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

描述（由申请人提供）：本申请旨在研究真实的时间功能磁共振成像（rtfMRI）作为治疗物质使用障碍的操作性训练反馈机制的应用。最近的数据表明，当个体被呈现有关该大脑区域激活的信息时，他们可以减少某些大脑区域（例如前扣带皮层，前扣带皮层，听觉皮层）的活动。实验和临床疼痛已减少与rtfMRI信号反馈，从喙前扣带回的方式成比例的减少血氧水平依赖（BOLD）的信号从该地区。这些区域与涉及药物滥用影响和药物使用障碍发展的区域重叠。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。本申请寻求扩展这些过程的研究并验证它们对物质依赖性志愿者的适用性。在最初的研究中，我们将检查尼古丁依赖志愿者减少吸烟欲望的能力。选择这种物质是因为其在一般人群中的高保留率和流行率以及公共卫生负担，但预计今后的研究将探讨其他形式的成瘾（如可卡因、阿片类药物）。我们的多学科团队建议通过以下方式推进该领域的现有知识：（1）使用来自尼古丁渴求和依赖网络的数据，而不是来自单个脑区，从而解释尼古丁渴求期间脑区激活模式的个体间差异;（2）通过使用动脉自旋标记（ASL）开发可量化的方法;以及（3）确定个体期望对这些过程的影响（例如，评估这些效应归因于安慰剂相关反应的程度）。这种应用的开发和实验元素将导致新的治疗途径，这些途径将容易推广到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。 公共卫生相关性：开发用于治疗物质使用障碍患者的新方法将代表这些障碍的治疗的显著进步。拟议的研究为这些高度复发和慢性疾病提供了一种新的治疗选择。

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.