Error Detection and Error Awareness in Incarcerated Cocaine Dependent Individuals

描述（由申请人提供）：现实世界的经验和临床研究表明，物质依赖的个人将继续使用药物，尽管往往强烈的愿望停止服用药物。这表明依赖性的主要特征是抑制功能失调的动作模式的能力降低，尽管有明确的证据表明它们适应不良（Paulus et al.，2002年）。越来越多的行为、认知、电生理和神经成像研究表明，可卡因依赖者对内部和外部产生的错误信号表现出核心不敏感。这种不敏感性可能会降低指导适应性行为调节的能力，并可能促进对功能失调行为模式的持续性增加，包括重复吸毒行为和共病犯罪。然而，尽管有越来越多的工作，这些错误监控缺陷的性质在很大程度上仍然没有区别。错误监控至少由两个潜在的独立过程组成：一个是自动错误检测系统，用于监控目标导向行为中的错误，另一个是与错误的意识表征相关的自动化程度较低的系统。在物质依赖人群中评价错误监测的大部分工作都集中在错误检测上，并报告了一致的损害。然而，目前对可卡因依赖人群的主观错误意识状态知之甚少，这排除了关于这些错误监测缺陷的基本性质的确切结论。最近的发展已经确定了系统地询问错误检测和错误意识指数的方法。本提案旨在使用多模态成像（ERP/fMRI）的特点的完整性，神经回路从事自动和有意识的错误监测组件在监禁可卡因依赖的个人。为此，MIND研究所最近购置了一台最先进的移动的磁共振成像扫描仪，目前部署在西新墨西哥州教养所。在过去的两个月里，我们在这个设施内完成了235次扫描，并认为移动的扫描仪提供了一个前所未有的机会来检查被监禁人群中与错误监控有关的神经认知系统。在这里，我们建议利用高分辨率的电生理和功能磁共振成像，以评估15个监禁可卡因依赖的个人，15个匹配的监禁非依赖的个人，和15个匹配的非监禁健康对照的错误监控系统的完整性。我们假设，监禁可卡因依赖的个人将显示减少错误意识，这种损害将预测相关的结果措施，包括药物使用的严重程度和共病犯罪活动的水平。我们的目标是使用I/START机制为我们预期的协议提供支持，该协议将作为更大，更全面的研究奋进的试点数据，重点关注可卡因依赖个体对错误监测完整性的神经认知影响。药物成瘾的慢性和重复性表明，药物依赖者可能难以识别和学习他们的适应不良行为模式。这些学习缺陷可能是由于识别和监测目标导向行为错误的过程中的核心障碍引起的，并可能导致持续吸毒和累犯犯罪倾向。本研究将收集电生理（EEG）和功能性磁共振成像（fMRI）数据，从监禁可卡因依赖的individals，以更好地表征这些错误监测缺陷的性质。这项工作的结果将有助于说明依赖和共病犯罪的机制，并将提供更多的见解，能够针对这些认知能力受损的药物依赖人群的治疗。

DESCRIPTION (provided by applicant): Real-world experience and clinical research converge in demonstrating that substance-dependent individuals will continue to use drugs despite an often strong desire to cease taking drugs. This suggests that a cardinal characteristic of dependency is reduced ability to inhibit dysfunctional action patterns despite clear evidence of their maladaptivity (Paulus et al., 2002). A growing body of behavioral, cognitive, electrophysiological and neuroimaging work suggests that cocaine-dependent individuals evidence core insensitivity to internally- and externally-generated signals of error. This insensitivity may reduce the ability to guide adaptive behavioral regulation, and may promote increased perseveration on dysfunctional action patterns, including repetitive drug-taking behavior and comorbid criminality. Despite this growing body of work, the nature of these error- monitoring deficits remains largely undifferentiated, however. Error-monitoring is composed of at least two potentially independent processes: an automatic error detection system that monitors for errors in goal-directed behavior and a less automatic system related to the conscious representation of that error. The majority of work evaluating error-monitoring in substance-dependent populations has focused on error-detection, and has reported consistent impairment. Little is currently understood regarding the state of subjective error-awareness in cocaine-dependent populations, however, which precludes firm conclusions regarding the underlying nature of these error-monitoring deficits. Recent developments have identified methods of systematically interrogating indices of error-detection and error-awareness, respectively. The present proposal seeks to use multi-modal imaging (ERP/fMRI) to characterize the integrity of neural circuits engaged in automatic and conscious components of error monitoring in incarcerated cocaine-dependent individuals. To this end, the MIND Institute has recently acquired a state-of-the-art mobile MRI scanner, currently deployed at the Western New Mexico Correctional Facility. In the last two months, we have completed 235 scanning sessions within this facility, and feel that the mobile scanner presents an unprecedented opportunity to examine the neurocognitive systems implicated in error- monitoring within incarcerated populations. Here we propose to utilize high-resolution electrophysiology and functional magntetic resonance imaging to assess the integrity of error-monitoring systems within 15 incarcerated cocaine-dependent individuals, 15 matched incarcerated non-dependent individuals, and 15 matched non-incarcerated healthy controls. We hypothesize that incarcerated cocaine-dependent individuals will show reduced error awareness, and that this impairment will predict relevant outcome measures including drug-use severity and level of comorbid criminal activity. Our goal is to use the I/START mechanism to provide support for a protocol we anticipate serving as pilot data for a larger, more comprehensive research endeavor focused on neurocognitive influences on error-monitoring integrity in cocaine-dependent individuals. The chronic and repetative nature of drug-addiction suggests that drug-dependent individuals may have difficulty identifying, and learning from, their maladaptive behavioral patterns. These learning deficits may arise from core impairment in processes underlying the identification and monitoring of errors in goal-directed behavior, and may lead to continued drug use, and recidivistic criminal tendencies. The present study will collect electrophysiological (EEG) and functional magnetic resonance imaging (fMRI) data from incarcerated cocaine-dependent individals in order to better characterize the nature of these error-monitoring deficits. The results of this work will aid delineation of mechanisms of dependency and comorbid criminality, and will provide increased insight into treatments capable of targeting those cognitive capacities damaged in drug-dependent populations.