Reduced fMRI activity predicts relapse in patients recovering from stimulant dependence.
Reduced fMRI activity predicts relapse in patients recovering from stimulant dependence.
复制标题
DOI：
10.1002/hbm.22184
复制
发表时间：
2014-02
影响因子：
4.8
通讯作者：
Calhoun, Vince D.
中科院分区：
文献类型：
--
作者：
Clark, Vincent P.;Beatty, Gregory K.;Anderson, Robert E.;Kodituwakku, Piyadassa;Phillips, John P.;Lane, Terran D. R.;Kiehl, Kent A.;Calhoun, Vince D.
复发是从兴奋剂依赖中恢复的患者面临的主要问题。在这里，我们检验了一个假设，即在禁欲早期获得的大脑功能模式可以区分后来复发的患者和保持禁欲的患者。使用随机事件相关功能性MRI（ER-fMRI）设计对45例最近戒断的兴奋剂依赖患者进行了测试，该设计旨在复制先前使用选择性注意任务进行的复发ERP研究，然后进行监测，直到6个月的验证戒断或兴奋剂使用发生。SPM显示较小的绝对BOLD反应幅度在双侧腹后扣带回和右侧岛叶皮质在23例阳性复发的兴奋剂使用相比，22人保持禁欲。ER-fMRI数据与精神病学，神经心理学，人口统计学，个人和家族吸毒史进行了比较，以形成预测模型，并发现预测禁欲的准确性高于本研究中获得的任何其他单一措施。使用右侧后扣带回和岛叶皮层的fMRI振幅进行Logistic回归，预测戒断的准确性为77.8%，当包括躁狂病史时，准确性增加到89.9%。使用10倍交叉验证，贝叶斯逻辑回归和多层感知器算法提供了84.4%的最高准确度。这些结果，结合以前的研究，表明边缘脑区的功能组织，包括腹前和后扣带回和右丘脑与患者的能力，以保持禁欲。新的治疗方法，旨在针对这些边缘区确定使用ER-fMRI可能会改善治疗结果。
Relapse presents a major problem for patients recovering from stimulant dependence. Here we examined the hypothesis that patterns of brain function obtained at an early stage of abstinence differentiates patients who later relapse vs. those who remain abstinent. Forty-five recently abstinent stimulant-dependent patients were tested using a randomized event-related functional MRI (ER-fMRI) design that was developed in order to replicate a previous ERP study of relapse using a selective attention task, and were then monitored until 6 months of verified abstinence or stimulant use occurred. SPM revealed smaller absolute BOLD response amplitude in bilateral ventral posterior cingulate and right insular cortex in 23 patients positive for relapse to stimulant use compared with 22 who remained abstinent. ER-fMRI data was compared with psychiatric, neuropsychological, demographic, personal- and family- history of drug use in order to form predictive models, and was found to predict abstinence with higher accuracy than any other single measure obtained in this study. Logistic regression using fMRI amplitude in right posterior cingulate and insular cortex predicted abstinence with 77.8% accuracy, which increased to 89.9% accuracy when history of mania was included. Using 10-fold cross-validation, Bayesian logistic regression and multilayer perceptron algorithms provided the highest accuracy of 84.4%. These results, combined with previous studies, suggest that the functional organization of paralimbic brain regions including ventral anterior and posterior cingulate and right insula are related to patients’ ability to maintain abstinence. Novel therapies designed to target these paralimbic regions identified using ER-fMRI may improve treatment outcome.
登录
查看更多内容
影响因子：
5.7
作者：
Chua, P;Krams, M;Dolan, R
通讯作者：
Dolan, R
影响因子：
25
作者：
Damasio, AR;Grabowski, TJ;Hichwa, RD
通讯作者：
Hichwa, RD
影响因子：
14.8
作者：
Bowie, Christopher R.;Harvey, Philip D.
通讯作者：
Harvey, Philip D.
影响因子：
4.2
作者：
Aharonovich, E;Hasin, DS;Nunes, EV
通讯作者：
Nunes, EV
影响因子：
10.6
作者：
Freire, L;Roche, A;Mangin, JF
通讯作者：
Mangin, JF