Maria Sekutowicz1, Matthias Guggenmos2, Sören Kuitunen-Paul3, Maria Garbusow2, Miriam Sebold2, Patricia Pelz2, Josef Priller4, Hans-Ulrich Wittchen5, Michael N Smolka6, Ulrich S Zimmermann7, Andreas Heinz2, Philipp Sterzer2, Katharina Schmack8. 1. Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany; Sozial und Präventivmedizin, Department Sport- und Gesundheitswissenschaften, Universität Potsdam, Potsdam, Germany. Electronic address: maria.sekutowicz@charite.de. 2. Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany. 3. Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. 4. Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Neuropsychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany. 5. Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Research Group Clinical Psychology and Psychotherapy, Department of Psychiatry and Psychotherapy, Ludwig Maximilans Universität Munich, Munich, Germany. 6. Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany. 7. Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Addiction Medicine and Psychotherapy, kbo-Isar-Amper-Klinikum München, Munich, Germany. 8. Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany; Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.
Abstract
BACKGROUND: Pavlovian-to-instrumental transfer (PIT) describes the influence of conditioned stimuli on instrumental behaviors and is discussed as a key process underlying substance abuse. Here, we tested whether neural responses during alcohol-related PIT predict future relapse in alcohol-dependent patients and future drinking behavior in adolescents. METHODS: Recently detoxified alcohol-dependent patients (n = 52) and young adults without dependence (n = 136) underwent functional magnetic resonance imaging during an alcohol-related PIT paradigm, and their drinking behavior was assessed in a 12-month follow-up. To predict future drinking behavior from PIT activation patterns, we used a multivoxel classification scheme based on linear support vector machines. RESULTS: When training and testing the classification scheme in patients, PIT activation patterns predicted future relapse with 71.2% accuracy. Feature selection revealed that classification was exclusively based on activation patterns in medial prefrontal cortex. To probe the generalizability of this functional magnetic resonance imaging-based prediction of future drinking behavior, we applied the support vector machine classifier that had been trained on patients to PIT functional magnetic resonance imaging data from adolescents. An analysis of cross-classification predictions revealed that those young social drinkers who were classified as abstainers showed a greater reduction in alcohol consumption at 12-month follow-up than those classified as relapsers (Δ = -24.4 ± 6.0 g vs. -5.7 ± 3.6 g; p = .019). CONCLUSIONS: These results suggest that neural responses during PIT could constitute a generalized prognostic marker for future drinking behavior in established alcohol use disorder and in at-risk states.
BACKGROUND: Pavlovian-to-instrumental transfer (PIT) describes the influence of conditioned stimuli on instrumental behaviors and is discussed as a key process underlying substance abuse. Here, we tested whether neural responses during alcohol-related PIT predict future relapse in alcohol-dependent patients and future drinking behavior in adolescents. METHODS: Recently detoxified alcohol-dependent patients (n = 52) and young adults without dependence (n = 136) underwent functional magnetic resonance imaging during an alcohol-related PIT paradigm, and their drinking behavior was assessed in a 12-month follow-up. To predict future drinking behavior from PIT activation patterns, we used a multivoxel classification scheme based on linear support vector machines. RESULTS: When training and testing the classification scheme in patients, PIT activation patterns predicted future relapse with 71.2% accuracy. Feature selection revealed that classification was exclusively based on activation patterns in medial prefrontal cortex. To probe the generalizability of this functional magnetic resonance imaging-based prediction of future drinking behavior, we applied the support vector machine classifier that had been trained on patients to PIT functional magnetic resonance imaging data from adolescents. An analysis of cross-classification predictions revealed that those young social drinkers who were classified as abstainers showed a greater reduction in alcohol consumption at 12-month follow-up than those classified as relapsers (Δ = -24.4 ± 6.0 g vs. -5.7 ± 3.6 g; p = .019). CONCLUSIONS: These results suggest that neural responses during PIT could constitute a generalized prognostic marker for future drinking behavior in established alcohol use disorder and in at-risk states.
Authors: Miriam Sebold; Maria Garbusow; Deniz Cerci; Ke Chen; Christian Sommer; Quentin Jm Huys; Stephan Nebe; Michael Rapp; Ilya M Veer; Ulrich S Zimmermann; Michael N Smolka; Henrik Walter; Andreas Heinz; Eva Friedel Journal: J Psychopharmacol Date: 2021-03-16 Impact factor: 4.153