannon, Lubar & Baldwin, 2008; Sokhadze, Cannon & Trudeau, 2008) and medication assisted therapies (MAT). Debate continues about MAT with drugs such as Suboxone despite positive reports of outcomes and overdose reductions (Chang & Raynor, 2021; Demetrovics et al., 2009; Elarabi et al., 2019; Finch, Kamien, & Amass, 2007; Furst, 2013; Towns, Mee, & McBride, 2020; Velander, 2018). This study examines the electrocortical effects of suboxone during induction and seven days of monitoring daily use. Methods: The current data from a larger study consists of 3 females with SUD with mean age 32.33, SD = 13.31, (range 21 – 47). Five-minute eyes-opened baseline EEG were collected prior to induction of suboxone using sublingual administration. The EEG was collected using the Truscan Acquisition System (Deymed Diagnostics) with 19 channels and linked ear reference. EEG were sampled at 256 cps. Data were recorded for fifteen minutes during induction procedures and contrasted to the Lifespan normative database (Applied Neuroscience) and pre baseline.
Daily EEG baselines were collected for one week and monitored for change.
Results: Induction itself did not produce significant changes in the topographical EEG or LORETA current source distributions. In two of the clients, dose dependent elevations were seen in both measures. As the dose was adjusted so did the decrease in amplitude in EEG and CSD levels. Symptoms for these amplitude excesses include lethargy, somnolence, giddy and odd behaviors that resolved upon dose adjustment. The greatest increases occurred in theta and beta frequency domains with one individual showing increases in all frequency domains. Coherence and asymmetry measures were reduced in two of the three individuals. LORETA increases occurred in theta and beta involving Brodmann areas 13, 38, 42, 21 and 20.
Discussion: The methods of qEEG and LORETA electrical neuroimaging may provide an important tool to aid in monitoring MAT for individuals with SUD. The opiate crisis has increased the need for holistic approaches with measurable outcomes to aid in the recovery for SUD, as well as decrease the likelihood of death. The data suggest that changes in the EEG and cortical volume related to Suboxone use can be determined and monitored to aid in administering dose specificity. Further research and data are ongoing and with larger sample sizes generalizable EEG and LORETA CSD patterns may become more evident. EEG and LORETA have been shown as reliable across time (Cannon et al., 2012) and therefore can provide an important tool to further evaluate MAT changes and characteristic amplitude, connectivity and current source density patterns associated with substances of abuse.
Presented by: Rex Cannon, Jeffrey Leighton, Carol Mills & Bruce Baker