Postpartum Intervention for Mothers with Opioid Use Disorders - Brain-Behavior Mechanisms

对患有阿片类药物使用障碍的母亲进行产后干预 - 大脑行为机制

• 批准号: 10377709
• 负责人: Maria Muzik
• 金额: $ 40.92万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10377709
• 关键词: Address; Affect; Aggressive behavior; Amygdaloid structure; Base of the Brain; Behavior; Behavioral Mechanisms; Biological Markers; Brain; Brain region; Caring; Child; Child Abuse and Neglect; Child Rearing; Chronic; Clinical; Crying; Data; Data Reporting; Drug usage; Emotional; Epidemic; Equilibrium; Event-Related Potentials; Evoked Potentials; Face; Family; Foundations; Functional Magnetic Resonance Imaging; Functional disorder; Fusiform gyrus; Goals; Gold; Grant; Hospitals; Human; Hyperactivity; Hypothalamic structure; Impairment; Incidence; Infant; Interpersonal Relations; Intervention; Investigation; Knowledge; Lead; Magnetic Resonance Imaging; Maternal Behavior; Measures; Mediating; Mental Depression; Mood Disorders; Moods; Mothers; Neurosciences Research; Opioid; Outcome; Outcome Measure; Outcome Study; Overdose; Parents; Patient Self-Report; Perinatal; Persons; Phase; Physiology; Population; Postpartum Period; Postpartum Women; Pregnant Women; Public Health; Publishing; Randomized; Relapse; Research; Rest; Sampling; Scientist; Site; Societies; Specific qualifier value; Stimulus; Stress; Substance Use Disorder; Testing; Ursidae Family; Withdrawal; Woman; Work; biomarker development; brain behavior; brain magnetic resonance imaging; buprenorphine treatment; caregiving; child bearing; clinical decision-making; comorbidity; cost; craving; drug craving; evidence base; flexibility; foster care; high risk; high risk behavior; improved; innovation; intervention effect; maternal outcome; midbrain central gray substance; mood symptom; multimodality; neurobiological mechanism; neuroimaging; non-opioid analgesic; opioid epidemic; opioid use; opioid use disorder; polysubstance use; psychosocial; response; stress symptom; therapy development; translational potential; treatment as usual; usual care arm; virtual; virtual delivery

Project Summary Postpartum Intervention for Mothers with Opioid Use Disorders - Brain-Behavior Mechanisms Opioid use disorder (OUD) is a fast-growing and devastating epidemic in the US with many suffering comorbid mood disorders. Despite receiving “gold standard” buprenorphine treatment to reduce withdrawal, OUD mothers still suffer have cravings, depression, impaired interpersonal interactions and maladaptive parenting behaviors that may lead to child maltreatment and costly utilization of foster care. We know that parenting interventions improve parent mood and sensitive caregiving behaviors for high-risk non-OUD populations. We developed “Mom Power” (MP), an evidence-based 13-session psychosocial mother-child intervention. We have established that MP enhances emotionally sensitive caregiving, while concurrently reducing parental stress and depression for non-OUD mothers. We also have preliminary feasibility data for MP with substance use disorders. However, we do not know about parenting interventions for mothers with OUD – specifically how virtual MP (vMP) will work to reduce drug use or improve mood. We also know about how the brain regulates parenting. Recent work from our team has established that a parenting intervention for non-OUD mothers was associated with a larger enhancement of evoke potential responses (ERPs) for emotional faces relative to neutral faces and that the magnitude of ERP responses to emotional faces was associated with observed maternal sensitivity. Using magnetic resonance imaging (MRI) of the brain, we have also established a Maternal Behavior Neurocircuit (MBN) that regulates flexible responses to the demands of their own infant – such as to the unique, ethologically salient own-baby cry and face stimuli during the early postpartum period. We have established MRI maternal brain changes associated with MP in non-OUD mothers, and brain effects of OUD on mothers. However, we do not know about parental brain mechanisms through which parenting interventions may work for mothers with OUD – whether they will affect ERP responses to baby stimuli or affect the MBN. Central hypotheses: Mothers with OUD who receive virtual MP (vMP), compared to matched controls, will show improved drug craving, mood, and stress symptoms, via changes in pre-specified MBN brain regions. In the high-risk R61 phase, we will establish if vMP (n=25) for OUD can be implemented and improve mood, reduce drug use and affect ERP brain responses to baby pictures compared with control (n=25). If hypotheses in the R61 are confirmed, we will confirm and expand this breakthrough with the R33 Phase (n=160, 80/group), adding richer maternal outcome measures and MBN MRI. This research will elucidate the effects of parenting intervention MP on drug use and brain function for OUD mothers - with translational potential for biomarker and treatment development.

项目摘要 阿片类药物使用障碍母亲的产后干预 - 脑行为机制 在美国，阿片类药物使用障碍（OUD）是一种快速增长且毁灭性的流行病 合并情绪障碍。尽管接受了“黄金标准”丁丙诺啡治疗以减少感恩 oud母亲仍然遭受渴望，抑郁，人际关系互动受损和适应不良 育儿行为可能导致儿童虐待和昂贵的寄养护理利用。 我们知道，育儿干预措施改善了父母的情绪和敏感的照顾行为 高风险的非狂欢人群。我们开发了“妈妈权力”（MP），这是一项基于证据的13条课程 心理母子干预。我们已经确定MP增强了情绪敏感的 照料，同时减少非饮食母亲的父母压力和沮丧。我们也有 具有药物使用障碍的MP的初步可行性数据。但是，我们不知道育儿 OUD母亲的干预措施 - 特别是虚拟MP（VMP）如何减少药物使用或 改善情绪。 我们还知道大脑如何调节育儿。我们团队的最新工作已经确定 对非母亲的育儿干预措施与更大的唤起潜力相关 相对于中性面孔的情感面孔的反应（ERP），ERP的大小对 情感面孔与观察到的母体灵敏度有关。使用磁共振成像（MRI） 在大脑中，我们还建立了一个孕产妇行为神经电路（MBN），以调节灵活性 对自己婴儿的需求的回应 - 例如独特的，伦理上显着的自己的宝贝哭泣和 在产后早期面部刺激。我们已经建立了MRI Mater的大脑变化 在不饮食的母亲中，国会议员和Oud对母亲的大脑影响。但是，我们不知道 父母的大脑机制可以通过育儿干预措施对有Oud的母亲起作用 - 它们是影响ERP对婴儿刺激的反应还是影响MBN。 中心假设：与匹配的对照相比，拥有虚拟MP（VMP）的OUD的母亲将 通过预先指定的MBN脑区域的变化，显示出改善的药物渴望，情绪和压力症状。 在高风险R61阶段，我们将确定是否可以实现VMP（n = 25）并改善情绪， 与对照组相比，减少药物使用并影响ERP脑对婴儿图片的反应（n = 25）。如果假设 在R61中，我们将使用R33阶段（n = 160，80/组）确认并扩展这一突破 添加较富裕的母校结果指标和MBN MRI。这项研究将阐明育儿的影响 干预MP关于OUD母亲的药物使用和大脑功能 - 具有生物标志物的潜力翻译 治疗开发。