Neuroimaging & Cognition for Predicting Tobacco Dependence Treatment Outcomes

尽管在调查和宣传烟草依赖的健康风险方面作出了协调一致的努力， 数以百万计的美国人继续长期吸烟。吸毒者的吸烟率是 一般民众的生活质量和健康受到越来越昂贵的影响。例如更 接受丁丙诺啡维持治疗阿片样物质依赖者中超过80%吸烟。最近 研究表明，吸烟对大脑形态、血流、生物化学和 认知.这些与吸烟有关的大脑异常与慢性吸毒者的大脑异常相似， 涉及奖励回路的主要组成部分，涉及各种形式的 成瘾烟草依赖也与药物滥用后非烟碱类药物使用水平较高有关 治疗阿片类药物和烟草联合依赖对神经生物学和行为的影响尚未得到证实。 已经系统地评估了它与这一人群中高吸烟复吸率的关系， 明白最近的研究表明，奖励回路的异常是复发的主要原因 在所有药物使用中，阿片类药物使用者在烟草依赖治疗中缺乏相应的证据。 该组件的主要目的是a）获得磁共振衍生和神经认知 阿片类药物依赖个体额叶皮层下脑回路完整性的测量 丁丙诺啡替代疗法，然后再进行扩展的创新烟草依赖治疗，B） 确定这些措施是否区分成功和不成功的戒烟者，以及c）确定他们的能力 在治疗随机化后3、6、12和18个月时的pnedlct \obstructive依赖治疗反应。 探索性遗传学研究将解决选择单核苷酸多态性对主要遗传因素的影响。 神经生物学和治疗结果的措施，以及这些多态性对戒烟率的影响。 这项研究的首要目的是在中心现有框架内， 在UCSF的两个富有成效的研究团队之间开展独特的合作， 多年来，我们一直致力于帮助减少药物滥用对社会的总体影响。这一多学科组成部分， 作为扩展和创新烟草依赖治疗的更大临床试验的一部分， 预计将增加我们对神经生物学和认知缺陷的程度的理解， 以及特定的基因型有助于个人保持长期戒烟的能力。

Despite concerted efforts at investigating and disseminating the health risks of tobacco dependence, millions of Americans continue to smoke chronically. Drug abusers have twice the smoking rate of the general population and suffer increasingly costly quality of life and health consequences. For example, more than 80% of opioid dependent individuals on buprenorphine maintenance therapy smoke cigarettes. Recent research suggests that cigarette smoking adversely affects brain morphology, blood flow, biochemistry, and cognition. These smoking-related brain abnormalities resemble those observed in chronic drug use and involve major components of the reward circuit, implicated in the initiation and maintenance of all forms of addiction. Tobacco dependence is also related to higher levels of non-nicotinic drug use after drug abuse treatment. The impact of combined opioid and tobacco dependence on neurobiology and behavior has not been evaluated systematically, and its relations to high smoking relapse rates in this population are poorly understood. Recent research implicates abnormalities in the reward circuitry as major contributor to relapse in all drug use, but corresponding evidence from opioid users in tobacco dependence treatment is lacking. The main purpose of this component is to a) obtain magnetic resonance-derived and neurocognitive measures of the integrity of frontal-subcortical brain circuits in opioid dependent individuals on buprenorphine replacement therapy before their extended, innovative tobacco dependence treatment, b) determine if these measures diffenentiate successful and unsuccessful quitters, and c) determine their ability to pnedlct \obacco dependence treatment response at 3, 6, 12, and 18 months after treatment randomization. Exploratory genetic studies will address the influence of select single nucleotide polymorphisms on the main neurobiological and treatment outcome measures and the impact of these polymorphisms on quit rates. The overarching purpose of this research is to enable - within the existing framework of the Center - the development of a unique collaboration among two productive research teams at UCSF that both have aimed for many years to help reduce the overall impact of drug abuse on society. This multidisciplinary component, performed as part of a larger clinical trial of extended and innovative tobacco dependence treatment, is expected to increase our understanding of the extent to which neurobiological and cognitive deficiencies as well as specific genotypes contribute to an individual's ability to maintain long-term tobacco abstinence.