Probabilistic Reversal Learning Deficits in Patients With Methamphetamine Use Disorder—A Longitudinal Pilot Study

Abstract

Methamphetamine use disorder (MUD) is increasing worldwide and commonly associated with learning deficits. Little is known the about underlying trajectories, i.e., how the affected higher-order cognitive functions develop over time and with respect to abstinence and relapse. A probabilistic reversal learning (PRL) paradigm was implemented to uncover the microstructure of impulsive choice and maladaptive learning strategies in 23 patients with MUD in comparison with 24 controls. Baseline data revealed fewer optimal choices and a pattern of altered learning behavior from negative and positive feedback in patients suggesting impairments in flexibly-adapting behavior to changes of reward contingencies. Integrating longitudinal data from a follow-up assessment after 3 months of specific treatment revealed a group-by-time interaction indicating a normalization of these cognitive impairments in patients with MUD. In summary, our study demonstrates behavioral correlates of maladaptive decision-making processes in patients with MUD, which may recover after 3 months of MUD-specific therapy paving the way for further learning-based interventions. Limited by a small sample size, the results of this pilot study warrant replication in larger populations.

Computational analysis of probabilistic reversal learning deficits in male subjects with alcohol use disorder

“…Probabilistic reversal learning (PRL) paradigms, in which subjects must adapt to changes in stimulus-outcome contingencies, have been applied to examine cognitive flexibility (2). Some studies using PRL tasks have reported higher perseverative responses after reversals supporting impaired cognitive flexibility in patients with SUD (3)(4)(5)(6)(7). However, available studies have not revealed robust and consistent findings as some studies have failed to evidence higher perseverative responses in patients with alcohol use disorder (AUDP) (8,9) as well as in amphetamine (3), cocaine (10), and methamphetamine (11) use disorder patients compared to controls.…”

Altered patterns of fractional amplitude of low-frequency fluctuation and regional homogeneity in abstinent methamphetamine-dependent users

“…Indeed, 34% to 77% of patients treated for MA had relapsed at different time points during their treatment programs 7 – 11 . Even though the overall relapse rate is high, there is evidence suggesting that longer abstinence/treatment period correlates with a lower relapse rate 7 , 8 , 10 , 11 . In China, rehabilitation for drug addiction can be classified as three types: voluntary detoxification, community drug treatment, and incarcerated isolated detoxification.…”

Housing Correlates in Pregnant and Parenting Women Using Methamphetamine and Accessing Psychiatric Care

“…Patients consult with a psychiatrist and/or psychotherapist from several times a week to once a month as needed. Mamadam provides women-only group psychotherapy based on a manual that combines methamphetamine-specific psychoeducation, motivational interviewing, and cognitive behavior therapy ( 20 – 23 ). Hospital social workers partner with community and government agencies to aid patients in finances, work, and housing.…”