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Opioid use disorder, cognition, and recovery: An investigation of neuropsychological change and associated recovery outcomes in buprenorphine and methadone treated patients [SUPPLEMENT]

阿片类药物使用障碍、认知和恢复：丁丙诺啡和美沙酮治疗患者的神经心理变化和相关恢复结果的调查[补充]

基本信息

批准号：
10405308
负责人：
Lauren A Hoffman
金额：
$ 1.56万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-01 至 2022-03-14
项目状态：
已结题

项目摘要

(F.220) 7. Project Summary/Abstract Opioid use disorder (OUD) accounts for 70% of the global disease burden attributable to drug use disorder, affects ~2 million American adults, and is the leading reason for receipt of drug treatment. Pharmacotherapies for OUD (RxOUD) are essential first-line treatment options that markedly facilitate recovery, and include the opioid agonist treatments (OAT) methadone (MET) and buprenorphine (BUP). Fortunately, government efforts have greatly expanded access to these lifesaving treatments. As OUD and OAT rates rise, characterization of the patients undergoing these treatments and the factors influencing their recovery is crucial. Neurological abnormalities are one of the most prevalent classes of secondary disease in OUD. Neurocognitive dysfunction is linked to poorer recovery outcomes and OUD-related deficits span a broad range of cognitive domains. Evidence indicates improvement with remission. Yet, the cognitive trajectories of BUP and MET treated OUD patients are largely unknown. Given the cognitive deficits accompanying OUD and OAT, and the role of cognition in addiction recovery, characterizing neurocognition during OAT and its relationship to OUD recovery has clinically relevant implications. This area of study can ultimately inform novel therapeutic approaches for enhancing OUD treatment and recovery. As a first step in this line of work, this prospective study seeks to enhance our understanding of cognitive change during OAT and its relationship to multifaceted measures of recovery (quality of life and opioid use frequency) in an ecologically valid sample of BUP and MET patients. This 3-year mentored project aims (1) to determine if cognition improves, declines, or remains static after 6 weeks of OAT, and whether these cognitive trajectories are specific to cognitive domain or OAT group, (2) to investigate whether cognitive trajectories predict 10-week recovery outcomes, and evaluate the influence of group and treatment-relevant measures on cognition-recovery relationships. The ultimate goal of this line of work is to assess RxOUD-specific and OUD-general cognitive trajectories, their neural substrates, and recovery outcomes via prospective controlled investigation. Accordingly, this study also aims (3) to demonstrate the feasibility of developing a similar but more comprehensive study. In addition to contributing to a limited literature, this project can ultimately provide an important foundation for future research and inform the development of cognitive rehabilitation treatments that complement RxOUD and enhance recovery outcomes. The scientific aims support training in 3 competency areas: (1) treatment/recovery research, (2) longitudinal design and implementation, and (3) OUD. Training will be fulfilled with the expert guidance of Drs. John Kelly (sponsor), Bettina Hoeppner (co-sponsor), Roger Weiss and Randi Schuster (consultants). The training and experience provided by this award will serve as a critical foundation from which to build a research program that will help inform one of the most substantial public health crises in modern times.

(F.220)7.项目摘要/摘要阿片使用障碍占可归因于药物使用障碍的全球疾病负担的70%，影响约200万美国成年人，是接受药物治疗的主要原因。药物疗法对于OUD(RxOUD)来说，是显著促进康复的基本一线治疗选择，包括阿片激动剂治疗(OAT)、美沙酮(MET)和丁丙诺啡(BUP)。幸运的是，政府的努力极大地扩大了获得这些救生治疗的机会。随着OUD和OAT利率的上升，接受这些治疗的患者和影响他们康复的因素至关重要。神经科异常是OUD最常见的继发性疾病之一。神经认知功能障碍与较差的恢复结果有关，与OUD相关的缺陷涉及广泛的认知领域。有证据表明病情有所改善，病情有所缓解。然而，BUP和MET的认知轨迹被认为是错误的患者在很大程度上是未知的。鉴于OUD和OAT伴随的认知缺陷，以及OID和OAT的作用成瘾康复中的认知、燕麦中神经认知的特征及其与OUD康复的关系具有临床相关意义。这一研究领域最终可以提供新的治疗方法加强乌德治疗和康复。作为这一工作的第一步，这项前瞻性研究试图加深我们对燕麦中认知变化的理解及其与多方面测量的关系在生态有效的BUP和MET患者样本中恢复(生活质量和阿片类药物使用频率)。这个为期3年的指导项目的目标是(1)确定认知能力在6年后是提高、下降还是保持不变燕麦，以及这些认知轨迹是否特定于认知领域或燕麦组，(2)至调查认知轨迹是否可以预测10周的康复结果，并评估认知-康复关系的团体和治疗相关措施。这条线路的最终目标是工作是评估RxOUD特定的和OUD一般的认知轨迹，它们的神经基础，以及通过前瞻性对照研究的恢复结果。因此，本研究也旨在(3) 论证开展类似但更全面的研究的可行性。除了对以下方面做出贡献作为一个有限的文献，这个项目最终可以为未来的研究和信息提供重要的基础补充RxOUD和促进康复的认知康复治疗的发展结果。科学目标支持3个能力领域的培训：(1)治疗/康复研究，(2) 纵向设计和实施；(3)OUD。培训将在博士生博士的专家指导下完成。约翰·凯利(赞助商)、贝蒂娜·霍普纳(共同赞助商)、罗杰·韦斯和兰迪·舒斯特(顾问)。这个该奖项提供的培训和经验将成为建立研究的重要基础该计划将有助于揭示现代最重大的公共卫生危机之一。