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Brain scans offer clue to drug relapse risk, study finds

Small trial conducted by Stanford researchers links activity in the brain's reward processing system with drug relapse in patient cohort.

Until now, it’s been difficult for clinicians to determine which patients are most likely to relapse after treatment for drug addiction.

But that could change, if preliminary results from new Stanford research hold up. In a study of 36 people receiving treatment for stimulant use disorders (like cocaine and amphetamines), psychologists were able to correctly predict more than three-quarters of the time whether patients would relapse — a significant improvement over past efforts.

Brain scans held the key, according to the research recently published in JAMA Network Open. Postdoctoral fellow Kelly MacNiven, PhD, is the lead author, and Brian Knutson, PhD, a professor of psychology, is the senior author.

As a Stanford News Service article explains:

Compared to healthy people, drug rehabilitation patients’ brains responded more to the drug images, particularly in a set of brain regions known as the mesolimbic system, known colloquially as the brain’s reward processing system.

What’s more, activity in one part of the reward system — a region called the nucleus accumbens — was strongly associated with relapse three months later… The researchers also found that the more the nucleus accumbens responded to drug images, the sooner patients relapsed.

The study was limited, focusing only on veterans, most of whom were men; but MacNiven and her colleagues plan to expand their research to include more women and to investigate how their findings may be able to guide treatment strategies.

With this information, doctors may be able to identify which patients need extra help combatting an addiction, the researchers said. As MacNiven told Stanford News Service:

There’s really no way of knowing whether someone is going to benefit from treatment or whether they’ll relapse… If we have a signal that is predictive of relapse, that is in and of itself important.

Photo by L.A. Cicero

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