Cognitive Predictors of Alcoholism Pharmacotherapy

描述（由申请人提供）： 认知功能，已知是变量之间的酗酒者，已被证明可以预测酒精治疗的结果在一些研究中，心理和认知行为治疗酒精依赖。酒精依赖治疗的一个相对较新的选择，药物治疗，是酒精使用障碍患者的替代治疗选择，但并非所有人都对这种类型的治疗有反应。因此，旨在预测哪些个体将从药物治疗中受益的研究在告知治疗决策方面是有价值的。 然而，认知功能是否可以预测药物治疗的结果尚未确定。一种用于治疗酒精依赖的药物是一种名为纳洛酮的阿片类拮抗剂。作为为期12周的纳洛酮临床试验的辅助，拟议的研究将在现有方案中增加神经心理学评估，以确定认知功能是否可以预测药物治疗的结果。此外，正在进行两项单独资助的正在进行的研究，以研究作为临床药物试验一部分的相同受试者中阿片系统活性的个体差异。这些研究将采用对纳洛酮激发的反应和通过PET成像测量的μ阿片受体结合，以研究阿片系统活性。由于这些研究将在相同的受试者人群中进行，因此拟定的研究还将检查认知功能与阿片系统活性之间的关系，作为次要目的。这项调查代表了以前的工作的延伸，解决方法和概念上的缺陷，以前的研究认知预测酒精治疗的结果。 本研究的主要目的是确定认知测试性能和纳洛酮治疗结果之间的关系，并检查随着时间的推移与认知功能的差异模式相关的因素。次要目的是表征整个戒断期的认知功能，并检查认知功能与阿片系统活性之间的关系。

DESCRIPTION (provided by applicant): Cognitive functioning, known to be variable among alcoholic individuals, has been shown to predict alcohol treatment outcomes in a number of studies regarding psychosocial and cognitive-behavioral treatment for alcohol dependence. A relatively newer option for the treatment of alcohol dependence, pharmacotherapy, represents an alternative treatment option for patients with alcohol use disorders, but not all individuals respond to this type of treatment. Accordingly, studies aimed at predicting which individuals will benefit from pharmaceutical treatment are valuable in informing treatment decisions. Whether cognitive functioning can predict outcomes for pharmacotherapy, however, has not been established. One type of drug used in the treatment of alcohol dependence is an opioid antogonist called naltrexone. As an adjunct to a 12-week naltrexone clinical trial, the proposed study will add neuropsychological assessment to an existing protocol to determine whether cognitive functioning can predict pharmacotherapy treatment outcomes. Additionally, two separately funded ongoing investigations are being conducted to investigate individual differences in opioid system activity in the same subjects who are part of the clinical drug trial. These investigations will employ responses to a naltrexone challenge and mu opioid receptor binding as measured through PET imaging in investigating opioid system activity. Because these investigations will be conducted with the same pool of subjects, the proposed study will also examine the relation between cognitive functioning and opioid system activity as a secondary aim. This investigation represents an extention of prior work by addressing methodological and conceptual shortcomings of previous studies of cognitive predictors of alcohol treatment outcomes. The primary aims of this investigation are to determine the relation between cognitive test performance and naltrexone treatment outcomes and to examine factors associated with differential patterns of cognitive functioning over time. Secondary aims are to characterize cognitive functioning throughout the withdrawal period, and to examine the relation between cognitive functioning and opioid system activity.