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Neurobehavioral and fMRI Research in HIV Infection and Cocaine Dependence

HIV 感染和可卡因依赖的神经行为和功能磁共振成像研究

基本信息

批准号：
8611906
负责人：
CHRISTINA S MEADE
金额：
$ 16.15万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-03-01 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8611906
关键词：
AIDS neuropathy AIDS/HIV problem Acquired Immunodeficiency Syndrome Adult Affect American Area Attention Behavioral Behavioral Sciences Bilateral Brain CD4 Lymphocyte Count Clinical Cocaine Cocaine Abuse Cocaine Dependence Cognitive Cognitive deficits Corpus striatum structure Data Analyses Decision Making Development Disease Disease Progression Dorsal Drug Addiction Drug abuse Drug user Early identification Educational workshop Environment Equation Functional Magnetic Resonance Imaging Functional disorder Future Gambling Goals HIV HIV Infections Health High Prevalence Impairment Impulsive Behavior Impulsivity Infection Institutes Interdisciplinary Study International Intervention Learning Licensing Life Light Magnetic Resonance Imaging Measures Mediating Memory Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methamphetamine Methodology Midbrain structure Modeling Motor Nature Neurobiology Neurocognitive Neuropsychology Outcome Parietal Participant Patient Self-Report Patients Pattern Performance Persons Population Prefrontal Cortex Prevention Psychologist Recruitment Activity Research Research Methodology Research Personnel Research Training Risk Risk Behaviors Risk-Taking Sampling Structure Sum Techniques Testing Training Translating United States Universities Unsafe Sex Visual attention addiction behavior measurement behavioral impairment career development clinical practice cognitive neuroscience comparison group design drug abuser executive function high risk improved innovation memory process neurobehavioral neurocognitive test neuroimaging neuropsychiatry non-drug novel patient oriented research processing speed programs relating to nervous system research study sexual risk taking skills statistics stimulant abuse symposium treatment adherence working group

项目摘要

DESCRIPTION (provided by applicant): Neurobehavioral and fMRI Research in HIV Infection and Cocaine Dependence Dr. Christina Meade's long-term goal is to establish an independent and productive program of patient-oriented research dedicated to understanding the impact of drug abuse on behavioral and clinical outcomes in persons living with or at risk for HIV/AIDS. This application presents integrated training and research plans focused on HIV neurobehavioral dysfunction. The guiding hypothesis is that co-occurring HIV infection and cocaine dependence is associated with greater neurocognitive impairment and behavioral risk compared to each disease independently. As the fields of HIV/AIDS and drug abuse evolve, transdisciplinary research has the potential to accelerate advances in the prevention and treatment of these neuropsychiatric diseases. Therefore, Dr. Meade, a licensed clinical psychologist with a strong behavioral science background in HIV/AIDS and drug abuse, aims to develop expertise in cognitive neuroscience. Specifically, she seeks advanced training in: (1) neuroAIDS and neurocognitive assessment; (2) functional magnetic resonance imaging (fMRI); (3) brain circuitry relevant to addiction and neuroAIDS; and (4) longitudinal data analysis with repeated measures and latent variables. The training plan includes didactic coursework and workshops, one- on-one mentorship, participation in working groups and seminars, and attendance at national and international conferences. Consistent with the transdisciplinary nature of the proposed research, a mentorship team with distinct but complementary areas of expertise has been assembled: Drs. Scott Huettel (fMRI and executive function), Kevin Robertson (neuroAIDS and neuropsychology), Joseph McClernon (addiction and neuroimaging), Kathleen Sikkema (behavioral aspects of HIV), Rick Hoyle (statistics and methodology), and Roger Weiss (drug addiction). Duke University provides a rich environment in which Dr. Meade's career development goals can be readily accomplished, including access to state-of-the-art neuroimaging facilities, clinical units supportive of patient-oriented research, graduate-level courses in fMRI, statistics, and neurobiology, and several directly relevant interdisciplinary research centers and institutes. The research plan has been carefully designed to parallel the training plan; for each training goal there is a corresponding research directive that will allow Dr. Meade to implement newly developed skills. Both HIV infection and stimulant abuse affect neurocognitive functioning, yet few studies have empirically examined the effects of co- occurring HIV infection and stimulant abuse on neurobehavioral outcomes. This is an important research topic due to the high prevalence of co-occurring HIV infection and stimulant abuse, and the high rates of risky and impulsive behavior in this population. The research plan has 2 studies with the following specific aims: (1) identify patterns of neurocognitive impairment in HIV infection and cocaine dependence, and test whether these are associated with risky decision making and behavioral risk; and (2) examine brain activation patterns associated with attention and decision making as a function of HIV disease progression and co-occurring versus independent HIV infection and cocaine dependence. A sample of 160 patients will be recruited for a 3- group comparison study of persons with co-occurring HIV infection and cocaine dependence, HIV infection only, and cocaine dependence only. Participants will complete a battery of neurocognitive and behavioral measures; results will be analyzed using latent variable techniques. A subset (25 from each group, 75 total) will participate in an fMRI experiment that examines brain activity during attention and decision tasks; within and between group analyses will be conducted. This integration of behavioral and cognitive neuroscience techniques is novel and innovative, and results may help shed light on the mechanisms underlying neuropsychiatric disorders characterized by risk taking and impulsivity. This line of research has the potential to improve techniques for early identification of neurocognitive impairment and guide the development of transformative treatment approaches to improve behavioral and clinical outcomes in this population. Moreover, as a clinician, Dr. Meade will be uniquely poised to translate these findings into clinical practice. In sum, the proposed K23 award will provide the advanced training and mentored research necessary for Dr. Meade to become a nationally recognized expert in the neuropsychiatry of drug abuse and HIV/AIDS and to conduct transdisciplinary research in this evolving field. PUBLIC HEALTH RELEVANCE: Over 1 million Americans are living with HIV/AIDS, with approximately 56,000 new infections each year in the United States. Stimulant abuse, primarily cocaine and methamphetamine, is common among HIV-infected adults and is associated with continued sexual risk taking, poor treatment adherence, and other risky behaviors. A better understanding of the underlying mechanisms associated with neurobehavioral dysfunction in HIV-infected drug abusers may guide the development of innovative prevention and treatment approaches.

描述（由申请人提供）：HIV感染和可卡因依赖的神经行为和功能磁共振成像研究Christina Meade博士的长期目标是建立一个独立的、富有成效的以患者为导向的研究项目，致力于了解药物滥用对HIV/AIDS感染者或有感染风险的人的行为和临床结果的影响。该应用程序提出了集中于HIV神经行为功能障碍的综合培训和研究计划。指导性假设是，与单独发生的每种疾病相比，同时发生的艾滋病毒感染和可卡因依赖与更大的神经认知障碍和行为风险相关。随着艾滋病毒/艾滋病和药物滥用领域的发展，跨学科研究有可能加速这些神经精神疾病的预防和治疗进展。因此，Meade博士是一名有执照的临床心理学家，在艾滋病毒/艾滋病和药物滥用方面有很强的行为科学背景，他的目标是发展认知神经科学方面的专业知识。具体来说，她寻求以下方面的高级培训：(1)神经艾滋病和神经认知评估；(2)功能磁共振成像（fMRI）；(3)与成瘾和神经aids相关的脑回路；(4)采用重复测量和潜在变量的纵向数据分析。培训计划包括教学课程和工作坊，一对一指导，参加工作组和研讨会，以及出席国内和国际会议。与拟议研究的跨学科性质相一致，已经组建了一个具有不同但互补的专业领域的指导团队：Scott Huettel （fMRI和执行功能），Kevin Robertson（神经艾滋病和神经心理学），Joseph McClernon（成瘾和神经成像），Kathleen Sikkema （HIV行为方面），Rick Hoyle（统计和方法论）和Roger Weiss（吸毒成瘾）。杜克大学提供了一个丰富的环境，使米德博士的职业发展目标可以很容易地完成，包括使用最先进的神经成像设备，支持以患者为导向的研究的临床单位，功能磁共振成像，统计学和神经生物学的研究生水平课程，以及几个直接相关的跨学科研究中心和研究所。研究计划经过精心设计，与训练计划并行；每一个培训目标都有一个相应的研究指令，这将允许米德博士实施新开发的技能。HIV感染和兴奋剂滥用都会影响神经认知功能，但很少有研究实证检验HIV感染和兴奋剂滥用共同发生对神经行为结果的影响。这是一个重要的研究课题，因为艾滋病病毒感染和兴奋剂滥用并存的患病率高，高风险和冲动行为的高发率在这一人群。本研究计划有两项研究，具体目的如下：(1)确定HIV感染和可卡因依赖中神经认知障碍的模式，并测试这些模式是否与风险决策和行为风险相关；(2)研究与注意力和决策相关的大脑激活模式作为HIV疾病进展和共同发生与独立的HIV感染和可卡因依赖的功能。160例患者将被纳入一项3组比较研究，包括同时发生HIV感染和可卡因依赖、仅感染HIV和仅依赖可卡因的患者。参与者将完成一系列神经认知和行为测量；结果将使用潜在变量技术进行分析。其中一部分人（每组25人，共75人）将参加fMRI实验，以检查注意力和决策任务期间的大脑活动；将进行组内和组间分析。这种行为和认知神经科学技术的整合是新颖和创新的，其结果可能有助于阐明以冒险和冲动为特征的神经精神疾病的机制。这条研究路线有潜力改善早期识别神经认知障碍的技术，并指导变革性治疗方法的发展，以改善这一人群的行为和临床结果。此外，作为一名临床医生，米德博士将以独特的姿态将这些发现转化为临床实践。总而言之，拟议的K23奖将为米德博士提供必要的高级培训和指导研究，使他成为全国公认的药物滥用和艾滋病毒/艾滋病神经精神病学专家，并在这一不断发展的领域进行跨学科研究。公共卫生相关性：超过100万美国人感染艾滋病毒/艾滋病，美国每年约有56,000例新感染。兴奋剂滥用，主要是可卡因和甲基苯丙胺，在艾滋病毒感染的成年人中很常见，并与持续的性冒险、不良的治疗依从性和其他危险行为有关。更好地了解与艾滋病毒感染药物滥用者神经行为功能障碍相关的潜在机制可能指导创新预防和治疗方法的发展。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Reward and executive control network resting-state functional connectivity is associated with impulsivity during reward-based decision making for cocaine users.

DOI：
10.1016/j.drugalcdep.2018.09.013
发表时间：
2019-01-01
期刊：
Drug and alcohol dependence
影响因子：
4.2
作者：
Hobkirk AL;Bell RP;Utevsky AV;Huettel S;Meade CS
通讯作者：
Meade CS

Cocaine dependence modulates the effect of HIV infection on brain activation during intertemporal decision making.

可卡因依赖调节艾滋病毒感染对跨期决策过程中大脑激活的影响。

DOI：
10.1016/j.drugalcdep.2017.05.043
发表时间：
2017
期刊：
Drug and alcohol dependence
影响因子：
4.2
作者：
Meade,ChristinaS;Hobkirk,AndreaL;Towe,SheriL;Chen,Nan-Kuei;Bell,RyanP;Huettel,ScottA
通讯作者：
Huettel,ScottA

Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa.