Long-Term Abstinence Clinical Issues and CNS Disinhibition

长期戒酒的临床问题和中枢神经系统抑制解除

基本信息

批准号：
8120879
负责人：
George Fein
金额：
$ 75.27万
依托单位：
NEUROBEHAVIORAL RESEARCH, INC.
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-01 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8120879
关键词：
4-aminospiroperidol Abstinence Affect Age Alcohol abuse Alcohol dependence Alcoholism Alcohols Amygdaloid structure Antisocial Personality Disorder Anxiety Anxiety Disorders Area Behavior Brain Cerebellum Characteristics Chronic Clinical Cognitive Communities Comorbidity Corpus Callosum Data Decision Making Diagnosis Diagnostic Diffusion Disease Disinhibition Drug Addiction Drug abuse Drug usage EP300 gene Equilibrium Event Family history of Future Gait Gambling Gender Goals Health Hippocampus (Brain)Image Impairment Impulsivity Individual Inherited Iowa Laboratories Light Longitudinal Studies Magnetic Resonance Imaging Measurement Measures Mental disorders Mood Disorders Moods Neurobiology Neurologic Nicotine Pharmaceutical Preparations Population Predisposition Prevalence Procedures Process Psychiatric Diagnosis Recording of previous events Recovery Recruitment Activity Research Rewards Role Sampling Sampling Studies Socialization Societies Structure Subgroup Substance Addiction Suggestion Symptoms System Testing Tissues Visual Visuospatial Woman Work addiction anti social base behavior test cognitive function cognitive recovery cohort deviant disability drinking drug/alcohol abstinence executive function gray matter improved information processing meetings men problem drinker psychologic success

项目摘要

DESCRIPTION (provided by applicant): Over the past years, our laboratory has been studying long-term abstinent alcoholics (LTAAs). The data from those studies are unique and of potential great importance. We have found: 1) essentially normal cognitive functioning, 2) decision- making impairments and reduced gray matter volumes in an area (the amygdala) implicated in decision making impairments in neurologic samples, 3) reduced visual P300 amplitudes and delayed latencies, 4) greater lifetime and current prevalence of psychiatric disorders, suggesting that alcoholics can achieve and maintain long-term abstinence in the face of an ongoing psychiatric disorder, 5) substantial comorbid psychiatric illness that consisted primarily of sub-diagnostic symptoms and abnormal scores on psychological measures, 6) greater comorbid psychiatric disturbance in LTAAs vs. normal controls, even if individuals with lifetime or current psychiatric diagnoses were excluded, 7) that current symptoms of Antisocial Personality Disorder were minimal despite evidence of deviance proneness, impulsivity and poor decision- making, and 8) very recent data that the LTAAs have reduced cortical gray matter volumes compared than controls. The goals of the proposed research are to replicate and extend the above findings in larger samples, expanding the studies to include individuals with comorbid SUDs, who may differ substantially from LTAAs without comorbid SUDs with regard to cognitive recovery, comorbid psychiatric disturbance, and the function of disinhibitory brain systems. We have modified the psychiatric symptom assessment procedure to obtain a much clearer picture of ongoing psychiatric illness and changes in ASPD symptoms with long-term abstinence. Finally, we will also study individuals in the very first months of abstinence. A focus of the proposed research is whether the neurobiological disinhibitory underpinnings of externalizing illness have changed with abstinence, or whether the predisposition is unchanged, but is kept under wraps by higher cognitive functions. The study of individuals in early abstinence will enable us to compare long-term abstinence with early abstinence to see if there are suggestions that disinhibitory function is different in long-term vs. the first months of abstinence. PUBLIC HEALTH RELEVANACE This project will examine long-term abstinent alcoholics to replicate and extend our earlier findings with regard to cognitive recovery, comorbid psychiatric disturbance, and the neurobiological underpinnings of the disinhibition/externalizing continuum, including whether, how, and to what extent these phenomena are modified in long-term abstinence. A major extension of the work will be to study samples with alcohol dependence alone vs. with alcohol dependence and other substance dependence. The proposed studies should help elucidate the clinical and neurobiological picture of long- term abstinence. We believe such data is essential. It is only by understanding the successes in dealing with chronic alcoholism among treated samples with significant comorbidity that society will be able to make significant progress in facilitating such successes in the future.

描述（由申请人提供）：在过去的几年中，我们的实验室一直在研究长期戒酒（LTAAS）。这些研究的数据是独一无二的，并且潜在的重要性。我们发现：1）本质上是正常的认知功能，2）决策 - 制定损害并减少灰色物质（杏仁核）（杏仁核），与神经系统样本的决策障碍有关，3），3）视觉p300振幅减少，并降低了延迟的延迟，4）延长的生命周期和当前的精神疾病，而不是精神上的疾病，则可以实现良好的范围，从而使酒精乱出的范围降低了，而不是进行酒精乱的范围。持续正在进行的精神障碍，5）主要由诊断症状组成的精神疾病，在心理学措施上主要由亚诊断症状和异常得分组成，6）在LTAAS中与正常控制中的综合精神病性障碍更大，即使患有生命周期或当前精神诊断的人的态度是无序的范围，即使是正常控制的范围，也是该疾病的范围，7）冲动性和决策不良，以及8）比对照组相比，LTAA的皮质灰质体积减少了。拟议的研究的目标是在较大的样本中复制和扩展上述发现，扩大研究以包括具有合并症的人，他们在认知恢复，合并症的精神病患者方面可能与没有合并症的LTAA有很大差异。我们已经修改了精神病症状评估程序，以获取持续的精神病和ASPD症状的变化，并长期禁欲的变化。最后，我们还将在禁欲的头几个月中研究个人。拟议的研究的重点是神经生物学的抑制性疾病的基础是否随着戒酒而改变，或者易感性是否没有变化，但通过更高的认知功能保留了倾向。对早期戒酒的个人的研究将使我们能够将长期的禁欲与早期的禁欲进行比较，以查看是否有建议在长期与禁欲的头几个月中是否有不同的抑制作用。公共卫生相关性该项目将研究长期戒酒，以复制和扩展我们关于认知恢复，合并症的精神病障碍以及对dis抑制/外部化连续性的神经生物学基础的早期发现，包括这些现象是否以及在多大程度上在长期陈述中进行了修改。这项工作的主要扩展将是仅研究酒精依赖性的样品与酒精依赖性和其他物质依赖性。拟议的研究应有助于阐明长期禁欲的临床和神经生物学图片。我们认为这些数据至关重要。只有了解与合并症相当合并症的处理样本中慢性酒精中毒的成功，社会将能够在未来促进这种成功方面取得重大进展。