Neural activation patterns in cannabis- and amphetamine-dependent individuals: alterations after 28-days of abstinence and prospective associations with relapse risk

上瘾是世界范围内的一个主要健康问题。特别是，戒毒后对毒品的持续渴求和高复发率对个人和社会都是具有挑战性的问题。成瘾通常被定义为一种慢性、复发性神经生物学疾病，其特征是药物中毒、渴求、暴饮暴食和戒断，并伴随着对药物相关行为的失控。越来越多的证据表明，从吸毒到上瘾的转变与大脑回路中为认知、情感和动机服务的过程的改变有关。拟议的功能核磁共振项目旨在(1)检查大麻和苯丙胺成瘾者在动机和情绪处理方面常见和明显的变化，以及(2)评估这些变化在多大程度上代表了复发风险增加的共同或特定物质预测因素。为此，我们打算在吸食大麻或安非他明成瘾的个人进入当地一家专门诊所接受治疗之前，招募不同的样本。为了检查改变的动机和情绪过程，吸毒成瘾的样本将与一组不使用药物的对照组进行比较。为了控制物质摄入的混杂(亚)急性影响，所有参与者将在检查前接受28天的监督禁欲。为了进一步检查评估的行为和神经指标对动机和情绪功能以及复发风险的预测价值，参与者将在最初检查后进行为期12个月的跟踪调查。在功能磁共振检查中，三个领域的完整性将受到挑战，这三个领域是成功长期戒酒的关键：(I)情绪和行为调节，(Ii)压力调节，以及(Iii)对药物相关线索的反应性。我们预计，本项目的发现可能有助于确定复发风险增加的个人。此外，本项目的研究结果可能有助于为大麻和苯丙胺成瘾制定更有效和针对具体物质的治疗方法。

Addiction is a major health problem worldwide. In particular, the persistent drug craving after detoxification and the high relapse rates represent challenging problems for both the individual and society. Addiction has generally been defined as a chronic, relapsing, neurobiological disease characterized by drug intoxication, craving, bingeing, and withdrawal accompanied by loss of control over drug related behaviors. Converging lines of evidence suggest that the transition from drug use to addiction is associated with altered processing in brain circuits subserving cognition, emotion and motivation. The proposed functional MRI project aims to (1) examine common and distinct alterations in motivational and emotional processing in cannabis- and amphetamine-addicted individuals, and (2) to assess to what extend these alterations represent common or substance-specific predictors of an increased relapse risk. To this end we intend to recruit separate samples of individuals with either cannabis- or amphetamine-addictions before they enter treatment in a specialized local clinic. To examine altered motivational and emotional processing the drug-addicted samples will be compared with a group of non-using controls. To control for confounding (sub-)acute effects of substance intake all participants will undergo 28-days of supervised abstinence before the examination. To further examine the predictive value of the assessed behavioral and neural indices of motivational and emotional functioning and relapse risk participants will be followed-up for a period of 12 months after the initial examination. During the functional MRI examination the integrity of three domains will be challenged that are key to successful long-term abstinence: (i) emotional and behavioral regulation, (ii) stress regulation, and (iii) reactivity to drug-associated cues. We expect that the findings from the present project may help to identify individuals with an increased relapse risk. Moreover, the findings from the present project may help to develop more efficient and substance-specific treatment approaches for cannabis and amphetamine addiction.