Virtual Reality Tools to Enhance Evidence Based Treatment of Substance Use Disorders (R41/R42 - Clinical Trial Optional)

R&R其他项目信息 7.项目摘要/摘要 成瘾引起的神经生物学改变损害行为控制并增加复发率 风险(Volkow，Koob和McLellan，2016)，证实了长期护理协调的必要性 物质使用障碍(SUD)患者的康复参与(Humphreys， Malenka，Knutson和MacCoun，2017)。因为上瘾会产生压力和奖励系统 情绪调节障碍和执行功能障碍 经历强烈的渴望(Volkow，Koob&McLellan，2016)，传统的说教复发 预防策略可能对早期康复的患者在过渡时的效果有限 回到他们自然社区的治疗出院后，在那里他们将暴露在 与SUD相关的刺激。新的恢复支持模式，可检测隐含线索诱导 神经生理失调和恢复实时调节能力以减少复发 风险具有临床意义。​这项可行性第一阶段研究将使用虚拟现实(VR) 用于1)模拟特定于患者的药物提示触发体验(VR_DUDICE)的技术 校准个性化神经生理学复发风险设置点，在会话中使用 功能近红外光谱分析(​Function Near-IR Spectrtics​)传感器，是功能磁共振成像的便携式替代产品，它将 集成到VR头盔显示器、​和生理传感器(智能手表 Empatica E4)在VR_Druit Scenario​(目标1)中穿戴；​和2)模拟恢复调节 使用特定于患者的虚拟生成清醒支持体验(VR_RECOVERY) 关系、恢复增强的环境条件和恢复相关的感觉 提示，以校准恢复调节的神经生理设置点，由相同的 会话中神经生理学传感器系统​(Aim 2)​。如果成功，在第二阶段，移动电话 将开发康复支持系统产品，以帮助个人在SUD恢复 通过监测他们个性化的神经生理学复发风险和 激活他们的恢复调节干预(VR_RECOVERY)来改变大鼠的冲动反应性 实时的。这种类型的移动干预可立即提供给康复中的个人 当他们离开治疗机构并过渡回他们的自然社区时可能会有所帮助 以允许参与其他康复相关的方式来管理瞬间的药物冲动 活动(例如，呼叫赞助商、参加会议)，降低实时复发风险 (Matto，&Seshaiyer，2018；Matto，2015；Matto等人，2014)。

R&R Other Project Information 7. Project Summary/Abstract Neurobiological changes caused by addiction impair behavioral control and increase relapse risk (Volkow, Koob, & McLellan, 2016), substantiating the need for long-term care coordination and recovery engagement for individuals with Substance Use Disorders (SUD) (Humphreys, Malenka, Knutson, & MacCoun, 2017). Because addiction creates stress and reward system dysregulation impairing emotional regulation and executive functioning capacities when experiencing intense craving (Volkow, Koob & McLellan, 2016), traditional didactic relapse prevention strategies may have limited efficacy for those in early recovery when they transition back to their natural communities’ post-discharge from treatment, where they will be exposed to SUD-related stimuli. New recovery support models that detect implicit cue-induced neurophysiological dysregulation and restore real-time regulatory capacity to decrease relapse risk are of clinical significance. ​This feasibility Phase I study will use Virtual Reality (VR) technology to 1) simulate a patient-specific drug cue-triggering experience (VR_drug) to calibrate a personalized neurophysiological relapse risk set-point, captured in-session using fNIRS (​Functional Near-Infrared Spectroscopy​) sensors, a portable alternative to fMRI which will be integrated into the VR HMD (Head Mounted Display),​ and physiological sensors (smartwatch Empatica E4) worn during the VR_drug scenario ​(Aim 1); ​and 2) simulate a recovery-regulation experience (VR_recovery) using patient-specific virtually-generated sober-supportive relationships, recovery-enhanced environmental conditions, and recovery-associated sensory cues, to calibrate a recovery-regulated neurophysiological set-point, captured by the same in-session neurophysiological sensors systems ​(Aim 2)​. If successful, in Phase II, a mobile recovery support system product will be developed to help individuals in SUD recovery modulate real-time craving by monitoring their personalized neurophysiological relapse risk and activating their recovery-regulation intervention (VR_recovery) to alter urge reactivity in real-time. This type of mobile intervention that is immediately available to individuals in recovery as they leave treatment institutions and transition back into their natural communities may help manage in-the-moment drug urges in ways that allow engagement in other recovery-related activities (e.g., calling a sponsor, getting to a meeting), decreasing real-time relapse risk (Matto,& Seshaiyer, 2018; Matto, 2015; Matto, et al, 2014).