Neurocognition, Nicotine and Polysubstance Abuse

描述（由申请人提供）：目前的研究正在为慢性药物使用对大脑行为关系的影响提供急需的数据。然而，这些关于长期物质使用障碍（sud）的神经行为伴随的文献具有相当大的异质性，许多因素可能导致这一结果。一个可能的原因是没有考虑到频繁使用/滥用兴奋剂尼古丁的影响。第二次修订寻求五年的资助，以解决尼古丁在功能性补偿慢性药物滥用者（SA）的长期神经认知影响中的作用。具体来说，我们建议测试尼古丁的认知增强特性的假设，特别是在工作记忆和注意力过程中所证明的，可能有助于抵消或功能上克服慢性sa的负面影响。该设计将根据主要滥用药物和当前临床诊断信息分配到亚组的男性和女性戒断、排毒SA （n=216）与社区对照（吸烟和不吸烟；n=144）进行直接比较，这些亚组与地理和人口变量相等。除了回答这个问题外，目前的设计还将扩展正在进行的关于药物使用亚组之间认知妥协差异的工作。采用双盲安慰剂对照研究，我们建议研究三种水平的尼古丁经皮给药（0、7和21毫克贴片）对寻求治疗的SA和社区对照组（男女人数相等）的影响。如果这些假设得到支持，现有的研究可能低估了慢性药物使用对特定认知过程的影响。这些发现将具有相当大的临床和科学意义。作为次要目的，我们计划调查相关和未充分研究的人口统计学变量之间的关联，包括抑郁症状、儿童行为障碍和焦虑症状学。此外，我们打算研究种族/民族，性别和sud家族史的作用。为了实现这一次要目标，我们制定了计划，对美国印第安人（Al）、非洲裔美国人（AA）和女性参与者进行过度抽样。

DESCRIPTION (provided by applicant): Current research is providing much needed data regarding the effects of chronic drug use on brain-behavior relations. This literature addressing the neurobehavioral concomitants of long-term substance use disorders (SUDs), however, is marked by considerable heterogeneity There are a number of factors which may contribute to this outcome. One likely contributor is the failure to account for the influence of the frequent use/abuse of the stimulant, nicotine. This second revision seeks five years of funding to address the role of nicotine in functionally compensating for the long-term neurocognitive effects of chronic substance abusers (SA s). Specifically, we propose to test the hypothesis that nicotine's cognitive enhancing properties, particularly as evidenced in working memory and attentional processes may serve to counterbalance or functionally overcome the negative effects observed in chronic SAs. The design entails the direct comparison of male and female abstinent, detoxified SA s (n=216) assigned to subgroups on the basis of their primary drug of abuse and current clinical diagnostic information with community controls (smoking and non-smoking; n=144) equated on geographic and demographic variables. In addition to responding to this question, the current design will also extend the on-going work regarding differences among drug using subgroups regarding cognitive compromise. Using a double-blind placebo controlled study, we propose to study the effect of three levels of nicotine via transdermal administration (0, 7 and 21 mg patches) in treatment-seeking SA and community controls (equal numbers of males and females). If the hypotheses are supported, existing research may underestimate the effects of chronic drug use on specific cognitive processes. These findings would have considerable clinical and scientific import. As a secondary aim, we plan to investigate associations among relevant, and understudied, demographic variables, including depressive symptoms, childhood behavioral disorders and anxiety symptomatology. Furthermore, we intend to examine the role of race/ethnicity, gender and family history of SUDs. To facilitate this secondary aim, we have instituted plans to over-sample American Indians (Al), African American (AA) and female participants.