The Impact of Real-time fMRI Feedback on Response to Nicotine Cues

描述（由申请人提供）：尼古丁依赖是当今世界上可预防的主要死亡原因。提示引起的渴望可能在复发中起重要作用。利用功能磁共振成像（fMRI）阐明了吸烟线索诱导的渴望和消退的神经关联。最近的进展使得利用实时功能磁共振成像（rtfMRI）反馈来改变行为、认知和大脑区域活动成为可能。本应用程序的目的是开发成像参数，脑机接口和标准化的程序，使用rtfMRI与视觉反馈，以帮助尼古丁依赖个体减少渴望时，呈现吸烟提示。本研究的探索性需要分阶段进行。第一阶段将着重于技术和研究范式的发展。为了进入第二阶段，必须有令人信服的证据表明，基于rtfMRI视觉反馈，很大一部分尼古丁依赖个体可以操纵与吸烟线索诱导的渴望相关的关键大脑区域的大脑活动。如果确定了这一点，将在第二阶段探索对照比较和效果持续时间。这个项目将为临床试验奠定基础，研究一种非常创新的方法来治疗尼古丁依赖和其他物质使用障碍。这项研究将提供关于最佳技术、耐久性和“可转移性”的关键信息，以影响扫描仪外的情况。本研究结果可用于指导临床试验的设计，以调查rtfMRI神经调节训练在戒烟中的应用。

DESCRIPTION (provided by applicant): Nicotine dependence is the leading preventable cause of mortality in the world today. Cue-induced craving is likely to play an important role in relapse. The neural correlates of smoking cue-induced craving and extinction have been elucidated using fMRI. Recent advances make it possible to utilize real-time fMRI (rtfMRI) feedback to modify behavior, cognitions and regional brain activity. The purpose of this application is to develop the imaging parameters, brain-computer interface and standardized procedures for using rtfMRI with visual feedback to help nicotine-dependent individuals decrease craving when presented with smoking cues. The exploratory nature of this study requires a phased approach. Phase 1 will focus on the development of the technology and study paradigm. In order to proceed to Phase 2, there must be convincing evidence that a substantial proportion of nicotine-dependent individuals can manipulate brain activity in critical brain regions associated with smoking cue-induced craving based on rtfMRI visual feedback. If this is established, a controlled comparison and duration of effect will be explored in Phase 2. This project will set the stage for clinical trials investigating a very innovative approach to the treatment of nicotine dependence and other substance use disorders. The study will provide critical information about optimal techniques, durability and "transferability" of the effects to situations outside of the scanner. The findings of this study can be used to inform the design of a clinical trial to investigate the use of rtfMRI neuromodulation training in smoking cessation. PUBLIC HEALTH RELEVANCE: Improving treatment for nicotine dependence will provide substantial public health benefit as nicotine dependence is the leading preventable cause of mortality in the world today. Moreover, if individuals can learn to modulate activity in critical brain regions that control urges and craving states, this could have applicability in a broad range of disease states with major public health significance (i.e. other substance use disorders, obesity).