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Reward-related neural activity and structure predict future substance use in dysregulated youth

Published online by Cambridge University Press:  21 December 2016

M. A. Bertocci*
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
G. Bebko
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
A. Versace
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
S. Iyengar
Affiliation:
Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
L. Bonar
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
E. E. Forbes
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
J. R. C. Almeida
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
S. B. Perlman
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
C. Schirda
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
M. J. Travis
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
M. K. Gill
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
V. A. Diwadkar
Affiliation:
Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
J. L. Sunshine
Affiliation:
Department of Radiology, University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
S. K. Holland
Affiliation:
Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
R. A. Kowatch
Affiliation:
Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
B. Birmaher
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
D. A. Axelson
Affiliation:
Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
T. W. Frazier
Affiliation:
Pediatric Institute, Cleveland Clinic, Cleveland, OH, USA
L. E. Arnold
Affiliation:
Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
M. A. Fristad
Affiliation:
Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
E. A. Youngstrom
Affiliation:
Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
S. M. Horwitz
Affiliation:
Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
R. L. Findling
Affiliation:
Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
M. L. Phillips
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
*
*Address for correspondence: M. Bertocci, Ph.D., Western Psychiatric Institute and Clinic, Loeffler Building, Room 203, 121 Meyran Avenue, Pittsburgh, PA 15213, USA. (Email: bertoccima@upmc.edu)

Abstract

Background

Identifying youth who may engage in future substance use could facilitate early identification of substance use disorder vulnerability. We aimed to identify biomarkers that predicted future substance use in psychiatrically un-well youth.

Method

LASSO regression for variable selection was used to predict substance use 24.3 months after neuroimaging assessment in 73 behaviorally and emotionally dysregulated youth aged 13.9 (s.d. = 2.0) years, 30 female, from three clinical sites in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Predictor variables included neural activity during a reward task, cortical thickness, and clinical and demographic variables.

Results

Future substance use was associated with higher left middle prefrontal cortex activity, lower left ventral anterior insula activity, thicker caudal anterior cingulate cortex, higher depression and lower mania scores, not using antipsychotic medication, more parental stress, older age. This combination of variables explained 60.4% of the variance in future substance use, and accurately classified 83.6%.

Conclusions

These variables explained a large proportion of the variance, were useful classifiers of future substance use, and showed the value of combining multiple domains to provide a comprehensive understanding of substance use development. This may be a step toward identifying neural measures that can identify future substance use disorder risk, and act as targets for therapeutic interventions.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2016 

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