Reducing Smoking Cue Reactivity and Behavior via a Retrieval-Extinction Mechanism

通过检索-消除机制减少吸烟提示反应和行为

• 批准号: 8570714
• 负责人: Michael E Saladin
• 金额: $ 22.43万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8570714
• 关键词: Abstinence; Addictive Behavior; Address; Alternative Therapies; Attenuated; Back; Behavior; Behavior Therapy; Behavioral; Blood Pressure; Cigarette; Cigarette Smoker; Clinical; Control Groups; Cues; Data; Development; Drug usage; Ensure; Evaluation; Exposure to; Extinction (Psychology); Galvanic Skin Response; Goals; Heart Rate; Heroin; Hour; Individual; Intervention; Investigation; Laboratories; Late Effects; Lead; Learning; Maintenance; Measures; Memory; Modification; Monitor; Morbidity - disease rate; Neurosciences Research; Nicotine; Nicotine Dependence; Outcome; Participant; Persons; Pharmaceutical Preparations; Physiological; Population; Process; Psychological reinforcement; Public Health; Publications; Randomized; Reaction; Relative (related person); Reporting; Research; Resistance; Retrieval; Rewards; Science; Smell Perception; Smoker; Smoking; Smoking Behavior; Societies; Substance Use Disorder; Substance of Abuse; Testing; Time; Training; Treatment outcome; Update; Vision; addiction; base; brief intervention; cost effective; craving; cue reactivity; design; diaries; follow-up; improved; indexing; innovation; learned behavior; memory process; memory retrieval; mortality; nicotine patch; non-smoking; novel; public health relevance; response; smoking cessation; success; treatment effect; varenicline

DESCRIPTION (provided by applicant): Presentation of cues involved in prior learning can elicit retrieval of memory for the learning. Retrieved memories are unstable before they are reconsolidated back into long-term storage. While unstable, the memories can be altered such that behaviors previously supported by the memories are significantly altered or eradicated. Nicotine addiction is multi-determined but one major etiological factor in the initiation and maintenance of smoking behavior is memory for smoking-related learning that develops as a consequence of frequent pairings between cues (e.g., sight and smell of cigarettes) and nicotine reward. The craving and other reactions that are elicited by exposure to these conditioned cues represent a significant threat to sustained cessation. Cue exposure therapy, which involves the repeated presentation of smoking cues in the absence of nicotine reward, was developed to extinguish cue-elicited craving and reactivity. Enthusiasm for this therapy waned as research revealed that extinguished responses would often reemerge with passage of time or if a smoking lapse occurred. The proposed exploratory study developed out of a recent Science publication that reported on the effects of a novel retrieval-extinction intervention on craving an cue reactivity in detoxified heroin addicts. The retrieval-extinction intervention consisted of two sessions in which brief heroin cue presentations, designed to elicit retrieval, were followed closely in time by protracted heroin cue exposure. Remarkably, this brief intervention led to significant reductions in heroin craving and cue reactivity that were sustained for 6-months. One explanation for these finding is that the brief 'retrieval' cue exposure initiated reconsolidation, thereby opening a window of opportunity in which protracted cue exposure could update the memories with information that would lead to dampened responsiveness to heroin cues. Given these initial and impressive findings, we propose to examine the effects of two sessions of retrieval-extinction training in smokers who are making a quit attempt. Retrieval will be initiated by a brief (5-min.) video with smoking-related content and the extinction will consist of protracted (1 hr.) exposure to smoking cues. A control group receiving the same treatment except that the retrieval video will have nonsmoking/neutral content will serve to demonstrate that retrieval is a key feature of retrieval-extinction training. Effects of the training on smokin craving and cue reactivity will be assessed 1-day, 2-weeks and 4-weeks post-training. The effects of the training on indices of smoking will also be preliminarily assessed. It is expected that the smoking-cue retrieval feature of this training will result in significant and enduring reductions in craving and reactivity to smoking cues and have a favorable impact on smoking. Positive findings from this study could lead to a safe and effective behavioral intervention that will help smokers overcome the threat to cessation posed by cue-elicited craving and reactivity, and thereby reduce the burden levied against society by this most costly addiction. Additionally, this treatment could be modified to address addiction to other substances of abuse.

描述(由申请人提供)：呈现先前学习中涉及的线索可以引发对学习记忆的提取。在重新整合到长期存储中之前，取回的记忆是不稳定的。虽然不稳定，但可以改变记忆，使得先前由记忆支持的行为被显著改变或根除。尼古丁成瘾是多方面决定的，但吸烟行为的启动和维持的一个主要病因是对吸烟相关学习的记忆，这是由于线索(例如，香烟的视觉和气味)与尼古丁奖励之间频繁配对的结果。暴露在这些条件性暗示下引发的渴望和其他反应代表着对持续戒烟的重大威胁。线索暴露疗法，包括在没有尼古丁奖励的情况下重复呈现吸烟线索，是为了消除线索引发的渴望和反应。随着研究表明，随着时间的推移或如果戒烟发生，消除的反应通常会重新出现，人们对这种疗法的热情减弱了。这项拟议的探索性研究源于最近发表的一份《科学》杂志，该杂志报道了一种新的提取-消退干预措施对戒毒海洛因成瘾者渴望线索反应的影响。恢复-灭绝干预包括两个 在简短的海洛因线索展示中，旨在引发提取的会议，紧随其后的是长期的海洛因线索暴露。值得注意的是，这一短暂的干预导致海洛因渴求和线索反应性显著降低，并持续了6个月。对这些发现的一种解释是，短暂的提取线索暴露引发了重新整合， 从而打开了一扇机会之窗，在这个窗口中，长期的线索暴露可能会用会导致对海洛因线索的反应减弱的信息来更新记忆。鉴于这些初步的和令人印象深刻的发现，我们建议检查两次恢复-消除训练对尝试戒烟的吸烟者的影响。将启动检索 短时间(5分钟)包含吸烟相关内容的视频和熄灭将由延长(1小时)组成。暴露在吸烟线索中。接受相同处理的对照组，除了检索视频将具有非吸烟/中性内容外，将用于证明检索是检索-消退训练的关键特征。训练对烟瘾和线索反应的影响将在训练后1天、2周和4周进行评估。还将初步评估培训对吸烟指数的影响。预计该培训的吸烟线索提取功能将显著和持久地减少对吸烟线索的渴望和反应，并对吸烟产生有利影响。这项研究的积极发现可能会带来安全有效的行为干预，帮助吸烟者克服由暗示引发的渴望和反应构成的戒烟威胁，从而减轻这种代价最高的成瘾给社会带来的负担。此外，可以对这种治疗进行修改，以解决对其他滥用物质的上瘾问题。