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，成瘾者可以使用基于大脑和按键的反馈来调节他们对药物提示的反应，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向短期快速奖励的重组、对长期后果的评估减少、冲动和行为库的缩小（即，在一个人表现出偏好的事物集合中的限制）。为了处理这些成瘾症状，一种治疗方法是通过行为疗法的调整来开发冲动最小化技术。这些治疗技术传统上集中在成瘾的心理社会措施，可能难以量化或客观地改变。成瘾神经科学的最新进展揭示了奖赏/厌恶回路的强大改变沿着成瘾中可能适用于行为技术的实验心理学变量。具体来说，结构和功能磁共振成像测量的前额叶皮层，指向局部差异，可以连接到一个关键的压力为基础的表型的相对偏好，量化他们的限制行为的剧目。技术和计算的进步表明，这些神经科学措施可能会被用于行为治疗。为此，该项目制定了一系列里程碑，作为R21提案，以开发（a）基于单体素和双体素光谱的高SNR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，用于基于行为和BOLD信号向个人提供反馈;（c）将成像、实验心理学和反馈平台与扫描仪中的受试者相结合。在成功实现这些里程碑之后，将另一组里程碑组织为R33提案，以证明：（d）这些技术可用于监测受试者的脑信号调制和相对偏好表型，（e）在现实测试条件下整合脑信号调制和按键响应，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的里程碑是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：本计画将发展一种方法，让成瘾者自我调节其大脑反应及药物偏好的行为表型。具体来说，来自大脑区域的实时反馈涉及改变对药物使用的判断和决策，将与偏好行为中类似法律模式的定量测量相结合，因此个人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.