Functional Spectroscopy with Real-Time Feedback for Altering Preferences in Addic

描述（由申请人提供）：该项目将开发一种实时神经成像和行为方法，通过该方法，成瘾个体可以使用基于大脑和按键的反馈来调节他们对药物线索的反应，并改变成瘾的大脑和行为特征。药物成瘾的特征可以是奖励系统的重组，以短期快速奖励，对长期后果的评估减少，冲动和行为曲目的缩小（即，对一个人表现出偏好的事物的限制）。为了处理这些成瘾症状，一种治疗方法是通过适应行为疗法来发展冲动最小化技术。这些治疗技术传统上侧重于成瘾的社会心理测量，这很难量化或客观地改变。成瘾神经科学的最新进展揭示了成瘾中奖励/厌恶回路以及实验心理学变量的强大变化，这些变化可能适用于行为技术。具体来说，前额叶皮层的结构和功能MRI测量指出了成瘾者的局部差异，这些差异可能与基于按键的相对偏好表型有关，该表型量化了他们的受限行为。技术和计算的进步表明，这些神经科学措施可能被用于行为治疗。为此，该项目制定了一系列里程碑，作为R21提案，以开发(a)基于单和双体素光谱的高信噪比定量BOLD激活测量的技术工作流程；(b)实时信号分析和显示软件，用于根据行为和BOLD信号向个人反馈；(c)成像平台、实验心理学平台和扫描仪中受试者反馈平台的集成。在成功达到这些里程碑之后，进一步的一系列里程碑被组织为R33提案，以证明：(d)这些技术可以应用于监测受试者对大脑信号和相对偏好表型的调制，(e)在实际测试条件下对大脑信号和按键反应的调制的整合，以及(f)将这些技术应用于可卡因依赖受试者。我们预见这些概念验证里程碑将成为未来在治疗试验中使用这种方法的先决条件。

DESCRIPTION (provided by applicant): This project will develop a real-time neuroimaging and behavioral method by which individuals with addiction may use brain- and key press-based feedback to modulate their responses to drug cues, and alter brain and behavior signatures of addiction. Drug addiction can be characterized by a restructuring of the reward system to short-term rapid rewards, decreased assessment of long-term consequences, impulsivity, and a narrowing of the behavioral repertoire (i.e., restriction in the set of things toward which one shows preference). To deal with these symptoms of addiction, one therapeutic approach has been to develop urge minimization techniques through adaptations of behavioral therapy. These therapy techniques have traditionally focused on psychosocial measures of addiction that can be difficult to quantify or alter objectively. Recent advances in addiction neuroscience have revealed robust alterations of reward/aversion circuitry along with experimental psychology variables in addiction that may be amenable to use with behavioral techniques. Specifically, structural and functional MRI measures of prefrontal cortex, point to localized differences in addicts that can be connected with a key press-based phenotype of relative preference that quantifies their restricted behavioral repertoire. Technical and computational advances suggest that these neuroscience measures might be harnessed for behavioral therapy. Toward this end, this project lays out a set of milestones as an R21 proposal to develop (a) a technical work-flow for high SNR, quantitative BOLD activation measurement based on single and double voxel spectroscopy; (b) real-time signal analysis and display software for feedback to individuals based on behavior and BOLD signal; (c) integration of platforms for imaging, experimental psychology, and feedback with subjects in the scanner. Following successful attainment of these milestones, a further set of milestones are organized as an R33 proposal to demonstrate: (d) that these technologies can be applied to monitor modulation of brain signal and relative preference phenotype by subjects, (e) integration of modulation of brain signal and key press responses during realistic testing conditions, and (f) the application of these techniques to cocaine dependent subjects. We foresee these proof-of-concept milestones to be prerequisites for the future use of such a method in therapeutic trials. PUBLIC HEALTH RELEVANCE: This project will develop a method for individuals with addiction to self-modulate their brain responses and behavioral phenotype of drug preference. Specifically, real-time feedback from brain regions involved with altered judgment and decision-making around drug use, will be merged with quantitative measures of law-like patterns in preference behavior, so individuals can objectively apply behavioral therapy techniques to alter neural signatures of addiction.