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  • Gowin, J. L., Ball, T. M., Wittmann, M., Tapert, S. F., & Paulus, M. P. (2015). Individualized relapse prediction: Personality measures and striatal and insular activity during reward-processing robustly predict relapse. Drug and Alcohol Dependence, 152, 93–101. https://doi.org/10.1016/j.drugalcdep.2015.04.018

    BACKGROUND: Nearly half of individuals with substance use disorders relapse in the year after treatment. A diagnostic tool to help clinicians make decisions regarding treatment does not exist for psychiatric conditions. Identifying individuals with high risk for relapse to substance use following abstinence has profound clinical consequences. This study aimed to develop neuroimaging as a robust tool to predict relapse. METHODS: 68 methamphetamine-dependent adults (15 female) were recruited from 28-day inpatient treatment. During treatment, participants completed a functional MRI scan that examined brain activation during reward processing. Patients were followed 1 year later to assess abstinence. We examined brain activation during reward processing between relapsing and abstaining individuals and employed three random forest prediction models (clinical and personality measures, neuroimaging measures, a combined model) to generate predictions for each participant regarding their relapse likelihood. RESULTS: 18 individuals relapsed. There were significant group by reward-size interactions for neural activation in the left insula and right striatum for rewards. Abstaining individuals showed increased activation for large, risky relative to small, safe rewards, whereas relapsing individuals failed to show differential activation between reward types. All three random forest models yielded good test characteristics such that a positive test for relapse yielded a likelihood ratio 2.63, whereas a negative test had a likelihood ratio of 0.48. CONCLUSIONS: These findings suggest that neuroimaging can be developed in combination with other measures as an instrument to predict relapse, advancing tools providers can use to make decisions about individualized treatment of substance use disorders.

  • Fink, M., Churan, J., & Wittmann, M. (2005). Assessment of auditory temporal-order thresholds - a comparison of different measurement procedures and the influences of age and gender. Restorative Neurology and Neuroscience, 23(5–6), 281–296.

    PURPOSE: The relationship between auditory temporal-order perception and phoneme discrimination has been discussed for several years, based on findings, showing that patients with cerebral damage in the left hemisphere and aphasia, as well as children with specific language impairments, show deficits in temporal-processing and phoneme discrimination. Over the last years several temporal-order measurement procedures and training batteries have been developed. However, there exists no standard diagnostic tool for adults that could be applied to patients with aphasia. Therefore, our study aimed at identifying a feasible, reliable and efficient measurement procedure to test for auditory-temporal processing in healthy young and elderly adults, which in a further step can be applied to patients with aphasia. METHODS: The tasks varied according to adaptive procedures (staircase vs. maximum-likelihood), stimuli (tones vs. clicks) and stimulation modes (binaural- vs. alternating monaural) respectively. A phoneme-discrimination task was also employed to assess the relationship between temporal and language processing. RESULTS: The results show that auditory temporal-order thresholds are stimulus dependent, age related, and influenced by gender. Furthermore, the cited relationship between temporal-order threshold and phoneme discrimination can only be confirmed for measurements with pairs of tones. CONCLUSION: Our results indicate, that different norms have to be established for different gender and age groups. Furthermore, temporal-order measurements with tones seem to be more suitable for clinical intervention studies than measurements with clicks, as they show higher re-test reliabilities, and only for measurements with tones an association with phoneme-discrimination abilities was found.

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