Cue Reactivity Modulation in MSM with Methamphetamine Use Disorder

甲基苯丙胺使用障碍 MSM 的提示反应性调节

• 批准号: 10663559
• 负责人: Muhammad Adeel Parvaz
• 金额: $ 41.26万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663559
• 关键词: Abstinence; Arousal; Attenuated; Behavior Therapy; Behavioral; Clinical; Cocaine use disorder; Control Groups; Cues; Development; Drug usage; Electroencephalography; Emotional; Evidence based intervention; FDA approved; Foundations; HIV; Incubated; Individual; Informal Social Control; Intervention; Knowledge; Light; Measures; Mediating; Methamphetamine; Methamphetamine overdose; Methamphetamine use disorder; Outcome; Outcome Measure; Participant; Patient Self-Report; Patients; Pharmaceutical Preparations; Phase; Population; Prefrontal Cortex; Prevalence; Psychophysiology; Randomized; Regulation; Relapse; Research; Role; Sampling; Severities; Severity of illness; Substance Use Disorder; Techniques; Testing; Time; Training; Treatment outcome; Visit; Work; addiction; adverse outcome; cocaine cue; cognitive control; cognitive reappraisal; cohort; comparison control; craving; cue reactivity; design; drug seeking behavior; effectiveness testing; executive function; experience; follow-up; improved; men who have sex with men; methamphetamine use; methamphetamine user; neurophysiology; opioid epidemic; overdose death; relapse prediction; relapse prevention; remediation; secondary outcome; sexual minority; substance use; success; treatment adherence; treatment response

PROJECT SUMMARY In the midst of the opioid epidemic, methamphetamine use is emerging as the next substance use crisis with disproportionately increasing prevalence in men who have sex with men (MSM), high relapse rates and no FDA-approved treatments for individuals with methamphetamine use disorder (MUD). One of the major contributors to relapse is the enhanced motivated arousal (cue-reactivity) to drug-related cues, even after protracted abstinence that leads to an increase in craving and drug-seeking. Although cue-reactivity is studied widely in other substance use disorders, its study is scarce in MUD and non-existent in MSM with MUD, creating a critical gap in knowledge needed for unbiased assessment of disease severity and treatment outcomes in this rapidly growing clinical population. Therefore, in this bi-phased study, we propose to first identify a psychophysiological marker of methamphetamine cue-reactivity and its incubation with abstinence from methamphetamine use and examine group-differences between MSM and non-MSM MUD. Subsequently, in the second phase we propose to longitudinally assess incubation of cue-reactivity, its reduction with cognitive reappraisal (CR; a self-regulation technique) and examine the impact of CR on clinical outcomes in MSM with MUD. In light of preliminary findings from our group, we hypothesize that LPP, an electroencephalography-derived marker of drug cue-reactivity, will track the incubation of methamphetamine cue-reactivity and its CR-mediated reduction, which in turn will be associated with improved clinical outcomes in MSM with MUD. In the R61 phase, we will cross-sectionally compare the LPP-assessed cue-reactivity between currently using (Group 1) and abstinent (1-3 months; Group 2) individuals with MUD (50% MSM in each group, matched on HIV status), and examine in-task changes in cue-reactivity with CR technique. In the R33 phase, we will assign a cohort of MUD to either the CR+ (Cognitive Reappraisal training) or the CR- (no Cognitive Reappraisal training) group (all MSM, matched on HIV status), and cue-reactivity will be assessed longitudinally at <2 weeks, 2 months, to 3 months after abstinence initiation. Successful completion of these aims will identify an EEG-based, objective, and clinically useful marker of methamphetamine cue-reactivity, and will delineate the impact of CR on methamphetamine cue-reactivity in relation to treatment response in MSM with MUD. This work will be the beginning of mechanistic research into the role of incubation of methamphetamine cue-reactivity and its reduction as a reliable and clinically meaningful outcome measure, establishing an empirical foundation to develop an intervention for MUD and possibly in other addictions.

项目总结 在阿片类药物流行的过程中，甲基苯丙胺的使用正在成为下一个药物使用危机 男男性行为者(MSM)的患病率不成比例地增加，复发率高，无 FDA批准的甲基苯丙胺使用障碍(MUD)患者的治疗。其中一个主要的 导致复发的因素是对与药物有关的线索的增强的动机唤醒(线索反应性)，即使在 长期禁欲导致渴望和寻求毒品的增加。尽管对线索反应性的研究 在其他物质使用障碍中广泛存在，在泥浆中研究很少，在有泥浆的MSM中不存在， 在对疾病严重程度和治疗进行公正评估所需的知识方面造成严重差距 在这一快速增长的临床人口中的结果。因此，在这项分两个阶段的研究中，我们建议首先 确定甲基苯丙胺线索反应性的心理生理标志物及其与戒断的关系 从甲基苯丙胺的使用和检查MSM和非MSM泥浆的组别差异。 随后，在第二阶段，我们建议纵向评估线索-反应的孵化，其 认知再评估(CR；一种自我调节技术)的恢复，并检查CR对临床的影响 MSM合并MUD的结局。根据我们小组的初步发现，我们假设LPP和 脑电衍生的药物线索反应性标志，将跟踪甲基苯丙胺的孵化 线索反应性及其CR介导的减少，这反过来将与改善临床结果相关 在有泥的男男性接触者中。在R61阶段，我们将横断面比较LPP评估的线索反应性 目前正在使用(第1组)和禁欲(1-3个月；第2组)的MUD患者(50%的MSM在 每组，与HIV状态匹配)，并用CR技术检查任务中线索反应性的变化。在 R33阶段，我们将把一组MUD分配给CR+(认知重新评估训练)或CR-(否 认知再评估培训)组(所有男男性接触者，艾滋病毒状况匹配)，并评估线索反应性 纵向上在戒酒开始后2周、2个月至3个月。成功完成这些任务 AIMS将确定一种基于脑电的、客观的、临床上有用的甲基苯丙胺线索反应性标记， 并将描绘CR对甲基苯丙胺线索反应性的影响，与治疗反应有关 加了泥的味精。这项工作将是对孵化的作用的机理研究的开始 甲基苯丙胺线索反应性及其减少作为一种可靠和有临床意义的结果衡量标准， 建立一个经验基础，以开发对MUD和可能的其他成瘾的干预。