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

增强药物使用障碍循证治疗的虚拟现实工具（R41/R42 - 临床试验可选）

• 批准号: 9898050
• 负责人: Erik Muendel
• 金额: $ 21.81万
• 依托单位: BRIGHTLINE INTERACTIVE, LLC
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-15 至 2022-08-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9898050
• 关键词: Address; Adult; Area; Artificial Intelligence; Back; Behavior Control; Behavioral; Brain; Brain region; Chronic; Clinical Trials; Cocaine; Cognitive; Communities; Conscious; Consumption; Cues; DSM-V; Data; Databases; Development; Disease; Drug Addiction; Emotional; Euphoria; Evidence based treatment; Exposure to; Feedback; Feeds; Functional Magnetic Resonance Imaging; Goals; Image; Imagery; Impaired cognition; Impairment; Individual; Informal Social Control; Institution; Intelligence; Intervention; Interview; Lead; Long-Term Care; Modeling; Monitor; Motivation; Near-Infrared Spectroscopy; Neurobiology; Patients; Persons; Pharmaceutical Preparations; Phase; Physiological; Pilot Projects; Play; Prevention strategy; Protocols documentation; Recovery; Regulation; Research; Rewards; Risk; Role; Sensory; Stimulus; Stress; Structure; Substance Use Disorder; Support System; System; Technology; Testing; Time; addiction; base; behavioral impairment; care coordination; clinically significant; cognitive control; conditioning; craving; cue reactivity; disorder later incidence prevention; emotion regulation; executive function; experience; head mounted display; implicit memory; meetings; neurophysiology; phase 1 study; portability; profiles in patients; prototype; relapse risk; response; sensor; simulation; smart watch; sobriety; tool; virtual; virtual reality; virtual reality simulation

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).

R&R 其他项目信息 7. 项目总结/摘要 成瘾引起的神经生物学变化会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 药物使用障碍 (SUD) 患者的康复参与（Humphreys， Malenka、Knutson 和 MacCoun，2017）。因为成瘾会产生压力和奖励系统 调节失调会损害情绪调节和执行功能 经历强烈的渴望（Volkow、Koob & McLellan，2016）、传统说教复发 预防策略对于那些处于过渡期的早期恢复者来说可能效果有限 治疗出院后返回自然社区，在那里他们将接触到 SUD 相关刺激。新的恢复支持模型可检测隐式提示诱发的 神经生理失调并恢复实时调节能力以减少复发 风险具有临床意义。​该可行性第一阶段研究将使用虚拟现实 (VR) 技术 1) 模拟患者特定的药物提示触发体验 (VR_drug) 校准个性化的神经生理学复发风险设定点，使用在会话中捕获 fNIRS（功能近红外光谱）传感器是 fMRI 的便携式替代品，它将 集成到 VR HMD（头戴式显示器）和生理传感器（智能手表） Empatica E4）在 VR_drug 场景中佩戴（目标 1）；​和 2) 模拟恢复调节 使用特定于患者的虚拟生成的清醒支持体验（VR_recovery） 关系、恢复增强的环境条件以及与恢复相关的感官 线索，以校准恢复调节的神经生理学设定点，由相同的捕获 会话中神经生理学传感器系统​（目标 2）​。如果成功的话，在第二阶段，移动 将开发恢复支持系统产品以帮助个人进行 SUD 恢复 通过监测个性化的神经生理学复发风险来调节实时渴望， 激活他们的恢复调节干预（VR_recovery）来改变冲动反应 即时的。这种类型的移动干预可以立即供康复中的个人使用 当他们离开治疗机构并返回自然社区时可能会有所帮助 以允许参与其他与康复相关的方式管理当前的药物冲动 活动（例如，致电赞助商、参加会议），降低实时复发风险 （Matto 和 Seshaiyer，2018 年；Matto，2015 年；Matto 等人，2014 年）。