Neural activation patterns of methamphetamine-dependent subjects during decision making predict relapse.
BACKGROUND
Relapse is a common clinical problem in individuals with substance dependence. Previous studies have implicated a multifactorial process underlying relapse; however, the contribution of specific neural substrates has not yet been examined.


OBJECTIVE
To determine whether results from functional magnetic resonance imaging (fMRI) shortly after drug cessation could predict relapse in stimulant-dependent individuals.


METHODS
Treatment-seeking methamphetamine-dependent males (N = 46) underwent fMRI 3 to 4 weeks after cessation of drug use. Of the 40 subjects who were followed up a median of 370 days, 18 relapsed and 22 did not.


METHODS
Blood oxygen level-dependent fMRI activation during a simple 2-choice prediction task.


RESULTS
The fMRI activation patterns in right insular, posterior cingulate, and temporal cortex obtained early in recovery correctly predicted 20 of 22 subjects who did not relapse and 17 of 18 subjects who did. A Cox regression analysis revealed that the combination of right middle frontal gyrus, middle temporal gyrus, and posterior cingulate activation best predicted the time to relapse.


CONCLUSIONS
To our knowledge, this is the first investigation to show that fMRI can be used to predict relapse in substance-dependent individuals.
Paulus
Martin P
MP
Laboratory of Biological Dynamics and Theoretical Medicine, Department of Psychiatry, University of California San Diego, La Jolla 92093-0603, USA. mpaulus@ucsd.edu
Tapert
Susan F
SF
Schuckit
Marc A
MA
D000328:Adult; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D002540:Cerebral Cortex / Q000503:physiopathology*; D003657:Decision Making / Q000502:physiology*; D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D011237:Predictive Value of Tests; D017397:Prefrontal Cortex / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012008:Recurrence; D012680:Sensitivity and Specificity; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology
D000697:Central Nervous System Stimulants; D008694:Methamphetamine