Longitudinal study of functional connectivity among cocaine users in treatment

描述（由申请人提供）：慢性可卡因使用是最难治疗的物质使用障碍之一。复发率高可能是由于边缘和认知因素的结合，包括易受显著边缘信号的影响和执行控制的丧失。这可能是由于边缘神经回路的功能连通性升高（例如内侧前额叶皮层（MPFC）和腹侧纹状体之间）和/或执行控制回路的功能连通性降低（例如背外侧前额叶皮层（DLPFC）和背侧纹状体之间）。这项纵向成像研究的首要目标是使用新的TMS/fMRI探针来确定执行回路和边缘回路完整性之间的关系，因为它涉及到

DESCRIPTION (provided by applicant): Chronic cocaine use is among the most difficult substance-use disorders to treat. High relapse rates are likely due to a combination of limbic and cognitive factors, including vulnerability to salient limbic cues and loss of executive control This may be due to elevated functional connectivity in limbic neural circuitry (e.g. between the medial prefrontal cortex (MPFC) and ventral striatum) and/or lower functional connectivity in executive control circuitry (e.g. between the dorsolateral prefrontal cortex (DLPFC) and dorsal striatum). The overarching goal of this longitudinal imaging study is to use the novel TMS/fMRI probe to determine the relationship between executive and limbic circuit integrity as it relates to immediate and extended outcomes after an intensive outpatient treatment program. This will be achieved by assessing functional connectivity in treatment-seeking cocaine users and non-drug using controls at baseline (Aim1) and the change in functional connectivity after a 28-day cognitive- behavioral treatment program (users only)(Aim 2). We will also determine the relationship between the integrity of these circuits and clinically meaningful outcome measures 60 days and 90 days after baseline (Aim 3). The fundamental neuroscience knowledge resulting from these aims regarding the importance of executive (e.g. DLPFC) and limbic (e.g. MPFC) circuit connectivity to addiction treatment outcomes. These data will provide a critical foundation from which the field can develop evidence-based brain stimulation treatment strategies (such as repetitive TMS) to amplify DLPFC connectivity among treatment-seeking individuals.