Effects of Mindfulness-Oriented Recovery Enhancement on reward responsiveness and opioid cue-reactivity.
Effects of Mindfulness-Oriented Recovery Enhancement on reward responsiveness and opioid cue-reactivity.
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DOI：
10.1007/s00213-014-3504-7
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发表时间：
2014-08
影响因子：
3.4
通讯作者：
Howard, Matthew O.
中科院分区：
文献类型：
--
作者：
Garland, Eric L.;Froeliger, Brett;Howard, Matthew O.
关键词：
失调的奖励处理是药物成瘾的一个显著特征；然而，很少有研究评估在成瘾治疗的背景下重组奖励处理。我们研究了正念导向恢复增强（MORE）对阿片类药物使用问题的慢性疼痛患者的奖励反应性（RR）和阿片类线索反应性的影响。我们之前报道过，与社会支持对照组（SG）相比，MORE减少了疼痛、阿片类药物滥用和渴望。在这里，我们研究了这些结果是否与一部分参与者的RR变化有关。参与者为慢性疼痛患者（71%为女性，年龄= 46.6±13.9），接受MORE （n=20）或SG （n=29）治疗。在包括阿片类药物、疼痛相关刺激和自然奖励刺激以及渴望评级的点探测任务期间，通过心率（HR）和心率变异性（HRV）反应测量治疗前后8周的RR。与SG组相比，MORE组在治疗期间报告阿片类药物滥用和阿片类药物渴望减少，表现出更少的主观阿片类药物线索反应性，更大的HR减速，以及治疗后所有线索的HRV更大的增加；HR和HRV效应在自然奖励线索中最为明显。在更多组中，HR对自然奖励线索的减速与对线索的主观唤醒增加相关，而HR对阿片类线索的减速与主观唤醒降低相关。更多对渴望的影响是由增强的RR介导的。结果表明，在MORE治疗期间，心脏对非药物奖励的自主反应性增加，而对阿片类奖励的反应性降低。需要研究来确定RR的变化是阿片类药物滥用和渴望减少的结果还是决定因素。RR可能在成瘾治疗中发挥作用。
Dysregulated reward processing is a hallmark feature of drug addiction; however scant research has evaluated restructuring reward processing in the context of addiction treatment. We examined effects of Mindfulness-Oriented Recovery Enhancement (MORE) on reward responsiveness (RR) and opioid cue-reactivity in a sample of chronic pain patients with opioid use problems. We previously reported that MORE decreased pain, opioid misuse and craving relative to a social support control group (SG). Here we examined whether these outcomes were linked to changes in RR in a subset of participants. Participants were chronic pain patients (71% women, age = 46.6±13.9) who received MORE (n=20) or SG (n=29). RR was measured before and after 8 weeks of treatment via heart rate (HR) and heart rate variability (HRV) responses during a dot-probe task that included opioid-, pain-related and natural reward stimuli, as well as craving ratings. The MORE group, who reported decreased opioid misuse and opioid craving during treatment, evidenced less subjective opioid cue-reactivity, greater HR decelerations, and greater increases in HRV to all cues after treatment compared to the SG; HR and HRV effects were most pronounced for natural reward cues. Within the MORE group, HR deceleration to natural reward cues was correlated with increased subjective arousal to the cues, whereas HR deceleration to opioid cues was correlated with decreased subjective arousal. Effects of MORE on craving were mediated by enhanced RR. Results suggest that during treatment with MORE, cardiac-autonomic responsiveness to non-drug reward increases, while reactivity to opioid reward decreases. Studies are needed to discern whether changes in RR were a result or a determinant of reductions in opioid misuse and craving. RR may play a role in addiction treatment.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
影响因子：
7.4
作者：
Butler, Stephen F.;Budman, Simon H.;Jamison, Robert N.
通讯作者：
Jamison, Robert N.
影响因子：
17.7
作者：
Kalivas, PW;Volkow, ND
通讯作者：
Volkow, ND
影响因子：
6
作者：
Carter, BL;Tiffany, ST
通讯作者：
Tiffany, ST