The Repair of Self Control in Alcohol Dependence: Working Memory & Real Time fMRI

描述（由申请人提供）：酒精依赖的个人往往有缺陷的自我控制，衡量他们的过度折扣延迟奖励。双神经行为决策系统模型表明，这些赤字可能是由于两个相互作用的神经生物系统之间的调节平衡中断。这些系统是执行系统（前额叶皮层和顶叶皮层），负责评估延迟奖励（即，长期目标），以及与即时奖励相关联的冲动系统（边缘系统和边缘系统区域）（即，即时满足）。我们最近的研究表明，工作记忆（WM）训练通过恢复这些系统之间的调节平衡来修复自我控制。然而，关于自我控制的修复，我们还有很多东西要学。 在目标1中，我们将进一步探索WM训练对范围的影响。 WM、自我控制和临床相关（例如，的措施）。此外，还将通过功能神经影像学技术探讨工作记忆训练的神经机制。我们将通过系统地改变几组酒精依赖个体的WM训练次数来检查WM训练的剂量效应功能。这些自我控制的改善持续时间将通过在培训后一个月、三个月和六个月进行随访评估来测试。 在目标2中，我们计划利用在目标1中获得的神经生物学知识来测试两种变体的真实的时间fMRI神经反馈对我们的WM套件，自我控制和临床显著措施的影响。神经反馈对神经认知和临床重要措施的影响的新探索将包括基于特定大脑区域和分布式神经网络的反馈技术的直接比较。神经功能和/或我们的神经认知指标的长期变化将在一个月的随访访视期间进行探索。 成功实现我们的目标可以使我们既完善我们目前的技术（即，WM训练），并可能开始开发新技术的过程（即，神经反馈）用于酒精依赖个体自我控制的修复。这一应用将有助于酒精依赖的个性化医疗方法，其中治疗是由记录的自我控制缺陷定义的。此外，在这两个目标收集的功能性神经影像学数据应该提供独特的见解，在酒精依赖和任何治疗相关的神经功能变化中看到的神经中断的模式。

DESCRIPTION (provided by applicant): Alcohol-dependent individuals frequently have deficits in self-control, as measured by their excessive discounting of delayed rewards. The dual neurobehavioral decision systems model suggests that these deficits may result from a disruption in the regulatory balance between two interacting neurobiological systems. These systems are the executive system (prefrontal cortex and parietal cortex) which is responsible for valuing delayed rewards (i.e., long-term goals), and the impulsive system (limbic and paralimbic areas) which is associated with immediate rewards (i.e., instant gratification). Our recent research has demonstrated that working memory (WM) training repairs self-control, putatively by restoring regulatory balance between these systems. There is, however, still much to learn about repairing self-control. In Aim 1, we will further explore the effects WM training on a range of WM, self-control, and clinically relevant (e.g., craving) measures. Additionally, the neural mechanisms of WM training will be explored though functional neuroimaging techniques. We will examine the dose-effect function of WM training by systematically varying the number of WM training sessions across several groups of alcohol-dependent individuals. The duration of these improvements in self-control will be tested by conducting follow-up assessments one month, three months, and six months after training. In Aim 2 we plan to capitalize on the neurobiological knowledge gained in Aim 1 to test the effects of two variants of real time fMRI neuro-feedback on our suite of WM, self-control, and clinically significant measures. This novel exploration of neuro-feedback effects on neurocognitive and clinically significant measures will include a direct comparison of feedback techniques based on a specific brain region and across a distributed neural network. Long-term changes in neural function and/or our neurocognitive measures will be explored during a one-month follow-up visit. Successfully achieving our aims could allow us to both refine our current techniques (i.e., WM training), and possibly begin the process of developing novel techniques (i.e., neuro-feedback) for the repair of self-control in alcohol-dependent individuals. This application will contribute to personalized medicine approaches in alcohol dependence, where treatment is defined by documented self-control deficits. Furthermore, the functional neuroimaging data collected across both aims should provide unique insights into both patterns of neural disruption seen in alcohol dependence and any treatment associated changes in neural function.