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FMRI-based prediction of naltrexone response in alcohol use disorder: a replication study
- Source :
- European Archives of Psychiatry and Clinical Neuroscience
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Pharmacological treatment in alcohol use disorder suffers from modest effect sizes. Efforts have been undertaken to identify patient characteristics that help to select individuals that benefit from pharmacological treatment. Previous studies indicated that neural alcohol cue-reactivity (CR) might provide a marker that identifies patients, which benefit from naltrexone treatment.We investigated the reproducibility of the association between ventral striatum (VS) activation and naltrexone (NTX) treatment response by analyzing data from a recent longitudinal clinical trial in N = 44 abstinent treatment-seeking alcohol-dependent patients. A follow-up was conducted over 3 months. We computed the percentage of significant voxels in VS and tested main effects and interactions with NTX treatment on relapse risk using Cox Regression models.We found a significant interaction effect between pre-treatment cue reactivity in the VS and NTX treatment on time to first heavy relapse (Hazard Ratio = 7.406, 95% CI 1.17–46.56, p = 0.033), such that the patient group with high VS activation (defined by a mean split) showed a significant medication effect (Hazard Ratio = 0.140, 95% CI 0.02–0.75, p = 0.022) with a number needed to treat of 3.4 [95% CI 2.413.5], while there was no significant effect in the group with low VS activation (Hazard Ratio = 0.726, p = 0.454).Thus, using an independent sample we replicated the previously described positive association between VS activation and NTX efficacy. Although our results should be considered cautiously in light of the small sample size, our results support the potential of neural alcohol CR as a tool for precision medicine approaches in alcohol dependence.
- Subjects :
- Oncology
medicine.medical_specialty
Alcohol addiction
Alcohol
Alcohol use disorder
Cue-reactivity
Naltrexone
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Recurrence
Internal medicine
Humans
Medicine
Pharmacology (medical)
Relapse
Biological Psychiatry
Original Paper
business.industry
Proportional hazards model
Precision medicine
Alcohol dependence
Reproducibility of Results
General Medicine
medicine.disease
Magnetic Resonance Imaging
3. Good health
030227 psychiatry
Clinical trial
Alcoholism
Psychiatry and Mental health
Treatment Outcome
chemistry
Cue reactivity
FMRI
Number needed to treat
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 14338491 and 09401334
- Volume :
- 271
- Database :
- OpenAIRE
- Journal :
- European Archives of Psychiatry and Clinical Neuroscience
- Accession number :
- edsair.doi.dedup.....112367c1853be9b019cacb6f14ad7a84