The Impact of Real-time fMRI Feedback on Response to Nicotine Cues

描述（由申请人提供）：尼古丁依赖是当今世界主要的可预防死亡原因。线索诱发的渴望可能在复发中起重要作用。吸烟线索诱导的渴望和灭绝的神经相关性已被阐明使用功能磁共振成像。最近的进展使得利用实时fMRI（rtfMRI）反馈来改变行为，认知和区域大脑活动成为可能。本申请的目的是开发成像参数，脑机接口和标准化程序，用于使用rtfMRI与视觉反馈，以帮助尼古丁依赖个体减少吸烟提示时的渴望。这项研究的探索性质要求采取分阶段的办法。第一阶段将侧重于技术和研究范式的发展。为了进入第二阶段，必须有令人信服的证据表明，相当一部分尼古丁依赖者可以根据rtfMRI视觉反馈操纵与吸烟线索诱导的渴望相关的关键大脑区域的大脑活动。如果确定了这一点，将在II期研究中探索对照比较和效应持续时间。该项目将为临床试验奠定基础，研究一种非常创新的方法来治疗尼古丁依赖和其他物质使用障碍。该研究将提供有关最佳技术、耐久性和效果在扫描仪外部情况下的“可转移性”的关键信息。本研究的结果可用于通知临床试验的设计，以调查使用rtfMRI神经调节训练戒烟。 公共卫生相关性：改善尼古丁依赖的治疗将为公共卫生带来巨大益处，因为尼古丁依赖是当今世界可预防的主要死亡原因。此外，如果个体能够学会调节控制冲动和渴望状态的关键大脑区域的活动，这可能适用于具有重大公共卫生意义的广泛疾病状态（即其他物质使用障碍，肥胖症）。

DESCRIPTION (provided by applicant): Nicotine dependence is the leading preventable cause of mortality in the world today. Cue-induced craving is likely to play an important role in relapse. The neural correlates of smoking cue-induced craving and extinction have been elucidated using fMRI. Recent advances make it possible to utilize real-time fMRI (rtfMRI) feedback to modify behavior, cognitions and regional brain activity. The purpose of this application is to develop the imaging parameters, brain-computer interface and standardized procedures for using rtfMRI with visual feedback to help nicotine-dependent individuals decrease craving when presented with smoking cues. The exploratory nature of this study requires a phased approach. Phase 1 will focus on the development of the technology and study paradigm. In order to proceed to Phase 2, there must be convincing evidence that a substantial proportion of nicotine-dependent individuals can manipulate brain activity in critical brain regions associated with smoking cue-induced craving based on rtfMRI visual feedback. If this is established, a controlled comparison and duration of effect will be explored in Phase 2. This project will set the stage for clinical trials investigating a very innovative approach to the treatment of nicotine dependence and other substance use disorders. The study will provide critical information about optimal techniques, durability and "transferability" of the effects to situations outside of the scanner. The findings of this study can be used to inform the design of a clinical trial to investigate the use of rtfMRI neuromodulation training in smoking cessation. PUBLIC HEALTH RELEVANCE: Improving treatment for nicotine dependence will provide substantial public health benefit as nicotine dependence is the leading preventable cause of mortality in the world today. Moreover, if individuals can learn to modulate activity in critical brain regions that control urges and craving states, this could have applicability in a broad range of disease states with major public health significance (i.e. other substance use disorders, obesity).