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Neural Response Patterns During Pavlovian-to-Instrumental Transfer Predict Alcohol Relapse and Young Adult Drinking

  • 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 theBACKGROUND: 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 (Delta = -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.show moreshow less

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Author:Maria SekutowiczORCiDGND, Matthias GuggenmosORCiDGND, Sören Kuitunen-PaulORCiDGND, Maria GarbusowORCiDGND, Miriam SeboldORCiDGND, Patricia PelzGND, Josef PrillerORCiDGND, Hans-Ulrich WittchenORCiDGND, Michael N. SmolkaORCiDGND, Ulrich S. Zimmermann, Andreas Heinz, Philipp SterzerORCiDGND, Katharina SchmackORCiD
DOI:https://doi.org/10.1016/j.biopsych.2019.06.028
ISSN:0006-3223
ISSN:1873-2402
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=31521335
Parent Title (English):Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry
Publisher:Elsevier
Place of publication:New York
Document Type:Article
Language:English
Year of first Publication:2019
Year of Completion:2019
Release Date:2020/09/29
Tag:Alcohol dependence; Future drinking behavior; Multivoxel classification; Pavlovian-to-instrumental transfer; Relapse
Volume:86
Issue:11
Pagenumber:7
First Page:857
Last Page:863
Funder:German Research Foundation (Deutsche Forschungsgemeinschaft)German Research Foundation (DFG) [FOR 1617, STE 1430/6-1, STE 1430/6-2, SCHM 3209/1-2, ZI 1119/3-1, ZI 1119/3-2, HE 2597/14-1, HE 2597/14-2, Exc 257, SFB TRR 265, WI 709/10-1, WI 709/10-2, SM 80/7-1, SM 80/7-2, SFB 940]; Federal Ministry of Education and Research BMBFFederal Ministry of Education & Research (BMBF) [01ZX1311H, 01ZX1311E/1611E, 01ZX1611H, 01EE1406A, 01EE1406B]; Charite Clinical Scientist Program - Charite-Universitatsmedizin Berlin; Berlin Institute of Health
Organizational units:Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit
Peer Review:Referiert