Neural responses to negative outcomes predict success in community-based substance use treatment

Background and aims: Activation in some specific brain regions has demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but this issue has not yet been explored in SDIs attending typical of community-based treatment. We used a data-driven, exploratory approach to identify brain-based predictors of treatment outcome in a representative community sample of SDIs. The predictive utility of brain-based measures was evaluated against clinical indicators, cognitive-behavioral performance, and self-report assessments. Design: Prospective clinical outcome design, evaluating baseline functional magnetic resonance imaging data from the Balloon Analogue Risk Task (BART) as a predictor of 3-month substance use treatment outcomes. Setting: Community-based substance use programs in Bloomington, Indiana, USA. Participants: Twenty-three SDIs (17 male, ages 18–43) in an intensive outpatient or residential treatment program; abstinent 1–4 weeks at baseline. Measurements: Event-related brain response, BART performance, and self-report scores at treatment onset, substance use outcome measure (based on days of use) Findings: Using voxel-level predictive modeling and leave-one-out cross-validation, an elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) at baseline successfully predicted greater substance use over the 3-month study interval (p ≤ 0.006, cluster-corrected). This effect was robust to inclusion of significant non-brain-based covariates. A larger response to negative feedback in bilateral Amyg/aHipp was also associated with faster reward-seeking responses after negative feedback (r(23) = −0.544, p = 0.007; r(23) = −0.588, p = 0.003). A model including Amyg/aHipp activation, faster reward-seeking after negative feedback, and significant self-report scores accounted for 45% of the variance in substance use outcomes in our sample. Conclusions: An elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) appears to predict relapse to substance use in people attending community-based treatment.


Publication Date:
Feb 03 2017
Date Submitted:
Nov 21 2018
ISSN:
0965-2140
Citation:
Addiction
112
Note:
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 Record created 2018-11-21, last modified 2019-04-03


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