NRT & Bupropion Mechanisms of Efficacy in Smokers

描述（由申请人提供）：本修订提案的第一个目的是准确评估3个不同治疗组（1)安非他酮SR （BIJP), 2）透皮尼古丁贴片（TNP）和3）安慰剂戒烟66天的戒烟症状和相关生物行为指标的持续时间和轨迹。研究的敏感性和准确性将通过使用旨在最大化禁欲和最小化研究退出的程序来最大化。第二个目标是描述BUP和TNP促进禁欲的大脑和心理机制。虽然BUP和TNP在促进戒烟方面的功效已被反复证明，但对这种功效的机制知之甚少。这一竞争性继续建议的最终主要目标是表征心理和大脑机制在介导BUP和TNP对戒烟和戒断症状的有益作用方面的个体差异。第二个目标是评估一系列创新的大脑和注意力和影响的生物行为测量来预测复发的能力。

DESCRIPTION (provided by applicant): The first aim of this revised proposal is to accurately assess the duration and trajectories of smoking abstinence symptoms and associated biobehavioral indices across 66 days of quitting smoking in 3 different treatment groups: 1) bupropion SR (BIJP), 2) transdermal nicotine patch (TNP), and 3) a placebo. Study sensitivity and accuracy will be maximized by using procedures designed to maximize abstinence and minimize study dropout. The second aim is to characterize brain and psychological mechanisms by which BUP and TNP promote abstinence. While the efficacies of BUP and TNP in promoting smoking abstinence have been repeatedly demonstrated little is known about the mechanisms mediating this efficacy. The final primary goal of this competitive continuation proposal is to characterize individual differences in psychological and brain mechanisms mediating the beneficial effects of BUP and TNP on smoking abstinence and withdrawal symptoms. A secondary goal is to assess the ability of a battery of innovative brain and biobehavioral measures of attention and affect to predict relapse. To achieve these goals the effects of quitting smoking with or without the help of TNP and BUP will be assessed intensively across 66 days of abstinence, Dependent measures will be mood, vigilance, attentional bias to smoking and emotional stimuli, and related physiological measures (resting EEC activation and activation asymmetry indices of affective states and traits, and event-related potential activity elicited by emotional and smoking stimuli). Smokers will be randomly assigned to one of three immediate-quit groups (N = 80 per group): (1) bupropion + placebo patch (2) placebo pill ¿ nicotine patch, and (3) placebo pill + placebo patch or to a fourth (control) group (N = 60) that will quit after the final experimental session (after the other subjects have completed their 66-day abstinence period). Subjects in the 3 treatment groups and the control group will have the same set of biobehavioral measures assessed during the experimental sessions at the same points in time. It is hypothesized that BUF and TNP will have both common and unique mechanisms by which they reduce withdrawal symptoms and that gender and personality traits will moderate the effects of these treatments. (Note,* To avoid final-session mood and arousal effects subjects will actually quit for 67 days, but biobehavioral measures will be collected on the 66 day of abstinence