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Compagne C, Mayer JT, Gabriel D, Comte A, Magnin E, Bennabi D, Tannou T. Adaptations of the balloon analog risk task for neuroimaging settings: a systematic review. Front Neurosci 2023; 17:1237734. [PMID: 37790591 PMCID: PMC10544912 DOI: 10.3389/fnins.2023.1237734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction The Balloon Analog Risk Task (BART), a computerized behavioral paradigm, is one of the most common tools used to assess the risk-taking propensity of an individual. Since its initial behavioral version, the BART has been adapted to neuroimaging technique to explore brain networks of risk-taking behavior. However, while there are a variety of paradigms adapted to neuroimaging to date, no consensus has been reached on the best paradigm with the appropriate parameters to study the brain during risk-taking assessed by the BART. In this review of the literature, we aimed to identify the most appropriate BART parameters to adapt the initial paradigm to neuroimaging and increase the reliability of this tool. Methods A systematic review focused on the BART versions adapted to neuroimaging was performed in accordance with PRISMA guidelines. Results A total of 105 articles with 6,879 subjects identified from the PubMed database met the inclusion criteria. The BART was adapted in four neuroimaging techniques, mostly in functional magnetic resonance imaging or electroencephalography settings. Discussion First, to adapt the BART to neuroimaging, a delay was included between each trial, the total number of inflations was reduced between 12 and 30 pumps, and the number of trials was increased between 80 and 100 balloons, enabling us to respect the recording constraints of neuroimaging. Second, explicit feedback about the balloon burst limited the decisions under ambiguity associated with the first trials. Third, employing an outcome index that provides more informative measures than the standard average pump score, along with a model incorporating an exponential monotonic increase in explosion probability and a maximum explosion probability between 50 and 75%, can yield a reliable estimation of risk profile. Additionally, enhancing participant motivation can be achieved by increasing the reward in line with the risk level and implementing payment based on their performance in the BART. Although there is no universal adaptation of the BART to neuroimaging, and depending on the objectives of a study, an adjustment of parameters optimizes its evaluation and clinical utility in assessing risk-taking.
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Affiliation(s)
- Charline Compagne
- UR LINC, Université de Franche-Comté, Besançon, France
- CIC-1431 INSERM, Centre Hospitalier Universitaire, Besançon, France
| | - Juliana Teti Mayer
- UR LINC, Université de Franche-Comté, Besançon, France
- Centre Département de Psychiatrie de l’Adulte, Centre Hospitalier Universitaire, Besançon, France
| | - Damien Gabriel
- UR LINC, Université de Franche-Comté, Besançon, France
- CIC-1431 INSERM, Centre Hospitalier Universitaire, Besançon, France
- Plateforme de Neuroimagerie Fonctionnelle Neuraxess, Besançon, France
| | - Alexandre Comte
- UR LINC, Université de Franche-Comté, Besançon, France
- Centre Département de Psychiatrie de l’Adulte, Centre Hospitalier Universitaire, Besançon, France
| | - Eloi Magnin
- UR LINC, Université de Franche-Comté, Besançon, France
- CHU Département de Neurologie, Centre Hospitalier Universitaire, Besançon, France
| | - Djamila Bennabi
- UR LINC, Université de Franche-Comté, Besançon, France
- Centre Département de Psychiatrie de l’Adulte, Centre Hospitalier Universitaire, Besançon, France
- Centre Expert Dépression Résistante Fondamentale, Centre Hospitalier Universitaire, Besançon, France
| | - Thomas Tannou
- UR LINC, Université de Franche-Comté, Besançon, France
- Plateforme de Neuroimagerie Fonctionnelle Neuraxess, Besançon, France
- CIUSS Centre-Sud de l’Ile de Montréal, Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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Carter T, Heaton K, Merlo LJ, Roche BT, Puga F. Relapse Prevention and Prediction Strategies in Substance Use Disorder: A Scoping Review. J Addict Nurs 2023; 34:146-157. [PMID: 37276204 DOI: 10.1097/jan.0000000000000527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Relapse prevention for those with substance use disorder (SUD) is an evolving practice. Initiatives focused on relapse prevention from other populations may provide the foundation for future considerations and recommendations for recovering anesthesia providers in the workplace. The purpose of this scoping review was to examine what is known about return-to-use prediction and prevention strategies in various populations struggling with SUDs to inform future considerations and implications for recovering anesthesia providers with a history of SUD. METHODS The Arksey and O'Malley framework was used to conduct a scoping review of the literature. A systematic search was conducted across three databases (PubMed, CINAHL, and PsycInfo) for relevant literature. Search terms used were "measures predicting relapse in substance use disorder" and "relapse prevention in substance use disorder AND anesthesia." Data from articles that met the eligibility criteria were extracted and summarized by the primary author. RESULTS The search identified 46 articles highlighting various relapse prediction and prevention strategies related to craving and stress, underlying biological factors, neuroimaging, and mindfulness. Relapse prediction and prevention strategies ranged from cell phone applications, monitoring biological markers, and functional neuroimaging of the brain. CONCLUSIONS Relapse is a concern for individuals with a history of SUD. For anesthesia providers, immediate access to powerful anesthesia medications requires return-to-use prediction and prevention strategies when anesthesia providers return to work after SUD treatment. Although some identified strategies are practical, more research is needed to predict and prevent return to use for recovering anesthesia providers.
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Gancz NN, Forster SE. Threats to external validity in the neuroprediction of substance use treatment outcomes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:5-20. [PMID: 36099534 PMCID: PMC9974755 DOI: 10.1080/00952990.2022.2116712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/09/2022] [Accepted: 08/21/2022] [Indexed: 10/14/2022]
Abstract
Background: Tools predicting individual relapse risk would invaluably inform clinical decision-making (e.g. level-of-care) in substance use treatment. Studies of neuroprediction - use of neuromarkers to predict individual outcomes - have the dual potential to create such tools and inform etiological models leading to new treatments. However, financial limitations, statistical power demands, and related factors encourage restrictive selection criteria, yielding samples that do not fully represent the target population. This problem may be further compounded by a lack of statistical optimism correction in neuroprediction research, resulting in predictive models that are overfit to already-restricted samples.Objectives: This systematic review aims to identify potential threats to external validity related to restrictive selection criteria and underutilization of optimism correction in the existing neuroprediction literature targeting substance use treatment outcomes.Methods: Sixty-seven studies of neuroprediction in substance use treatment were identified and details of sample selection criteria and statistical optimism correction were extracted.Results: Most publications were found to report restrictive selection criteria (e.g. excluding psychiatric (94% of publications) and substance use comorbidities (69% of publications)) that would rule-out a considerable portion of the treatment population. Furthermore, only 21% of publications reported optimism correction.Conclusion: Restrictive selection criteria and underutilization of optimism correction are common in the existing literature and may limit the generalizability of identified neural predictors to the target population whose treatment they would ultimately inform. Greater attention to the inclusivity and generalizability of addiction neuroprediction research, as well as new opportunities provided through open science initiatives, have the potential to address this issue.
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Affiliation(s)
- Naomi N. Gancz
- VA Pittsburgh Healthcare System, VISN 4 Mental Illness Research, Education, & Clinical Center (MIRECC)
- University of California, Los Angeles, Department of Psychology
| | - Sarah E. Forster
- VA Pittsburgh Healthcare System, VISN 4 Mental Illness Research, Education, & Clinical Center (MIRECC)
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Brown JW. Transcranial Electrical Neurostimulation as a Potential Addiction Treatment. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231221286. [PMID: 38145317 PMCID: PMC10750523 DOI: 10.1177/00469580231221286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 12/26/2023]
Abstract
Addiction remains difficult to treat, but non-invasive transcranial electrical and magnetic neurostimulation methods may provide promising and cost-effective treatment approaches. We provide a narrative review of recent developments and evidence of effectiveness and consider newer technology that may yield improved treatment approaches. In particular, we review temporal interference electrical neurostimulation, which allows non-invasive and focal stimulation of deep brain regions. This provides a promising new potential approach to treat addiction, because many of the brain regions that seem most important for addiction are deeper in the brain, out of reach of existing technologies such as transcranial direct current stimulation.
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Gibson BC, Claus ED, Sanguinetti J, Witkiewitz K, Clark VP. A review of functional brain differences predicting relapse in substance use disorder: Actionable targets for new methods of noninvasive brain stimulation. Neurosci Biobehav Rev 2022; 141:104821. [PMID: 35970417 DOI: 10.1016/j.neubiorev.2022.104821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/17/2022]
Abstract
Neuroimaging studies have identified a variety of brain regions whose activity predicts substance use (i.e., relapse) in patients with substance use disorder (SUD), suggesting that malfunctioning brain networks may exacerbate relapse. However, this knowledge has not yet led to a marked improvement in treatment outcomes. Noninvasive brain stimulation (NIBS) has shown some potential for treating SUDs, and a new generation of NIBS technologies offers the possibility of selectively altering activity in both superficial and deep brain structures implicated in SUDs. The goal of the current review was to identify deeper brain structures involved in relapse to SUD and give an account of innovative methods of NIBS that might be used to target them. Included studies measured fMRI in currently abstinent SUD patients and tracked treatment outcomes, and fMRI results were organized with the framework of the Addictions Neuroclinical Assessment (ANA). Four brain structures were consistently implicated: the anterior and posterior cingulate cortices, ventral striatum and insula. These four deeper brain structures may be appropriate future targets for the treatment of SUD using these innovative NIBS technologies.
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Affiliation(s)
- Benjamin C Gibson
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA
| | - Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jay Sanguinetti
- The Center for Consciousness Studies, University of Arizona, Tucson, AZ 85719, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA; The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA.
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Hüpen P, Habel U, Votinov M, Kable JW, Wagels L. A Systematic Review on Common and Distinct Neural Correlates of Risk-taking in Substance-related and Non-substance Related Addictions. Neuropsychol Rev 2022; 33:492-513. [PMID: 35906511 PMCID: PMC10148787 DOI: 10.1007/s11065-022-09552-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/24/2022] [Indexed: 12/01/2022]
Abstract
Both substance-related as well as non-substance-related addictions may include recurrent engagement in risky actions despite adverse outcomes. We here apply a unified approach and review task-based neuroimaging studies on substance-related (SRAs) and non-substance related addictions (NSRAs) to examine commonalities and differences in neural correlates of risk-taking in these two addiction types. To this end, we conducted a systematic review adhering to the PRISMA guidelines. Two databases were searched with predefined search terms to identify neuroimaging studies on risk-taking tasks in individuals with addiction disorders. In total, 19 studies on SRAs (comprising a total of 648 individuals with SRAs) and 10 studies on NSRAs (comprising a total of 187 individuals with NSRAs) were included. Risk-related brain activation in SRAs and NSRAs was summarized individually and subsequently compared to each other. Results suggest convergent altered risk-related neural processes, including hyperactivity in the OFC and the striatum. As characteristic for both addiction types, these brain regions may represent an underlying mechanism of suboptimal decision-making. In contrast, decreased DLPFC activity may be specific to SRAs and decreased IFG activity could only be identified for NSRAs. The precuneus and posterior cingulate show elevated activity in SRAs, while findings regarding these areas were mixed in NSRAs. Additional scarce evidence suggests decreased ventral ACC activity and increased dorsal ACC activity in both addiction types. Associations between identified activation patterns with drug use severity underpin the clinical relevance of these findings. However, this exploratory evidence should be interpreted with caution and should be regarded as preliminary. Future research is needed to evaluate the findings gathered by this review.
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Affiliation(s)
- Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany. .,JARA - Translational Brain Medicine, Aachen, Germany.
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany
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Morie KP, Wu J, Potenza MN, Krishnan-Sarin S, Mayes LC, Hammond CJ, Crowley MJ. Daily cannabis use in adolescents who smoke tobacco is associated with altered late-stage feedback processing: A high-density electrical mapping study. J Psychiatr Res 2021; 139:82-90. [PMID: 34052575 PMCID: PMC8314801 DOI: 10.1016/j.jpsychires.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/15/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
Impairments in feedback processing, often associated with risk-taking behavior, may have implications for development of substance abuse in adolescents. The most commonly used substances by adolescents include tobacco and cannabis, with some individuals using both substances, potentially heightening risk. Our objective was to examine feedback processing and impulsivity in adolescents who smoke cigarettes and use cannabis daily (N = 21), comparing them with adolescents who smoke cigarettes daily and use cannabis occasionally (N = 18) and non-smoking (N = 27) adolescents. To do this, the Balloon Analog Risk Task (BART) with concurrent EEG was used to measure risk-related feedback processing, and impulsivity was measured using the Barratt's impulsiveness scale (BIS-11). It was found that adolescent daily tobacco/cannabis smoking was associated with higher BIS-11 scores, shortened feedback-related-negativity (FRN) latencies and reduced P300 amplitudes. In addition, FRN latencies during win conditions were inversely associated with tobacco-use severity, indicated by scores on the Fagerstrom Test for Nicotine Dependence (FTND), and with BIS-11 scores. Adolescents with concurrent tobacco and cannabis use show altered feedback processing and higher impulsivity. Future work should disentangle whether the effect reflects risk, consequences of use or both.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - Jia Wu
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Connecticut Mental Health Center, New Haven, CT, 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Suchitra Krishnan-Sarin
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Connecticut Mental Health Center, New Haven, CT, 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Department of Pediatrics, Yale University School of Medicine, New Haven, CT, 06519, USA; Department of Psychology, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Christopher J Hammond
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
| | - Michael J Crowley
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
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Bland AR, Ersche KD. Deficits in recognizing female facial expressions related to social network in cocaine-addicted men. Drug Alcohol Depend 2020; 216:108247. [PMID: 32896724 DOI: 10.1016/j.drugalcdep.2020.108247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/23/2020] [Accepted: 08/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The ability to accurately recognise facial expressions of emotion is crucial for social functioning and maintaining healthy relationships. Recognising the emotional state of others allows us to respond to their needs and adjust our behaviour appropriately. Impairments in facial affect recognition have been reported in chronic cocaine users but little is known whether these contribute to their difficulties in social situations. METHODS We assessed facial emotional expression recognition in forty-five men with cocaine use disorder (CUD) and forty-four healthy control participants. Using standardised questionnaires, we also collected information on perceived social support, social provision and community integration. RESULTS Our results found that male cocaine users had greater difficulty in recognising female emotional facial expressions than male controls. This effect was not explained by demographic variables but it was associated with their social network; including social support, social provisions and community integration. CONCLUSION Our findings suggest that men with CUD have greater difficulty in identifying emotional expression in female faces, which is linked with their social support networks. This may play an important role in misunderstanding non-verbal communications that contribute to destabilising friendship and family ties typically seen in drug addiction. Addressing deficits in recognising female emotional expressions may be an important piece of information for counselling and other interventions.
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Affiliation(s)
- Amy R Bland
- Department of Psychiatry, Herchel Smith Building for Brain & Mind Sciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0SZ, UK; Department of Psychology, Brooks Building, Manchester Metropolitan University, Manchester, M15 6GX, UK
| | - Karen D Ersche
- Department of Psychiatry, Herchel Smith Building for Brain & Mind Sciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0SZ, UK.
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Forster SE, Dickey MW, Forman SD. Regional cerebral blood flow predictors of relapse and resilience in substance use recovery: A coordinate-based meta-analysis of human neuroimaging studies. Drug Alcohol Depend 2018; 185:93-105. [PMID: 29428325 DOI: 10.1016/j.drugalcdep.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Predicting relapse vulnerability can inform level-of-care and personalized substance use treatment. Few reliable predictors of relapse risk have been identified from traditional clinical, psychosocial, and demographic variables. However, recent neuroimaging findings highlight the potential prognostic import of brain-based signals, indexing the degree to which neural systems have been perturbed by addiction. These proposed "neuromarkers" forecast the likelihood, severity, and timing of relapse but the reliability and generalizability of such effects remains to be established. METHODS Activation likelihood estimation was used to conduct a preliminary quantitative, coordinate-based meta-analysis of the addiction neuroprediction literature; specifically, studies wherein baseline measures of regional cerebral blood flow were prospectively associated with substance use treatment outcomes. Consensus patterns of activation associated with relapse vulnerability (greater activation predicts poorer outcomes) versus resilience (greater activation predicts improved outcomes) were specifically investigated. RESULTS Twenty-four eligible studies yielded 134 foci, representing 923 subjects. Consensus activation was identified in right putamen and claustrum (p < .05, cluster-corrected) in relation to positive and negative treatment outcomes - likely reflecting variability in measurement context (e.g., task, sample characteristics) across datasets. A single cluster in rostral-ventral anterior cingulate cortex (rACC) was associated with relapse resilience, specifically (p < .05, cluster-corrected); no significant vulnerability-related clusters were identified. CONCLUSIONS Right putamen activation has been associated with relapse vulnerability and resilience, while increased baseline rACC activation has been consistently associated with improved treatment outcomes. Methodological heterogeneity within the existing literature, however, limits firm conclusions and future work will be necessary to confirm and clarify these results.
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Affiliation(s)
- Sarah E Forster
- VA Pittsburgh Healthcare System, United States; University of Pittsburgh, Department of Psychiatry, United States.
| | - Michael Walsh Dickey
- VA Pittsburgh Healthcare System, United States; University of Pittsburgh, Department of Psychology, United States; University of Pittsburgh, Department of Communication Science and Disorders, United States
| | - Steven D Forman
- VA Pittsburgh Healthcare System, United States; University of Pittsburgh, Department of Psychiatry, United States
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