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

描述(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，上瘾患者可以使用基于大脑和按键的反馈来调整他们对药物提示的反应，并改变上瘾的大脑和行为特征。吸毒成瘾的特征可以是奖赏系统重组为短期快速奖赏，对长期后果的评估减少，冲动，以及行为模式的缩小(即，限制对一个人表现出偏好的事物的集合)。为了应对这些上瘾症状，一种治疗方法是通过调整行为疗法来开发最大限度地减少冲动的技术。这些治疗技术传统上侧重于成瘾的心理社会措施，这些措施可能很难量化或客观改变。成瘾神经科学的最新进展揭示了奖赏/厌恶回路的强大变化，以及成瘾的实验心理学变量，这些变量可能适合使用行为技术。具体地说，前额叶皮质的结构和功能MRI测量表明，吸毒者的局部差异可能与基于按键的相对偏好表型有关，这种表型量化了他们受限的行为模式。技术和计算方面的进步表明，这些神经科学措施可能被用于行为治疗。为此，该项目列出了一套里程碑，作为R21提案，以开发(A)基于单体素和双体素光谱的高信噪比定量BOLD激活测量的技术工作流；(B)基于行为和BOLD信号向个人反馈的实时信号分析和显示软件；(C)与扫描仪中的受试者集成成像、实验心理学和反馈平台。在成功实现这些里程碑之后，又组织了一套里程碑作为R33提案，以证明：(D)这些技术可用于监测受试者大脑信号的调制和相对偏好表型，(E)在现实测试条件下大脑信号调制和按键反应的整合，以及(F)这些技术在可卡因依赖受试者中的应用。我们预计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。 公共卫生相关性：该项目将为成瘾者开发一种方法，以自我调节他们的大脑反应和药物偏好的行为表型。具体地说，来自大脑区域的实时反馈涉及对药物使用的改变的判断和决策，将与偏好行为中类似法律模式的量化测量相结合，这样个人就可以客观地应用行为治疗技术来改变成瘾的神经特征。

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.