{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:50:33Z","timestamp":1781189433048,"version":"3.54.1"},"reference-count":56,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,11,24]],"date-time":"2014-11-24T00:00:00Z","timestamp":1416787200000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"German Federal Ministry of Education and Research (BMBF)","award":["#01 EB 0410"],"award-info":[{"award-number":["#01 EB 0410"]}]},{"name":"Federal Government of Germany"},{"name":"Alkermes, Lundbeck and Merck Sharp & Dohme"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Alcoholism Clin &amp;amp; Exp Res"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Effect sizes of pharmacotherapy in alcoholism are modest. They might improve if subjects could be divided into more homogeneous subgroups and would then be treated targeted to their neurobiological profile. In such an effort, we tested neural cue reactivity as a potential predictor of treatment response to naltrexone. Alcohol\u2010associated cues cause brain activations in mesocorticolimbic networks due to the positive reinforcing properties of alcohol. These activations were reported to be associated with relapse behavior. Naltrexone, an antagonist at the mu\u2010opioid receptor, improves drinking behavior in some but not all patients probably by blocking the positive reinforcement of alcohol. Conversely, acamprosate is proposed to modulate negative reinforcement (withdrawal and cue\u2010induced withdrawal). Identifying subjects with elevated cue reactivity and testing their response to medical treatment could thus improve our understanding of some of the mechanisms underlying pharmacotherapy response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A picture\u2010perception task featuring alcohol\u2010related and neutral stimuli was presented to 64 recently detoxified alcohol\u2010dependent patients. Patients came from 1 center of a larger double\u2010blind randomized multicenter clinical trial (the \u201cPREDICT Study\u201d). They were scanned prior to being randomized to either naltrexone or acamprosate. We examined the interaction between medication and functional magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">fMRI<\/jats:styled-content>) cue reactivity, as measured by the percentage of voxels activated, using the time to the first severe relapse as the outcome criterion. Our a priori formulated hypothesis was that naltrexone but not acamprosate should be efficacious in subjects with high cue reactivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed an interaction effect between pretreatment brain activation induced by alcohol images and medication (acamprosate\/naltrexone) on relapse behavior. In line with our hypothesis, this interaction was driven by treatment response to naltrexone in patients with elevated pretreatment cue reactivity in the ventral striatum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>fMRI has the potential for predicting treatment response to naltrexone in a subgroup of alcohol\u2010dependent patients. However, this approach will be limited to researching the mechanisms and principles of treatment response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.12546","type":"journal-article","created":{"date-parts":[[2014,11,24]],"date-time":"2014-11-24T15:41:43Z","timestamp":1416843703000},"page":"2754-2762","source":"Crossref","is-referenced-by-count":91,"title":["Predicting Naltrexone Response in Alcohol\u2010Dependent Patients: The Contribution of Functional Magnetic Resonance Imaging"],"prefix":"10.1111","volume":"38","author":[{"given":"Karl","family":"Mann","sequence":"first","affiliation":[{"name":"Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health Mannheim Medical Faculty Mannheim Heidelberg University Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Vollst\u00e4dt\u2010Klein","sequence":"additional","affiliation":[{"name":"Department of Addictive Behavior and Addiction Medicine Central Institute of 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