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

摘要/项目摘要：项目#3 在成瘾个体中，暴露于条件性药物线索（例如，paraffernalia）eleleventh渴望：该 吸毒的欲望1.渴望越来越被认为是成瘾的一个重要因素， 一般情况下，尤其是在吸烟2 -7。事实上，它已被证明可以预测吸烟和复吸 戒断后8 -16，表明需要治疗以减轻线索诱导的渴望的影响17。 一致的是，在调节渴望（认知控制的一种形式）的技能训练是许多的重要特征， 干预7，18-22，包括认知行为疗法23，24和基于正念的治疗25，26。 渴求及其调节具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前额叶皮质27 -29。我们开发了渴望的规则 (ROC)任务30 -35研究与渴求调节相关的神经机制。在这项任务中， 尼古丁依赖性吸烟者暴露于与吸烟相关的刺激。在一种情况下，他们会有渴望， 而在另一种情况下（调节条件），他们被指示使用一种策略来调节他们对食物的渴望。 31.研究表明，自我报告的渴望和与渴望相关的神经活动是显著的。 在调节条件下减少32，34，36.然而，调节的确切神经机制 操作取决于所使用的策略。具体来说，认知策略对渴求的调节取决于 前额叶区域的激活，通常与认知控制相关，如背外侧和 ventrolateral prefrontal cortex腹外侧前额叶皮层32，36-38.然而，正念策略的调节不涉及PFC 34。 我们建议，在调节烟瘾方面进行简短的培训可能会增加戒烟的效果 治疗，但在认知与正念为基础的策略培训可以通过不同的操作 心理和神经机制。我们建议通过随机抽取126名受试者， 吸烟者要具备以下条件：1）短暂的渴求认知调节训练+标准 治疗，2）正念训练+标准治疗，3）标准治疗（无训练）。 培训将在为期四周的4x 1小时计算机课程中进行，并进行为期8周的随访。我们 将通过自我报告和功能测试来评估训练对渴望和渴望调节的影响。 磁共振成像在ROC任务期间给予治疗前和治疗后，以及吸烟。 这个项目有望推进我们对渴望的心理和神经生物学理解， 它的规则，这些过程如何在特定类型的培训中变化，以及它们如何与实际的 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，目的是发现治疗结果的潜在精确生物学预测。

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.