tDCS to Decrease Opioid Relapse

经颅直流电刺激 (tDCS) 减少阿片类药物复发

• 批准号: 9788396
• 负责人: Ana M Abrantes
• 金额: $ 41.33万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9788396
• 关键词: Abstinence; Acute; Address; Adjuvant; Aftercare; Anodes; Brain; Buprenorphine; Caring; Cathodes; Clinical; Cognitive; Consumption; Critiques; Dropout; Drug Addiction; Drug usage; Functional Magnetic Resonance Imaging; Functional disorder; Heroin Users; Impulsivity; Informal Social Control; Intervention; Left; MRI Scans; Measures; Modeling; Motivation; Neurons; Opioid; Opioid user; Outcome; Participant; Persons; Pharmaceutical Preparations; Phase; Population; Prefrontal Cortex; Randomized; Relapse; Research Personnel; Rest; Rewards; Safety; Short-Term Memory; Substance Use Disorder; System; Techniques; Testing; Treatment Failure; Validation; Withdrawal Symptom; Work; addiction; base; behavior measurement; buprenorphine treatment; clinical care; clinical efficacy; cognitive control; craving; cue reactivity; follow-up; high risk; neurobehavioral; neuromechanism; neuroregulation; opioid epidemic; opioid use; opioid use disorder; overdose risk; portability; relating to nervous system; response; treatment duration; treatment response

Buprenorphine has emerged as a leading treatment for opioid use disorder (OUD), but recipients have high early relapse rates likely due to varying degrees of dysfunction within craving and cognitive control neuronal networks. Transcranial direct current stimulation (tDCS) may have promise as adjuvant treatment for buprenorphine initiators because considerable work on addictive substances suggests treatment targeted at the dorsolateral prefrontal cortex (DLPFC; region involved in self-regulation) may reduce craving and drug consumption. We will measure behavioral and brain responses following tDCS stimulation to the DLPFC delivered during cognitive control network (CCN) priming. Participants in their first week of prescribed buprenorphine will be assessed twice using FMRI, once prior to tDCS+CCN priming and again at the completion of 5 sessions of tDCS+CCN priming (one week later). Task-based and resting state functional connectivity will be used to examine networks associated with craving (CR) and cognitive control. In the UG3 phase (n=60), FMRI will provide validation of expected changes in these networks following tDCS stimulation. Go/no go criteria for the UH3 phase will be demonstration of greater FMRI change in any node of the CR or CCN networks AND greater change in subjective craving measured prior to (outside FMRI scan) or during an FMRI cue reactivity task following the tDCS+CCN priming intervention compared to sham tDCS+CCN priming. In the UH3 phase (n=100), we will perform a larger RCT (vs. sham control) to address long-term neurobehavioral outcomes, including opioid relapse, craving, and sustained fMRI changes. Because tDCS is safe, inexpensive and portable, if this intervention provides FMRI validation of targeted brain effects and produces clinical response, it could have great impact augmenting the care of persons entering buprenorphine treatment, a population at high risk for treatment failure.

丁丙诺啡已成为阿片类药物使用障碍（OUD）的主要治疗方法，但接受者的高 早期复发率可能是由于不同程度的功能障碍，在渴望和认知控制神经元 网络.经颅直流电刺激（tDCS）可能有希望作为辅助治疗， 丁丙诺啡引发剂，因为大量关于成瘾物质的研究表明， 背外侧前额叶皮层（DLPFC;参与自我调节的区域）可能会减少渴望和药物 消费我们将测量tDCS刺激DLPFC后的行为和大脑反应 在认知控制网络（CCN）启动期间传递。参与者在第一周的规定 丁丙诺啡将使用FMRI评估两次，一次在tDCS+CCN预充之前，另一次在 完成5次tDCS+CCN预充（一周后）。基于任务和静息状态功能 连通性将被用来检查与渴望（CR）和认知控制相关的网络。在UG 3 阶段（n=60），FMRI将提供tDCS刺激后这些网络中预期变化的验证。 UH 3阶段的通过/不通过标准将证明CR的任何节点的FMRI变化较大，或 CCN网络和更大的变化，在主观渴望之前（外部功能磁共振成像扫描）或期间测量， 与假tDCS+CCN相比，tDCS + CCN预激干预后的FMRI提示反应性任务 启动在UH 3阶段（n=100），我们将进行一项更大的RCT（与假手术对照相比），以解决长期 神经行为结果，包括阿片类药物复发，渴望和持续的fMRI变化。因为tDCS是 安全、廉价和便携，如果这种干预能提供针对大脑效应的功能磁共振成像验证， 产生临床反应，它可能会产生很大的影响，增加对进入丁丙诺啡的人的护理 治疗失败的高风险人群。