Working memory: a critical factor underlying alcohol reduction intervention response

工作记忆：减酒干预反应的关键因素

• 批准号: 8922223
• 负责人: Vaughn E Bryant
• 金额: $ 3.79万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-20 至 2018-05-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8922223
• 关键词: Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcoholic beverage heavy drinker; Alcohols; Anterior; Anti-Retroviral Agents; Area; Back; Behavior; Behavior Therapy; Behavioral; Beryllium; Biological Neural Networks; Client; Clinical; Cognitive; Decision Making; Effectiveness of Interventions; Elements; Functional Magnetic Resonance Imaging; Future; Goals; HIV; HIV Seropositivity; Hepatitis C; Hepatitis C virus; Individual; Inferior; Intervention; Letters; Life; Liver Dysfunction; Maintenance; Measures; Mediating; Medical; Memory; Modeling; Morbidity - disease rate; Motivation; Motor; Neurocognitive; Outcome; Parietal Lobe; Performance; Play; Population; Prefrontal Cortex; Process; Psychiatric Diagnosis; Public Health; Research; Resources; Rest; Risk; Role; Sampling; Short-Term Memory; Speech; Testing; Work; alcohol abuse therapy; base; behavior change; blood oxygen level dependent; cingulate cortex; co-infection; cognitive ability; depressive symptoms; drinking; frontal lobe; hazardous drinking; high risk sexual behavior; interest; medication compliance; memory retrieval; mortality; motivational enhancement therapy; neurobiological mechanism; phonology; psychosocial; public health relevance; response; success; transmission process

 DESCRIPTION (provided by applicant): The goal of the proposed project is to examine the predictive role of working memory (WM) networks in reduced alcohol consumption, among a group of HIV positive heavy drinkers, receiving a Motivational Interviewing (MI) intervention. Hazardous alcohol use (HAU) is common in people living with HIV (PLWH) with estimates of HAU between 5-33% in this population (4-7). There are many deleterious consequences of hazardous alcohol use in this population, which include increased risk of: HIV transmission, exacerbation of comorbid medical conditions, comorbid psychiatric diagnoses, and other psychosocial consequences. In order to effectively intervene upon alcohol use, it is important to understand the mechanisms by which cognitive abilities impact intervention effectiveness. Previous studies have suggested that WM abilities, prior to behavioral intervention, are associated with intervention outcome (11-12). The basic role of WM has been defined as a form of memory that supports the temporary storage and maintenance of internal representations and mediates the controlled manipulation of these representations (13-14). A critical component of WM is the phonological loop which supports the process of storing speech based information, so that it can be manipulated (13). A critical element of MI, which involves the use of phonological loop resources, is the element of client change talk. Client change talk is among the most consistent predictors of intervention success because verbalizing change talk can help to resolve ambivalence, which can help move the individual toward a greater likelihood of behavior change (15-16). MI is one of the most effective behavioral treatments for problems with alcohol. However, no studies have directly investigated the predictive role of WM networks, as predictors of drinking reduction following MI. We aim to examine WM networks using functional magnetic resonance imaging (fMRI) blood oxygen level dependent (BOLD) response during n-back (0-back and 2-back) tasks, resting state functional connectivity analyses, as well as WM abilities using cognitive measures, to evaluate whether baseline WM abilities are predictive of alcohol reduction, in response to MI intervention. We will test whether decreased fMRI BOLD activation in WM regions of interest (ROI) during n-back performance predict alcohol reduction among individuals receiving MI intervention. We will also evaluate whether higher baseline neurocognitive WM abilities (N-back performance, Letter Number Sequencing, Trails, Stroop) predict greater alcohol reduction in response to MI. Finally, we will determine if higher baseline Total Independence levels (i.e., functional connectivity) between WM ROIs predict reduced alcohol consumption at 6 months, among individuals receiving MI. Findings from this research will contribute to an understanding of mechanisms associated with successful response to behavioral intervention. Furthermore, understanding changes in the underlying neural networks associated with positive response to MI, may inform future interventions, which may focus on enhancing WM abilities, prior to behavioral alcohol reduction intervention.

 描述(由申请人提供)：拟议项目的目标是研究工作记忆(WM)网络在接受动机访谈(MI)干预的一组HIV阳性酗酒者中减少酒精消费方面的预测作用。危险酒精使用(HAU)在艾滋病毒携带者(PLWH)中很常见，估计HAU在这一人群(4-7岁)中的比例在5%-33%之间。在这一人群中，危险饮酒有许多有害后果，其中包括：艾滋病毒传播的风险增加、并存疾病的恶化、并存精神诊断以及其他心理社会后果。为了有效地干预酒精使用，了解认知能力影响干预效果的机制是很重要的。先前的研究表明，在行为干预之前，工作记忆能力与干预结果有关(11-12)。WM的基本角色被定义为一种存储形式，它支持内部表征的临时存储和维护，并调节这些表征的受控操作(13-14)。WM的一个关键组件是语音环路，它支持存储基于语音的信息的过程，从而可以对其进行操作(13)。涉及使用语音循环资源的MI的一个关键要素是客户变更谈话的要素。客户改变谈话是干预成功的最一致的预测因素之一，因为口头上的改变谈话可以帮助解决矛盾心理，这可以帮助个人走向更大的行为改变的可能性(15-16)。MI是治疗酒精问题的最有效的行为疗法之一。然而，没有研究直接调查WM网络作为MI后饮酒减少的预测因素的预测作用。我们的目标是使用功能磁共振成像(FMRI)在n-back(0-back和2-back)任务中的血氧水平依赖(BOLD)反应、休息状态功能连接性分析以及使用认知测量的WM能力来检查WM网络，以评估基线WM能力是否可以预测MI干预下的酒精减少。我们将测试在n-back运动中WM感兴趣区(ROI)功能磁共振大胆激活的减少是否可以预测接受MI干预的个体的酒精减少。我们还将评估较高的基线神经认知WM能力(N-back成绩、字母数字排序、Trails、Stroop)是否预示着MI反应中更大的酒精减少。最后，我们将确定在接受心肌梗死的个体中，WM ROI之间更高的基线总独立性水平(即功能连接)是否预示着6个月后酒精消耗量的减少。这项研究的发现将有助于理解与行为干预的成功反应相关的机制。此外，了解与对MI的积极反应相关的潜在神经网络的变化，可能会为未来的干预提供信息，这些干预可能侧重于在行为减少酒精干预之前增强WM能力。