The Repair of Self Control in Alcohol Dependence: Working Memory & Real Time fMRI

描述（由申请人提供）：酒精依赖者经常在自我控制方面有缺陷，这可以通过他们对延迟奖励的过度折扣来衡量。双重神经行为决策系统模型表明，这些缺陷可能是由于两个相互作用的神经生物系统之间的调节平衡被破坏。这些系统是负责评估延迟奖励（即长期目标）的执行系统（前额叶皮层和顶叶皮层）和与即时奖励（即即时满足）相关的冲动系统（边缘和副边缘区域）。我们最近的研究表明，工作记忆（WM）训练可以通过恢复这些系统之间的调节平衡来修复自我控制。然而，关于修复自我控制，还有很多东西需要学习。在Aim 1中，我们将进一步探讨WM训练对靶场的影响

DESCRIPTION (provided by applicant): Alcohol-dependent individuals frequently have deficits in self-control, as measured by their excessive discounting of delayed rewards. The dual neurobehavioral decision systems model suggests that these deficits may result from a disruption in the regulatory balance between two interacting neurobiological systems. These systems are the executive system (prefrontal cortex and parietal cortex) which is responsible for valuing delayed rewards (i.e., long-term goals), and the impulsive system (limbic and paralimbic areas) which is associated with immediate rewards (i.e., instant gratification). Our recent research has demonstrated that working memory (WM) training repairs self-control, putatively by restoring regulatory balance between these systems. There is, however, still much to learn about repairing self-control. In Aim 1, we will further explore the effects WM training on a range of WM, self-control, and clinically relevant (e.g., craving) measures. Additionally, the neural mechanisms of WM training will be explored though functional neuroimaging techniques. We will examine the dose-effect function of WM training by systematically varying the number of WM training sessions across several groups of alcohol-dependent individuals. The duration of these improvements in self-control will be tested by conducting follow-up assessments one month, three months, and six months after training. In Aim 2 we plan to capitalize on the neurobiological knowledge gained in Aim 1 to test the effects of two variants of real time fMRI neuro-feedback on our suite of WM, self-control, and clinically significant measures. This novel exploration of neuro-feedback effects on neurocognitive and clinically significant measures will include a direct comparison of feedback techniques based on a specific brain region and across a distributed neural network. Long-term changes in neural function and/or our neurocognitive measures will be explored during a one-month follow-up visit. Successfully achieving our aims could allow us to both refine our current techniques (i.e., WM training), and possibly begin the process of developing novel techniques (i.e., neuro-feedback) for the repair of self-control in alcohol-dependent individuals. This application will contribute to personalized medicine approaches in alcohol dependence, where treatment is defined by documented self-control deficits. Furthermore, the functional neuroimaging data collected across both aims should provide unique insights into both patterns of neural disruption seen in alcohol dependence and any treatment associated changes in neural function.