Cognitive Predictors of Alcoholism Pharmacotherapy

酒精中毒药物治疗的认知预测因素

• 批准号: 6615449
• 负责人: CYNTHIA Ann MUNRO
• 金额: $ 8.18万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-05-01 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6615449
• 关键词: alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse chemotherapy; behavioral /social science research tag; clinical research; clinical trials; cognition; drug withdrawal; human middle age (35-64); human subject; human therapy evaluation; longitudinal human study; naltrexone; neuroendocrine system; neuropsychological tests; neuropsychology; opioid receptor; outcomes research; patient oriented research; positron emission tomography; psychopharmacology; therapy compliance; young adult human (21-34)

DESCRIPTION (provided by applicant): Cognitive functioning, known to be variable among alcoholic individuals, has been shown to predict alcohol treatment outcomes in a number of studies regarding psychosocial and cognitive-behavioral treatment for alcohol dependence. A relatively newer option for the treatment of alcohol dependence, pharmacotherapy, represents an alternative treatment option for patients with alcohol use disorders, but not all individuals respond to this type of treatment. Accordingly, studies aimed at predicting which individuals will benefit from pharmaceutical treatment are valuable in informing treatment decisions. Whether cognitive functioning can predict outcomes for pharmacotherapy, however, has not been established. One type of drug used in the treatment of alcohol dependence is an opioid antogonist called naltrexone. As an adjunct to a 12-week naltrexone clinical trial, the proposed study will add neuropsychological assessment to an existing protocol to determine whether cognitive functioning can predict pharmacotherapy treatment outcomes. Additionally, two separately funded ongoing investigations are being conducted to investigate individual differences in opioid system activity in the same subjects who are part of the clinical drug trial. These investigations will employ responses to a naltrexone challenge and mu opioid receptor binding as measured through PET imaging in investigating opioid system activity. Because these investigations will be conducted with the same pool of subjects, the proposed study will also examine the relation between cognitive functioning and opioid system activity as a secondary aim. This investigation represents an extention of prior work by addressing methodological and conceptual shortcomings of previous studies of cognitive predictors of alcohol treatment outcomes. The primary aims of this investigation are to determine the relation between cognitive test performance and naltrexone treatment outcomes and to examine factors associated with differential patterns of cognitive functioning over time. Secondary aims are to characterize cognitive functioning throughout the withdrawal period, and to examine the relation between cognitive functioning and opioid system activity.

描述(由申请人提供)：已知的认知功能在酗酒者中是不同的，在一些关于酒精依赖的心理社会和认知行为治疗的研究中，已经证明认知功能可以预测酒精治疗的结果。治疗酒精依赖的一种相对较新的选择是药物疗法，这是酒精使用障碍患者的另一种治疗选择，但并不是所有人都对这种治疗有反应。因此，旨在预测哪些人将从药物治疗中受益的研究在指导治疗决策方面具有重要价值。然而，认知功能是否可以预测药物治疗的结果还没有确定。一种用于治疗酒精依赖的药物是一种名为纳曲酮的阿片类药物。作为为期12周的纳曲酮临床试验的补充，拟议的研究将在现有方案中增加神经心理学评估，以确定认知功能是否可以预测药物治疗结果。此外，正在进行两项单独资助的正在进行的研究，以调查参与临床药物试验的同一受试者阿片系统活动的个体差异。这些研究将利用对纳曲酮挑战的反应和通过正电子发射计算机断层扫描(PET)成像测量的u阿片受体结合来研究阿片系统的活性。由于这些调查将以相同的受试者群体进行，拟议的研究还将审查认知功能与阿片系统活动之间的关系，作为次要目标。这项调查是对先前工作的延伸，解决了以前对酒精治疗结果的认知预测因素研究的方法学和概念性缺陷。这项研究的主要目的是确定认知测试成绩和纳曲酮治疗结果之间的关系，并检查与认知功能随时间的不同模式相关的因素。第二个目标是描述整个戒断期的认知功能，并检查认知功能和阿片系统活动之间的关系。