Development and Use of rtfMRI for Self-control of Nicotine Craving

描述（由申请人提供）：本申请旨在研究实时功能磁共振成像（rtfMRI）作为操作性训练反馈机制在治疗物质使用障碍中的应用。最近的数据表明，当个体看到有关某些大脑区域（如前扣带皮层、前岛叶、听觉皮层）激活的信息时，他们可以减少这些大脑区域的活动。实验和临床疼痛的减少与rtfMRI信号反馈从吻侧前扣带的方式成正比的减少血氧水平依赖（BOLD）信号。这些区域与滥用物质的影响和物质使用障碍（SUDs）发展有关的区域重叠。初步的信息打开了应用神经反馈来改善患者样本治疗结果的可能性。本申请旨在扩大对这些过程的调查，并验证其对物质依赖志愿者的适用性。在最初的研究中，我们将检验尼古丁依赖志愿者减少对香烟渴望的能力。选择这种物质是因为它在一般人群中的留存率高、流行率高和公共卫生负担重，但预计今后的研究将探讨其他形式的成瘾（如可卡因、鸦片剂）。我们的多学科团队建议通过以下方式来推进这一领域的现有知识：(1)使用的数据不是来自单一的大脑区域，而是来自涉及尼古丁渴望和依赖的网络，从而解释尼古丁渴望期间大脑区域激活模式的个体差异；(2)建立动脉自旋标记（ASL）定量方法；(3)确定个体期望对这些过程的影响（例如，评估这些影响可归因于安慰剂相关反应的程度）。该应用程序的发展和实验元素将导致新的治疗途径，这将很容易推广到除尼古丁以外的其他形式的药物成瘾，并可能影响大量寻求药物滥用治疗的个人的结果。

DESCRIPTION (provided by applicant): This application aims to study the application of functional magnetic resonance imaging in real time (rtfMRI) as an operant training feedback mechanism for treating substance use disorders. Recent data suggest that individuals can reduce activity in some brain regions (e.g. anterior cingulate cortex, anterior insula, auditory cortex when they are presented with information about activation in that brain region. Experimental and clinical pain have been reduced with rtfMRI signal feedback from the rostral anterior cingulate in a manner proportional to reductions in the blood oxygenation level dependent (BOLD) signal from that region. These regions overlap with those involved in the effects of substances of abuse and the development of substance use disorders (SUDs). The initial information opens the possibility of applying neurofeedback to improve treatment outcomes in patient samples. The present application seeks to expand the investigation of these processes and validate their applicability to substance dependent volunteers. In initial studies we will examine the capacity of nicotine dependent volunteers to reduce their craving for cigarettes. This substance was selected for its high retention rates and prevalence and public health burden in the general population, but it is expected that future studies would explore other forms of addiction (e.g. cocaine, opiates). Our multidisciplinary team proposes to advance current knowledge in this area by: (1) using data not from a single brain region, but from networks involved in nicotine craving and dependence, thereby accounting for inter- individual differences in brain regional activation patterns during nicotine craving; (2) developing a quantifiable method by using arterial spin labeling (ASL); and (3) determining the influence of individual expectations on these processes (e.g. assessing the degree to which these effects are attributable to placebo-related responding). The developmental and experimental elements of this application will lead to new avenues for treatment that would be readily generalizable to other forms of drug addiction besides nicotine, and potentially impacting on the outcomes of the substantial numbers of individuals seeking substance abuse treatment. PUBLIC HEALTH RELEVANCE: The development of new methodology for the treatment of patients with substance use disorders would represent a significant advance in the therapeutics of these disorders. The studies proposed offer a new treatment alternative for these otherwise highly recurrent and chronic illnesses.