Functional Brain Network Predictors of Abstinence Treatment Outcomes in Methamphetamine Use Disorder.

backgroundMethamphetamine (MA) use poses a serious threat to community safety and public health. Despite the existence of some treatment modalities, relapse rates remain high and the effectiveness of these treatments varies among individuals. Identifying behavioral, neuroimaging, and gene expression biomarkers associated with treatment efficacy can enhance our multiscale understanding of the neurobiological mechanisms underlying individualized responses to abstinence-based treatments. This approach has the potential to advance the development of personalized or innovative therapeutic strategies.

methodsOur study included 82 MA users and 68 healthy controls (HCs). Demographic information, craving scale scores, MA use assessment, and MRI scans were collected from the MA group prior to treatment. All MA users underwent abstinence-based treatment, during which they refrained from using MA and received only basic medical care and education on abstinent rehabilitation. Following long-term abstinence-based treatment, craving scale scores were reassessed. A reduction in craving scale scores greater than 30% was defined as the responders. Similarly, demographic information and MRI scans were collected from the 68 HCs. We calculated whole-brain functional connectivity based on fMRI data and applied principal component regression (PCR) with leave-one-out cross-validation to identify response network patterns predictive of abstinence response scores. Furthermore, we evaluated the stability of the predictive models from multiple perspectives. Network strength of the identified response network was then compared to that of HCs to assess its clinical relevance. We also assessed the efficacy of network strength in making binary predictions. Finally, we combined the discovered brain patterns with the Allen Human Brain Atlas data to explore the genetic basis associated with the identified response network.

resultsAmong the 82 MA users, 39 were responders and 43 were non-responders. The 68 HCs had a mean age of 40.1 years, with 46 males. PCR identified a stable MA response network pattern, characterized by network connections positively associated with attention regulation and executive control abilities (within visual, between frontoparietal and default mode, and between visual and dorsal attention), as well as negative network connections associated with emotion regulation and behavioral automatization (within somatomotor, between somatomotor and default mode, and between default mode and ventral attention). HC exhibited moderate levels of network strength between responders and non-responders. The identified network pattern demonstrated efficacy in individual-level binary predictions. This neuroimaging pattern was further associated with synaptic signaling and inhibitory neurons.

conclusionsTogether, our results not only provide new neuroimaging markers for predicting personalized treatment response, but also reveal the underlying neurobiological mechanisms associated with abstinence response, providing potential regulatory targets for addiction treatment.