Project #3 Regulation of Craving: Brief Neurocognitive Training & Neural Mechanis

项目

• 批准号: 8742768
• 负责人: Hedy Kober
• 金额: $ 38.72万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8742768
• 关键词: Abstinence; Address; Aftercare; Behavioral; Biological; Brain region; Cigarette Smoker; Cognitive; Cognitive Therapy; Cues; Data; Development; Diagnostic and Statistical Manual of Mental Disorders; Disease; Exposure to; Failure; Freedom; Functional Magnetic Resonance Imaging; Gender; Hour; Individual; Individual Differences; Intervention; Judgment; Lead; Link; Measurement; Measures; Meta-Analysis; Modeling; Motivation; Neurobiology; Neurocognitive; Nicotine; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Prefrontal Cortex; Process; Psychotherapy; Randomized; Regulation; Reporting; Research; Rewards; Smoker; Smoking; Smoking Behavior; Staging; Stimulus; Training; Treatment outcome; Ventral Striatum; Withholding Treatment; abstracting; addiction; base; cigarette smoking; cognitive control; computerized; craving; design; efficacy testing; experience; follow-up; improved; indexing; mindfulness; neurobiological mechanism; neuromechanism; psychologic; relating to nervous system; research and development; skills; skills training; smoking cessation; smoking relapse; standard care; trial comparing

Abstract/Project Summary: Project #3 In addicted individuals, exposure to conditioned drug cues (e.g., paraphernalia) elicits craving: the desire to use drugs1. Craving is increasingly recognized as an important contributory factor in addiction in general, and in cigarette smoking in particular2-7. Indeed, it has been shown to predict smoking and relapse following abstinence8-16, suggesting that treatments to mitigate the effects of cue-induced craving are needed17. Consistently, skills training in regulation of craving (a form of cognitive control) is an important feature of many interventions7, 18-22, including cognitive-behavioral therapy23, 24 and mindfulness-based treatments25, 26. Craving and its regulation have distinct neurobiological mechanisms. The neural correlates of craving include the ventral striatum and ventromedial prefrontal cortex27-29. We developed the Regulation of Craving (ROC) task30-35 to investigate the neural mechanisms associated with the regulation of craving. In this task, nicotine-dependent smokers are exposed to smoking-related stimuli. In one condition they experience craving, and in another (the regulation condition), they are instructed to use a strategy to modulate their craving for cigarettes31. Research has shown that self-reported craving and craving-related neural activity are significantly reduced during the regulation condition32, 34, 36. However, the exact neural mechanisms by which regulation operates depend on the strategy used. Specifically, regulation of craving with cognitive strategies depends on activation in prefrontal regions, typically associated with cognitive control, such as dorsolateral and ventrolateral prefrontal cortex32, 36-38. However, regulation with mindfulness strategies does not involve PFC34. We propose that brief training in regulation of craving may increase the efficacy of smoking cessation treatments, but that training in cognitive vs. mindfulness-based strategies may operate via different psychological and neural mechanisms. We propose to test the efficacy of such training by randomizing 126 cigarette smokers to the following conditions: 1) brief training in cognitive regulation of craving + standard treatment, 2) mindfulness-based training + standard treatment, and 3) standard treatment (no training). Training will be delivered in 4x1 hour computerized sessions over four weeks, with an 8-week follow-up. We will evaluate the effects of training on craving and regulation of craving measured by self-report and functional magnetic resonance imaging during the ROC task administered pre- and post- treatment, as well as smoking. This project promises to advance our psychological and neurobiological understanding of craving and its regulation, how these processes change during specific types of training, and how they relate to actual smoking behaviors. Results from this study hold potential to allow neurobiologically-targeted adaptation of current treatments, with an aim of discovering potentially precise biological predictions of treatment outcomes.

摘要/项目摘要：项目#3 在上瘾的人中，接触条件药物提示(例如，用具)会引起渴望： 吸毒的欲望1。渴望日益被认为是导致成瘾的一个重要因素 一般情况下，尤其是在吸烟方面2-7。事实上，它已经被证明可以预测吸烟和复发。 戒酒后8-16，这表明需要治疗来减轻线索诱导的渴望的影响17。 一直以来，控制渴望(一种认知控制)的技能培训是许多 干预措施7、18-22，包括认知行为疗法23、24和正念疗法25、26。 渴求及其调控有不同的神经生物学机制。渴望的神经关联 包括腹侧纹状体和腹内侧额前皮质27-29。我们开发了对渴望的调节 (ROC)任务30-35研究与渴望调节相关的神经机制。在这项任务中， 尼古丁依赖型吸烟者暴露在与吸烟相关的刺激中。在一种情况下，他们会经历渴望， 在另一种(调节条件)中，他们被指示使用一种策略来调节他们对 香烟31.研究表明，自我报告的渴望和与渴望相关的神经活动显著 在规则条件32、34、36期间减少。然而，调控的确切神经机制 运营取决于所使用的策略。具体地说，认知策略对渴望的调节依赖于 前额叶区域的激活，通常与认知控制有关，如背外侧和 腹外侧额叶皮质32，36-38。然而，正念策略的监管不涉及PFC34。 我们建议，短暂的渴望调节训练可以提高戒烟的效果。 治疗，但认知策略与正念策略的训练可能通过不同的方式进行 心理和神经机制。我们建议通过随机抽取126人来测试这种训练的有效性 吸烟者达到以下条件：1)短暂训练对渴求的认知调节+标准 治疗，2)正念训练+标准治疗，3)标准治疗(不训练)。 培训将在四周内以4x1小时的计算机化课程进行，并进行为期8周的后续培训。我们 我将通过自我报告和功能测试来评估训练对渴望的影响和对渴望的调节 在ROC任务中，磁共振成像在治疗前和治疗后进行，以及吸烟。 这个项目承诺促进我们对渴望和焦虑的心理和神经生物学理解 它的规则，这些过程在特定类型的培训中如何变化，以及它们如何与实际情况相关联 吸烟行为。这项研究的结果有可能使神经生物学靶向适应 目前的治疗方法，目的是发现对治疗结果的潜在精确的生物学预测。