The interpretation that elevated visual cortex activity to drug cues versus neutral cues indicates an attentional bias to these stimuli has implications for predicting relapse following substance-use treatment. Many studies have investigated attentional bias as a bell-weather for treatment success across multiple drug-classes including in cocaine (Kennedy et al., 2014; Kilts et al., 2014), heroin (Marrisen et al., 2006), smoking (Waters et al., 2003, Janes et al., 2010), and alcohol (Cox et al., 2002). Other studies have even used attentional bias as a target of treatment itself including Attentional Retraining (Atwood et al., 2008). While many of these studies have mixed results, they typically utilized interference tasks such as the Stroop, rather than direct visual fixation metrics (or visual cortex activity metrics), as their indicators for success. Given the consistency with which the functional neuroimaging studies in this meta-analysis observed visual cortex activity to drug-related cues, it is possible that drug cue-elicited visual cortex activation might be a more sensitive metric to predict treatment outcome.
