Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany; Sozial und Präventivmedizin, Department Sport- und Gesundheitswissenschaften, Universität Potsdam, Potsdam, Germany.
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
Biol Psychiatry. 2019 Dec 1;86(11):857-863. doi: 10.1016/j.biopsych.2019.06.028. Epub 2019 Jul 11.
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.
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.
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).
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.
条件刺激对工具性行为的影响被称为条件反射到工具性行为的转移（PIT），它被认为是物质滥用的关键过程。在这里，我们测试了酒精相关 PIT 期间的神经反应是否可以预测酒精依赖患者的未来复发和青少年的未来饮酒行为。
最近戒断酒精依赖的患者（n=52）和无依赖的年轻成年人（n=136）在进行酒精相关 PIT 范式时接受了功能磁共振成像，并且在 12 个月的随访中评估了他们的饮酒行为。为了从 PIT 激活模式预测未来的饮酒行为，我们使用了基于线性支持向量机的多体素分类方案。
当在患者中训练和测试分类方案时，PIT 激活模式以 71.2%的准确率预测了未来的复发。特征选择表明，分类完全基于内侧前额叶皮层的激活模式。为了探究这种基于功能磁共振成像的未来饮酒行为预测的泛化能力，我们将已经在患者中训练过的支持向量机分类器应用于青少年的 PIT 功能磁共振成像数据。交叉分类预测分析表明，那些被归类为戒酒者的年轻社交饮酒者在 12 个月随访时的饮酒量减少幅度大于被归类为复饮者（Δ=-24.4±6.0 g 与-5.7±3.6 g；p=0.019）。
这些结果表明，PIT 期间的神经反应可能构成已确立的酒精使用障碍和高危状态下未来饮酒行为的通用预后标志物。
