How structural and functional neuroimaging may predict future relapse in alcohol dependent patients

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Seo S2, Beck A1, Mohr J2, Wüstenberg T1, Heinz A1, Obermayer K2

1 Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Campus Mitte, Germany
2 Neural Information Processing Group, Department of Electrical Engineering and Computer Science, Technische Universität Berlin, and Bernstein Center for Computational Neuroscience Berlin, Germany

We built a prediction model for prospective relapse of alcohol-dependent patients that combines structural and functional brain images derived from an experiment in which 46 subjects (16 abstainers, 30 relapsers) were exposed to alcohol-related cues. Naïve Bayes, support vector machines and learning vector quantization were used to infer prediction models for relapse based on the mean and maximum values of gray matter volume and brain responses on alcohol-related cues within a priori defined regions of interest. Model performance was estimated by leave-one-out cross-validation. Learning vector quantization yielded the model with the highest balanced accuracy (79.4 percent, p<0.0001; 90 percent sensitivity, 68.8 percent specificity). The most informative individual predictors were functional brain activation features in the right and left ventral tegmental areas and the right ventral striatum, as well as gray matter volume features in left orbitofrontal cortex and right medial prefrontal cortex. In contrast, the best pure clinical model reached only chance-level accuracy (61.3 percent). Our results indicate that an individual prediction of future relapse from imaging measurement outperforms prediction from clinical measurements.