fMRI of CBT and CM for Cocaine Dependence

描述（由申请人提供）：我们的目的是研究可卡因依赖的行为治疗的神经机制。虽然多种行为治疗，包括认知行为疗法（CBT）和应急管理（CM）已被证明是有效的可卡因依赖和其他成瘾性疾病的治疗，很少有人知道关于大脑的变化背后的作用机制。我们建议将功能性磁共振成像（fMRI）测量纳入NIDA资助的CBT和CM行为治疗试验中，以调查治疗前后的脑功能。我们建议在研究开始时和治疗12周后分别使用三种成像范式来评估可卡因渴望，奖励处理和认知控制。我们建议使用类似的措施，在一个非成瘾的控制组成像两次12周间隔作为一个重要的对照组。我们预测，治疗前，可卡因依赖的主题将不同于这些功能磁共振成像和认知措施的控制。我们还预测，可卡因依赖受试者将显示治疗后的功能磁共振成像和认知/行为功能的变化，而对照组受试者将不会显示类似的变化时，成像12周间隔。将探索用于CBT和CM的可卡因依赖的有效行为治疗的神经预测因子和相关性，因为这些将具有改进治疗的显著潜力，并且将特定治疗靶向特定形式的可卡因依赖（例如，具有特定神经激活模式的那些）。该项目的成功完成将为未来的研究奠定基础（例如，那些结合行为和药理学治疗的药物）在可卡因依赖和其他成瘾性疾病中的应用。

DESCRIPTION (provided by applicant): We aim to study the neural mechanisms of behavioral treatment of cocaine dependence. Although multiple behavioral treatments including cognitive behavioral therapy (CBT) and contingency management (CM) have been shown to be effective in the treatment of cocaine dependence and other addictive disorders, little is known regarding the brain changes underlying their mechanisms of action. We propose integrating functional magnetic resonance imaging (fMRI) measures into a NIDA-funded behavioral treatment trial of CBT and CM to investigate brain function before and after treatment. We propose using at study onset and following 12 weeks of treatment three imaging paradigms that assess cocaine craving, reward processing and cognitive control, respectively. We propose using similar measures in a non-addicted control grouped imaged twice twelve weeks apart as an important comparison group. We predict that prior to treatment, cocaine dependent subjects will differ from controls on these fMRI and cognitive measures. We also predict that cocaine dependent subjects will show changes in fMRI and cognitive/behavioral functioning following treatment, and that control subjects will not show similar changes when imaged 12 weeks apart. Neural predictors and correlates of effective behavioral treatment for cocaine dependence for CBT and CM will be explored as these would have significant potential for refining therapies, and targeting specific therapies to specific forms of cocaine dependence (e.g., those with specific neural activation patterns). Successful completion of this project would lay the foundation for future studies (e.g., those combining behavioral and pharmacological treatments) in cocaine dependence and other addictive disorders.