Drug addictions in Malaysia: a mini-review on drug types, rehabilitation centers and therapeutic programs.

Drug addiction remains one of the most complex social problems worldwide that has yet to be resolved. In Malaysia, abuse of various types of drugs has been reported which warrants the government to take immediate strategies in managing drug addicts. Despite implementing various strategies to treat drug addiction, statistics show the number of relapses continues to skyrocket over the years. This calls for urgent attention to improve the effectiveness of substance abuse treatment services in Malaysia. Moreover, emerging evidence shows a change in trend in the type of drug being abused. This factor could potentially contribute to the ineffectiveness of the strategies employed in the treatment of substance abuse. Therefore, this review provides an overview of the major types of drugs commonly abused in Malaysia. Additionally, in an effort to search for ways to improve the effectiveness of substance abuse treatment services, we identified the public institutions responsible for managing drug addicts in Malaysia and discussed the therapeutic programs offered at the institutions. Review findings support the need for future research on the effectiveness of these therapeutic programs and recommend the implementation of evidence-based programs to improve the effectiveness of substance abuse treatments in Malaysia.

Effects of Different Scan Duration on Brain Effective Connectivity among Default Mode Network Nodes.

BACKGROUND: Resting-state functional magnetic resonance imaging (rs-fMRI) can evaluate brain functional connectivity without requiring subjects to perform a specific task. This rs-fMRI is very useful in patients with cognitive decline or unable to respond to tasks. However, long scan durations have been suggested to measure connectivity between brain areas to produce more reliable results, which are not clinically optimal. Therefore, this study aims to evaluate a shorter scan duration and compare the scan duration of 10 and 15 min using the rs-fMRI approach. METHODS: Twenty-one healthy male and female participants (seventeen right-handed and four left-handed), with ages ranging between 21 and 60 years, were recruited. All participants underwent both 10 and 15 min of rs-fMRI scans. The present study evaluated the default mode network (DMN) areas for both scan durations. The areas involved were the posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC), left inferior parietal cortex (LIPC), and right inferior parietal cortex (RIPC). Fifteen causal models were constructed and inverted using spectral dynamic causal modelling (spDCM). The models were compared using Bayesian Model Selection (BMS) for group studies. RESULT: The BMS results indicated that the fully connected model was the winning model among 15 competing models for both 10 and 15 min scan durations. However, there was no significant difference in effective connectivity among the regions of interest between the 10 and 15 min scans. CONCLUSION: Scan duration in the range of 10 to 15 min is sufficient to evaluate the effective connectivity within the DMN region. In frail subjects, a shorter scan duration is more favourable.

Effects of white noise on word recall performance and brain activity in healthy adolescents with normal and low auditory working memory.

The present study examined the impact of white noise on word recall performance and brain activity in 40 healthy adolescents, split in two groups (normal and low) depending on their auditory working memory capacity (AWMC). Using functional magnetic resonance imaging, participants performed a backward recall task under four different signal-to-noise ratio (SNR) conditions: 15, 10, 5, and 0-dB SNR. Behaviorally, normal AWMC individuals scored significantly higher than low AWMC individuals across noise levels. Whole-brain analyses showed brain activation not to be statistically different between groups across noise levels. In the normal group, a significant positive relationship was found between performance and number of activated voxels in the right superior frontal gyrus. In the low group, significant positive correlations were found between performance and number of activated voxels in left superior frontal gyrus, left inferior frontal gyrus, and left anterior cingulate cortex. These findings suggest that the strategic structure involved in the enhancement of AWM performance may differ in normal and low AWMC individuals.

Hemispheric Lateralization of Auditory Working Memory Regions During Stochastic Resonance: An fMRI Study.

BACKGROUND: The auditory and prefrontal cortex supports auditory working memory processing. Many neuroimaging studies have shown hemispheric lateralization of auditory working memory brain regions in the presence of background noise, but few studies have focused on the lateralization of these regions during stochastic resonance. PURPOSE: To investigate the effects of stochastic resonance on lateralization of auditory working memory regions, and also to examine the brain-behavior relationship during stochastic resonance. STUDY TYPE: Cross-sectional. POPULATION/SUBJECTS: Forty healthy young adults (18-24 years old). FIELD STRENGTH/SEQUENCE: 3.0T, T1 , and T2 *-weighted imaging. ASSESSMENT: The auditory working memory performance was assessed using a backward recall task. Functional magnetic resonance imaging (fMRI) was used to measure brain activity during task performance. Functional MRI data were analyzed using SPM12 and WFU PickAtlas. STATISTICAL TESTS: One-way independent analyses of variance (ANOVA) were conducted on the behavioral and functional data to examine the main effect of noise level on performance (P < 0.01) and brain activity (P < 0.0042). Hemispheric lateralization was determined by calculating the laterality index. A paired samples t-test was performed to compare brain activity between hemispheres (P < 0.05). Pearson's correlation analysis and simple linear regression (P < 0.0042) were used to examine the relationship between brain activity and behavioral performance. RESULTS: Performance was significantly enhanced during the 50 and 55 dB sound pressure level (SPL) conditions via the stochastic resonance mechanism [F(1,195) = 49.17, P < 0.001]. Activity of the right superior frontal gyrus in the 55 dB SPL condition was significantly positively correlated with performance (R2 = 0.681, P < 0.001). DATA CONCLUSION: Our findings demonstrate changes in the lateralization of auditory working memory regions during stochastic resonance and suggest that the right superior frontal gyrus may be a strategic structure involved in the enhancement of auditory working memory performance. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2020;51:1821-1828.

Low intensity white noise improves performance in auditory working memory task: An fMRI study.

Research suggests that white noise may facilitate auditory working memory performance via stochastic resonance. Stochastic resonance is quantified by plotting cognitive performance as a function of noise intensity. The plot would appear as an inverted U-curve, that is, a moderate noise is beneficial for performance whereas too low and too much noise attenuates performance. However, knowledge about the optimal signal-to-noise ratio (SNR) needed for stochastic resonance to occur in the brain, particularly in the neural network of auditory working memory, is limited and demand further investigation. In the present study, we extended previous works on the impact of white noise on auditory working memory performance by including multiple background noise levels to map out the inverted U-curve for the stochastic resonance. Using functional magnetic resonance imaging (fMRI), twenty healthy young adults performed a word-based backward recall span task under four signal-to-noise ratio conditions: 15, 10, 5, and 0-dB SNR. Group results show significant behavioral improvement and increased activation in frontal cortices, primary auditory cortices, and anterior cingulate cortex in all noise conditions, except at 0-dB SNR, which decreases activation and performance. When plotted as a function of signal-to-noise ratio, behavioral and fMRI data exhibited a noise-benefit inverted U-shaped curve. Additionally, a significant positive correlation was found between the activity of the right superior frontal gyrus (SFG) and performance in 5-dB SNR. The predicted phenomenon of SR on auditory working memory performance is confirmed. Findings from this study suggest that the optimal signal-to-noise ratio to enhance auditory working memory performance is within 10 to 5-dB SNR and that the right SFG may be a strategic structure involved in enhancement of auditory working memory performance.