IMAGING OPIOID RECEPTORS IN COCAINE ADDICTION TREATMENT

描述：(申请人摘要) 可卡因滥用是美国的一个主要公共卫生问题，但 对调节这种强化的神经化学途径知之甚少。 以及可卡因的其他特性。也没有对 停用可卡因后伴随的神经化学变化 治疗。众所周知，大脑的内源性阿片系统发挥着 在奖励机制中的重要作用，我们的实验室已经证明 C-11卡芬太尼与正电子发射计算机断层扫描脑内局部阿片类药物的应用 受体的增加与可卡因的渴求程度有关。 此外，我们已经证明，在接下来的4周零90天里 受监控的戒断许多可卡因成瘾者正常化或重新设置他们的 MU阿片受体增加，而其他阿片受体持续增加 级别。我们现在建议评估门诊治疗的效果 可卡因滥用对u阿片受体的影响。我们将比较两种治疗方式： 临时和非临时凭证管理。除了……之外 证明了治疗结果和大脑功能之间的联系，这些 研究将确定是否测量大脑局部阿片受体 在治疗过程中预测长期治疗结果 关于复吸可卡因的问题。这些调查的结果将 为开发和改进行为AS提供至关重要的见解 以及对可卡因成瘾患者的药物治疗。我们会 还分别研究和分析了男性和女性患者的数据 探讨可卡因成瘾的性别差异及治疗反应。 这项建议的具体目的是：1)确定 应急管理与变更的非或有凭证处理 慢性阻塞性肺疾病患者局部脑内MU阿片受体与可卡因的使用 可卡因成瘾；2)确定可卡因使用与 脑局部MU阿片受体在服药4周和12周后的PET变化 可卡因成瘾患者的治疗；以及3)确定是否有 服药12周后脑局部MU阿片受体的关系 治疗和治疗后可卡因的使用。

DESCRIPTION: (Applicant's Abstract) Cocaine abuse is a major public health problem in the United States, but little is known of the neurochemical pathways that mediate the reinforcing and other properties of cocaine. Nor is there an understanding of the neurochemical changes that accompany cessation of cocaine use following treatment. The brain's endogenous opioid system is known to play an important role in reward mechanisms and our laboratory has demonstrated by the use of C-11 carfentanil and PET scanning that regional brain mu opioid receptors are increased in relation to the degree of cocaine craving. Furthermore, we have demonstrated that following 4 weeks and 90 days monitored abstinence many cocaine addicts normalize or "reset" their increased mu opioid receptors whereas others have persistently elevated levels. We now propose to evaluate the effect of out-patient treatment of cocaine abuse on mu opioid receptors. We will compare 2 forms of treatment: contingent and non-contingent voucher management. In addition to demonstrating a link between treatment outcome and brain function, these studies will determine if measurement of regional brain opioid receptors during the course of therapy predict the long-term treatment outcome with regard to relapse to cocaine use. Results from these investigations will provide vital insights for the development and improvement of behavioral as well as medication treatment of patients with cocaine addiction. We will also separately study and analyze data from men and women patients to explore sex differences in cocaine addiction and the response to treatment. The specific aims of this proposal are: 1) Determine the effect of contingency management versus non-contingent voucher treatment on the change in regional brain mu opioid receptors and cocaine use in patients with cocaine addiction; 2) Determine the relationship between cocaine use and the change in regional brain mu opioid receptors by PET after 4 and 12 weeks of treatment in patients with cocaine addiction; and 3) Determine if there is a relationship between regional brain mu opioid receptors after 12 weeks of treatment and cocaine use after treatment.