The effect of N-acetylcysteine and working memory training on cocaine use, craving and inhibition in regular cocaine users: correspondence of lab assessments and Ecological Momentary Assessment
The effect of N-acetylcysteine and working memory training on cocaine use, craving and inhibition in regular cocaine users: correspondence of lab assessments and Ecological Momentary Assessment
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DOI：
10.1016/j.addbeh.2017.11.044
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发表时间：
2018-04-01
影响因子：
4.4
通讯作者：
Waters, Andrew J.
中科院分区：
文献类型：
--
作者：
Schulte, Mieke H. J.;Wiers, Reinout W.;Waters, Andrew J.
简介：可卡因使用障碍的有效治疗应该抑制过敏性线索诱导的动机过程和/或加强执行控制。采用随机、双盲、安慰剂对照干预，本研究的主要目的是研究N-乙酰半胱氨酸（NAC）和工作记忆（WM）训练对减少可卡因使用和渴求以及改善实验室和生态瞬时评估（EMA）期间评估的抑制的影响。第二个目的是检查实验室和EMA data.Methods之间的对应关系：二十四个38可卡因使用男性完成了25天的干预与2400毫克/天NAC或安慰剂和VVM培训，以及两个实验室访问评估可卡因的使用，渴望和抑制（停止信号任务）。此外，可卡因的使用，渴望和认知（Stroop任务）进行了评估，使用EMA在治疗过程中，26名参与者完成819 assessment.Results：可卡因的问题，根据药物使用障碍识别测试（DUDIT）下降后NAC比安慰剂后，可卡因阳性尿液的比例在实验室访问2是较低的NAC组。没有发现NAC对渴望的影响。对于可卡因的使用和渴望，实验室数据的结果通常与EMA结果相似。NAC还显示出对认知控制的一些影响：在实验室中使用停止信号任务评估的抑制改善，并在EMA期间降低经典Stroop性能。有没有显着的影响，完成WM-培训sessions.Conclusions：总体而言，这项研究揭示了混合的结果，可卡因使用障碍的治疗与NAC和WM-培训。NAC对抑制作用的影响有待进一步研究。
Introduction: Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.Methods: Twenty-four of 38 cocaine-using men completed a 25-day intervention with 2400 mg/day NAC or placebo and VVM-training as well as two lab-visits assessing cocaine use, craving and inhibition (Stop Signal task). Additionally, cocaine use, craving and cognition (Stroop task) were assessed using EMA during treatment, with 26 participants completing 819 assessments.Results: Cocaine problems according to the Drug Use Disorder Identification Test (DUDIT) decreased more after NAC than after placebo, and the proportion of cocaine-positive urines at lab-visit 2 was lower in the NAC group. No NAC effects were found on craving. For cocaine use and craving, results from the lab data were generally similar to EMA results. NAC also showed some effects on cognitive control: improved inhibition assessed with the Stop Signal task in the lab, and decreased classic Stroop performance during EMA. There were no significant effects of number of completed WM-training sessions.Conclusions: Overall this study revealed mixed findings regarding the treatment of cocaine use disorders with NAC and WM-training. The effect of NAC on inhibition should be further investigated.