Longitudinal investigation of TMS as a tool to improve alcohol treatment outcomes

TMS 作为改善酒精治疗结果工具的纵向调查

• 批准号: 10052962
• 负责人: Colleen A Hanlon
• 金额: $ 66.4万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10052962
• 关键词: Longitudinal; investigation; TMS; tool; improve

With advances in optogenetic stimulation techniques, preclinical studies have demonstrated that activity in frontal-striatal neural circuits has a causal influence on heavy drinking and alcohol reinstatement. Clinically, however, we have not yet translated this research into a neural circuit based therapeutic technique for patients with alcohol use disorder (AUD). The long term goal of our multidisciplinary research team is to determine the optimal parameters through which non- invasive theta burst stimulation (TBS – a patterned form or transcranial magnetic stimulation) can be used to improve alcohol drinking outcomes (abstinence, heavy drinking days) among individuals seeking behavioral treatment for AUD. Building on a foundation of several target identification studies and a small double blinded clinical trial in treatment-engaged AUD patients by our group, here we propose a double-blind placebo controlled, randomized study to evaluate the relative efficacy of 2 potential TBS treatment strategies for alcohol use disorder. Specifically, using the existing infrastructure of the MUSC Intensive Outpatient treatment Program, consenting participants will be randomized to receive real or sham TBS delivered to the ventral medial prefrontal cortex (mPFC), or dorsolateral prefrontal cortex (dlPFC) for 20 sessions (2x/day, 10 days) immediately before their daily intensive outpatient therapy sessions. The scientific premise of this 5 year R01 proposal is that, by modulating the neural circuits that regulate alcohol cue-reactivity (Strategy 1, Aim 1, mPFC) or executive control (Strategy 2, Aim 2, dlPFC) it will be possible to increase alcohol abstinence rates and decrease heavy drinking days over a 4 month period. With our combined scientific expertise in brain stimulation (Hanlon, neuroimaging (Schacht and Hanlon), alcohol use disorder research (Schacht, Anton, Book), and clinical practice with AUD patients (Book, Smith) our research team at MUSC is uniquely suited to develop this critical line of research. The outcomes of these Aims will provide an evidence-based foundation for a multisite clinical trial and will hasten progress towards developing a new neural circuit based treatment for patients with AUD.

随着光遗传学刺激技术的进步，临床前研究已经证明， 额叶-纹状体神经回路的活动对大量饮酒和酒精有因果关系 复职然而，在临床上，我们还没有将这项研究转化为神经回路 酒精使用障碍（AUD）患者的治疗技术。的长期目标 我们的多学科研究团队是为了确定最佳参数， 侵入性theta爆发刺激（TBS --一种模式化形式或经颅磁刺激）可以 用于改善饮酒结果（戒酒，酗酒日）， 寻求AUD行为治疗的个人。建立在几个目标的基础上 在接受治疗的AUD患者中进行的识别研究和小型双盲临床试验 在这里，我们提出了一个双盲安慰剂对照，随机研究，以评估 2种潜在TBS治疗策略对酒精使用障碍的相对疗效。具体地说， 使用MUSC强化门诊治疗计划的现有基础设施，同意 参与者将随机接受递送至腹内侧的真实的或假TBS 前额叶皮层（mPFC）或背外侧前额叶皮层（dlPFC），持续20次（2次/天，10 天），然后立即进行每日强化门诊治疗。科学 这个5年R 01提案的前提是，通过调节调节酒精的神经回路， 线索反应（策略1，目标1，mPFC）或执行控制（策略2，目标2，dlPFC），它将是 有可能在4个月内提高戒酒率并减少酗酒天数 期凭借我们在脑刺激（汉隆，神经成像）方面的综合科学专长， （Schacht和Hanlon），酒精使用障碍研究（Schacht，Anton，Book）和临床实践 对于AUD患者（Book，Smith），我们在MUSC的研究团队非常适合开发这种方法。 研究的关键路线。这些目标的成果将提供一个基于证据的基础 进行多点临床试验，并将加速开发一种新的神经回路， 治疗AUD患者。