Neural Phenotypes of Impulsive Choice in Recovery from Alcohol Dependence

描述（由申请人提供）：该项目有两个具体目标：SA 1。a）量化和表征AD与对照组在决策过程中对延迟、概率和奖励幅度的脑反应的参数变化。B）量化大脑连接的破坏作为AD中冲动性增加的相关性。SA 2.确定在何种程度上可以通过行为冲动的神经基质的表型变异来预测复发。方法：从当地居民治疗项目中招募80名最近戒断的AD受试者。将从公众和患者的非酒精依赖性朋友中招募40名对照受试者。受试者将在其首次清醒日期后随访3个月。他们将每月进行一次评估，用电脑和问卷测量冲动。患者将记录饮酒日记，以记录研究期间复发的所有因素。他们将在首次访视时接受功能和解剖MRI评价，以量化对冲动选择的主要元素的神经反应，并评估大脑连接的功能和解剖变化程度。一个统计模型将把来自大脑成像的信息与复发的可能性联系起来。相关性：在这项研究中定义的神经配置文件将提高折扣行为的基本要素作为AD复发的预测因子的理解。AD个体选择机制的定量特征将为个体治疗方案的定制提供有价值的信息。这将直接影响未来的治疗方法，不仅在酗酒，而且在一般的药物滥用和成瘾行为。这些知识将使药物滥用治疗计划的资金得到更有效的利用。 公共卫生相关性：酗酒是一个跨越社会经济界限的普遍问题，是造成大量医疗发病率和经济负担的原因。该项目使用功能性磁共振成像来测量冲动决策中的个体表型差异，并将这些表型特征的基本要素与短期酒精依赖恢复的可能性联系起来。我们预测，可量化的神经配置文件的发展将提供有价值的信息，为定制的个人治疗方案;加深了解大脑功能的关系，从酒精依赖的临床过程中恢复有影响的其他成瘾和神经精神疾病的治疗。

DESCRIPTION (provided by applicant): The project has two Specific Aims: SA1. a) Quantify and characterize the parametric variation of cerebral response to delay, probability, and reward magnitude during decision making in AD vs Controls. b) Quantify disruptions of cerebral connectivity as a correlate of increased impulsivity in AD. SA2. Determine the extent to which relapse can be predicted by phenotypic variation in the neural substrates of behavioral impulsivity. METHODS: Eighty recently abstinent AD subjects will be recruited from local residential treatment programs. Forty control subjects will be recruited from the general public and non alcohol dependent friends of the patients. Subjects will be followed for 3 months after their initial sobriety date. They will be evaluated monthly with computerized and questionnaire measures of impulsivity. Patients will keep a drinking diary to allow capture of all elements of relapse during the study period. They will undergo a functional and anatomical MRI evaluation at the initial visit to quantify the neural response to cardinal elements of impulsive choice and to assess the extent of functional and anatomical changes in cerebral connectivity. A statistical model will relate information from brain imaging to the likelihood of relapse. RELEVANCE: The neural profiles defined in this study will improve understanding of the cardinal elements of discounting behavior as a predictor of relapse in AD. Quantitative profiles of mechanisms of choice in AD individuals will provide valuable information for the tailoring of individual treatment regimens. This will directly impact future treatment approaches not only in alcoholism but also for substance abuse and addictive behaviors in general. This knowledge will allow funding for substance abuse treatment programs to be used more effectively. PUBLIC HEALTH RELEVANCE: Alcoholism is a widespread problem that crosses socioeconomic boundaries and is the cause of substantial medical morbidity and economic burden. This project uses functional magnetic resonance imaging to measure individual phenotypic differences in impulsive decision making and relate the cardinal elements of these phenotypic profiles to the likelihood of short-term recovery from alcohol dependence. We predict that development of quantifiable neural profiles will provide valuable information for the tailoring of individual treatment regimens; a deepened understanding of the relationship of brain function to the clinical course of recovery from alcohol dependence has implications for treatment of other addictions and neuropsychiatric disorders.