Longitudinal study of functional connectivity among cocaine users in treatment

可卡因使用者在治疗中功能连接的纵向研究

• 批准号: 9067266
• 负责人: Colleen A Hanlon
• 金额: $ 33.06万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9067266
• 关键词: Abstinence; Aftercare; Attenuated; Base of the Brain; Behavioral; Brain; Brain region; Chronic; Cocaine Users; Cognitive; Cognitive Therapy; Corpus striatum structure; Cues; Data; Dorsal; Drug usage; Elements; Environment; Foundations; Functional Magnetic Resonance Imaging; Goals; Health; Image; Individual; Insula of Reil; Knowledge; Literature; Longitudinal Studies; Magnetic Resonance Imaging; Medial; Neurosciences; Outcome; Outcome Measure; Outpatients; Pharmaceutical Preparations; Physiologic pulse; Prefrontal Cortex; Process; Recording of previous events; Recruitment Activity; Relapse; Sampling; Signal Transduction; Substance Use Disorder; Testing; Time; Transcranial magnetic stimulation; Treatment outcome; Urine; Ventral Striatum; addiction; clinically relevant; cocaine relapse; cocaine use; cognitive control; cohort; comparison group; cue reactivity; evidence base; executive function; gray matter; knowledge of results; neural circuit; neuroimaging; non-drug; novel; peer; relapse prediction; repetitive transcranial magnetic stimulation; treatment program; treatment strategy

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.

描述（由申请人提供）：长期使用可卡因是最难治疗的物质使用障碍之一。高复发率可能是由于边缘和认知因素的综合作用，包括对显着边缘线索的脆弱性和执行控制的丧失，这可能是由于边缘神经回路的功能连接性升高（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接性较低（例如背外侧前额叶皮层之间） （DLPFC）和背侧纹状体）。这项纵向成像研究的总体目标是使用新型 TMS/fMRI 探头来确定执行回路和边缘回路完整性之间的关系，因为它与 强化门诊治疗计划后的即时和长期结果。这将通过评估基线时寻求治疗的可卡因使用者和非药物使用对照的功能连接（目标 1）以及 28 天认知行为治疗计划（仅限用户）后功能连接的变化来实现（目标 2）。我们还将确定这些回路的完整性与基线后 60 天和 90 天的有临床意义的结果测量之间的关系（目标 3）。这些目标产生的基本神经科学知识涉及执行（例如 DLPFC）和边缘（例如 MPFC）回路连接对成瘾治疗结果的重要性。这些数据将提供重要的基础 该领域可以据此开发基于证据的脑刺激治疗策略（例如重复 TMS），以增强寻求治疗的个体之间的 DLPFC 连接性。