Ambulatory assessment of cue-reactivity during naturalistic cue exposure in gamblers.

“线索反应”的概念，指的是对成瘾相关线索的条件神经元和心理生理反应，在人类成瘾神经科学中起着核心作用，涉及物质使用障碍和行为成瘾，如赌博障碍。尽管这一概念很流行，也有许多研究调查了线索反应性措施的临床应用（例如，调查治疗疗效或预测临床结果），但荟萃分析显示，在涉及的神经元系统和效应大小方面，存在实质性的异质性。其中一个因素可能是缺乏标准线索反应范式的生态有效性，这通常涉及在实验室中暴露于简单的单峰视觉线索。在此，我建议通过结合基于gps的地理定位跟踪和动态心理生理评估来提高赌徒自然线索暴露过程中主观和心理生理线索反应测量的生态有效性。赌博与遍布城市环境的特定场所（老虎机赌场，博彩设施）有关，我建议利用这些显著的环境线索来调查赌徒在现场设置中的线索反应。频繁的赌徒和匹配的对照组将沿着预先确定的城市路线移动，而主观渴望和心理生理线索反应分别使用电子瞬时评估和动态心理生理学进行评估。地理定位是通过GPS追踪的。据预测，赌徒的主观和心理生理线索反应是由直接暴露于线索位置和对熟悉的城市路线的预期影响共同塑造的。研究结果将揭示线索反应性（人类成瘾神经科学的一个核心概念）是否可以在现场环境下的线索暴露中测量，以及它是否像强化学习理论预测的那样是由预期形成的。

The concept of “cue-reactivity”, which refers to conditioned neuronal and psychophysiological responses to addiction-related cues, plays a central role in human addiction neuroscience, with respect to both substance use disorders and behavioral addictions such as gambling disorder. Despite the prevalence of the concept and numerous studies investigating the clinical utility of cue-reactivity measures (e.g. for investigating treatment efficacy or prediction of clinical outcomes), meta-analyses revealed substantial heterogeneity with respect to implicated neuronal systems and effect sizes. One contributing factor might be a lack of ecological validity of the standard cue-reactivity paradigm, which typically involves exposure to simple unimodal visual cues in the lab. Here I propose to improve ecological validity of subjective and psychophysiological cue-reactivity measures by combining GPS-based geolocation tracking and ambulatory psychophysiological assessment during naturalistic cue exposure in gamblers. Gambling is linked to specific venues (slot machine casinos, betting facilities) located throughout urban environments, and I propose to leverage these salient environmental cues to investigate cue-reactivity in gamblers in a field setting. Frequent gamblers and matched controls will move along pre-determined urban routes while subjective craving and psychophysiological cue-reactivity are assessed using electronic momentary assessment and ambulatory psychophysiology, respectively. Geolocation is tracked via GPS. Subjective and psychophysiological cue-reactivity in gamblers are predicted to be shaped by both direct exposure to cue locations and expectation effects specific to familiar urban routes. Results will shed light on whether cue-reactivity, a central concept in human addiction neuroscience, can be measured during cue exposure in a field setting, and whether it is shaped by expectation, as predicted by reinforcement learning theories.