ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Addictive Disorders
The effects of sleep disturbances on patients receiving methadone treatment for Opioid Use Disorder(OUD) :Cortical thickness evidence
Feng Cui 1,2
Yan Chang 2,3
Xin-Wei Ma 4
Tang-Fen Wang 4
Xin Zhang 2
Tao Hu 2
Qing-Qian Guo 2
Xiao-Yu Feng 3
Xu Guo 2
Tian-Xiao Shen 5,6
Xiaodong Yang 2,3
Jianbing Zhu 4
Jian Zheng 2
Ke-Jia Hu 7
1. School of Biomedical Engineering (Suzhou), Division of Life Science and Medicine, University of Science and Technology of China, 230026 Hefei, Anhui, China, Hefei, Anhui, China
2. Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, 215163 Suzhou, Jiangsu, China, Suzhou, Jiangsu, China
3. Ji Hua Laboratory, 528000 Foshan, Guangdong, China, Foshan, Guangdong, China
4. Department of Radiology, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, 215163 Suzhou, Jiangsu, China, Suzhou, Jiangsu, China
5. Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin Street, Shanghai 200025, China, Shanghai, China
6. Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), No. 2 West Zheshan Road, Wuhu, 241001, Anhui, China, Wuhu, Anhui, China
7. Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin Street, Shanghai 200025, China, Shangha, China
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Abstract
Background: Sleep disturbances are prevalent among patients with methadone maintenance treatment (MMT) for opioid use disorder (OUD), yet the neurobiological implications remain poorly understood. So we investigated cortical thickness between the MMT and the MMT with sleep disturbances (MMTS) patients to determine the interplay between MMT, sleep disturbances, and cortical remodeling. Methods: This study was approved by the ethics committee of the Affiliated Suzhou Hospital, Medical School of Nanjing University (IRB2024070). We recruited 30 MMT and 33 MMTS participants in this study. All subjects underwent a high-resolution MRI for calculating the cortical thickness by the surface-based morphometry (SBM). Meanwhile, sleep quality of all subjects were recorded using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), and evaluated the relationship between the cortical alternations and sleep disturbances. Results: There were significant increases of cortical thickness in MMTS patients within the left entorhinal cortex, right pericalcarine cortex, and left frontalpole cortex compared to the MMT patients after adjusting for covariates (all p < 0.05). The increase thickness of the left frontalpole cortex was positively correlated with the PSQI (p =0.038, r=0.27) and its sub-items (Sleep Quality, p =0.04, r=0.27; Daytime Dysfunction, p =0.037, r=0.28). While the increase thickness of the left entorhinal cortex (Sleep Quality, p =0.017, r=0.31; Sleep Duration, p =0.041, r=0.27) and right pericalcarine coetex(Sleep Latency, p =0.036, r=0.27) showed associations with specific sleep items. No correlations emerged with the ISI. Conclusions: These findings identify increased cortical thickness in the left entorhinal, right pericalcarine, and left frontalpole cortices in MMTS patients, potentially driven by the receptor effects of methadone, neuroinflammation, or synaptic plasticity linked to sleep disturbances. The study underscored sleep disturbances as a critical modifier of neuroanatomical alternations in MMT, advocating for sleep-targeted interventions to mitigate relapse risk and optimize MMT strategies. Longitudinal studies integrating objective sleep measures were warranted to validate these biomarkers for clinical prognostication.
Summary
Keywords
cortical thickness, disturbances, Maintenance, Methadone, Sleep, Surface-based morphometry, Treatment
Received
19 August 2025
Accepted
17 February 2026
Copyright
© 2026 Cui, Chang, Ma, Wang, Zhang, Hu, Guo, Feng, Guo, Shen, Yang, Zhu, Zheng and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Jianbing Zhu; Jian Zheng; Ke-Jia Hu
Disclaimer
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