The use of qEEG in predicting relapse among AUD Veterans to improve treatment and function

使用 qEEG 预测 AUD 退伍军人的复发，以改善治疗和功能

• 批准号: 10311100
• 负责人: MO MODARRES
• 金额: --
• 依托单位: EDITH NOURSE ROGERS MEMORIAL VETERANS HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10311100
• 关键词: 20 year old; Abstinence; Acute; Affect; Alcohol abuse; Alcohol consumption; Alcohols; Attention; Behavior; Biological Markers; Brain; Brain region; Chronic; Clinical; Clinical assessments; Cognitive; Coin; Complex; Consumption; Cues; Data; Disease remission; Drug Metabolic Detoxication; Economics; Electroencephalogram; Electroencephalography; Electrophysiology (science); Enrollment; Environment; Exercise; Eye; Family; Functional disorder; Future; Goals; Impulsivity; Individual; Inpatients; Interpersonal Relations; Investigation; Knowledge; Legal; Length; Life; Literature; Measurement; Measures; Medical; Medical Records; Mental disorders; Methodology; Methods; Monitor; Morbidity - disease rate; Neuropsychological Tests; Neuropsychology; Outcome; Participant; Patients; Personal Satisfaction; Persons; Physiological; Pilot Projects; Play; Post-Traumatic Stress Disorders; Probability; Problem Solving; Process; Quality of life; Questionnaires; Relapse; Reporting; Research; Research Design; Research Personnel; Rest; Risk Factors; Role; Site; Sleep; Social Network; Surveys; Technology; Time; Translational Research; Validation; Veterans; acceptability and feasibility; accurate diagnosis; activity marker; addiction; alcohol effect; alcohol relapse; alcohol use disorder; base; clinical practice; cognitive function; craving; daily functioning; disorder later incidence prevention; executive function; follow up assessment; frontal lobe; genetic risk factor; high risk; improved; improved functioning; innovation; insight; modifiable risk; mortality; neurophysiology; novel strategies; optimal treatments; patient oriented; prevent; programs; reduced alcohol use; relapse patients; relapse prediction; response; satisfaction; sobriety; substance use treatment; treatment planning; treatment program

Alcohol Use Disorder (AUD) is a varied and complex psychiatric disorder involving the interactions of behavior, environment, and genetic risk factors and has a significant adverse impact on functioning. To improve functioning for those suffering from AUD, it is imperative that we understand the modifiable risk factors for each Veteran across various domains, to discover how to better predict relapse. There is extensive literature demonstrating the deleterious effects of chronic alcohol abuse can have on brain function. There has been less attention, however, devoted to translational research that focuses on methods that may provide more accurate diagnosis and predict relapse among individuals with AUD, which in turn may guide treatment plans and better meet the medical and psychiatric needs of Veterans and improve functioning. The use of neuro-electrophysiological measures provides a potentially powerful way to assist in predicting the likelihood of relapse, with the potential of informing the best type and length of treatment necessary for each individual. Quantitative electroencephalogram (qEEG) has shown encouraging predictive power of relapse, especially when using fast beta activity isolated in the frontal lobes. Specifically, beta activity and the dysfunction observed in the frontal lobes may serve as an accurate predictor of alcohol relapse. Despite promising research in this field, only a handful of empirical studies exist that describe the use and predictive accuracy of beta activity for determining whether an individual will relapse, and no study to-date attempted to adapt these findings for clinical utility. Currently, the measurement of beta activity is a relatively ambiguous description of brain activity and would benefit from further investigation into its possible clinical and neuropsychological meaning along with potential functional correlates. The frontal lobes are implicated in executive functioning processes, including planning, response inhibition/impulse control, problem-solving, set-shifting, and goal-directed behavior. Many of these cognitive functions play a crucial role in substance use treatment completion and outcomes. Therefore, to better understand the neuropsychological meaning of the beta dysfunction within the frontal lobes and to provide insight and cross-validation of possible covarying cognitive function related to beta dysfunction, the assessment of executive functioning via measures is needed. In addition, there has been much research investigating the role of impulsivity and craving within the addiction literature. Craving has been shown to predict the probability of relapse as well as the extent of consumption following abstinence. Research has also demonstrated a positive association between cue-induced craving affect beta activity. Lastly, quality of life has been demonstrated to improve with more prolonged remission, and it has been suggested that higher levels of life satisfaction may protect against future relapse. Given these established findings, we will ask participants to complete a battery of alcohol-related and clinical and functional questionnaires and neuropsychological tests to explore the relationships between beta activity, cognitive function, and addiction in order to improve the quality of life of Veterans with AUD. This pilot study has two primary aims: 1) to assess the feasibility and acceptability of the proposed qEEG and other physiological, neuropsychological, clinical, and functional measures assessment to predict alcohol relapse among Veterans with AUD being discharged from an inpatient acute psychiatric and detoxification unit and 2) to investigate possible differences in EEG activity and connectivity among Veterans who relapse and those who do not and explore possible physiological, neuropsychological, clinical, and functional covariates to improve the Veterans’ functioning and quality of life.

Alcohol Use Disorder (AUD) is a varied and complex psychiatric disorder involving the interactions of behavior, environment, and genetic risk factors and has a significant adverse impact on functioning. To improve functioning for those suffering from AUD, it is imperative that we understand the modifiable risk factors for each Veteran across various domains, to discover how to better predict relapse. There is extensive literature demonstrating the deleterious effects of chronic alcohol abuse can have on brain function. There has been less attention, however, devoted to translational research that focuses on methods that may provide more accurate diagnosis and predict relapse among individuals with AUD, which in turn may guide treatment plans and better meet the medical and psychiatric needs of Veterans and improve functioning. The use of neuro-electrophysiological measures provides a potentially powerful way to assist in predicting the likelihood of relapse, with the potential of informing the best type and length of treatment necessary for each individual. Quantitative electroencephalogram (qEEG) has shown encouraging predictive power of relapse, especially when using fast beta activity isolated in the frontal lobes. Specifically, beta activity and the dysfunction observed in the frontal lobes may serve as an accurate predictor of alcohol relapse. Despite promising research in this field, only a handful of empirical studies exist that describe the use and predictive accuracy of beta activity for determining whether an individual will relapse, and no study to-date attempted to adapt these findings for clinical utility. Currently, the measurement of beta activity is a relatively ambiguous description of brain activity and would benefit from further investigation into its possible clinical and neuropsychological meaning along with potential functional correlates. The frontal lobes are implicated in executive functioning processes, including planning, response inhibition/impulse control, problem-solving, set-shifting, and goal-directed behavior. Many of these cognitive functions play a crucial role in substance use treatment completion and outcomes. Therefore, to better understand the neuropsychological meaning of the beta dysfunction within the frontal lobes and to provide insight and cross-validation of possible covarying cognitive function related to beta dysfunction, the assessment of executive functioning via measures is needed. In addition, there has been much research investigating the role of impulsivity and craving within the addiction literature. Craving has been shown to predict the probability of relapse as well as the extent of consumption following abstinence. Research has also demonstrated a positive association between cue-induced craving affect beta activity. Lastly, quality of life has been demonstrated to improve with more prolonged remission, and it has been suggested that higher levels of life satisfaction may protect against future relapse. Given these established findings, we will ask participants to complete a battery of alcohol-related and clinical and functional questionnaires and neuropsychological tests to explore the relationships between beta activity, cognitive function, and addiction in order to improve the quality of life of Veterans with AUD. This pilot study has two primary aims: 1) to assess the feasibility and acceptability of the proposed qEEG and other physiological, neuropsychological, clinical, and functional measures assessment to predict alcohol relapse among Veterans with AUD being discharged from an inpatient acute psychiatric and detoxification unit and 2) to investigate possible differences in EEG activity and connectivity among Veterans who relapse and those who do not and explore possible physiological, neuropsychological, clinical, and functional covariates to improve the Veterans’ functioning and quality of life.