Cognitive Remediation and Transcranial Direct Current Stimulation to aid Smokers with Schizophrenia

项目摘要/摘要 患有严重精神疾病(SMI)的成年人吸烟的可能性是非SMI成年人的三倍， 消费美国所有香烟的35%-44%；而且，与烟草相关的疾病和 患有精神分裂症的吸烟者中有死亡病例。不幸的是，不仅精神分裂症患者 可能会接受吸烟治疗，但戒烟药物在帮助这方面只能起到一定的作用 部分吸烟者戒烟。因此，发现新的治疗辅助物，特别是帮助这种高- 吸烟者的风险子集，以实现成功戒烟。为此，我们提出了一种新的非 直接针对认知障碍的药物技术，这是一种很久以前的方法 研究表明，在患有精神分裂症的吸烟者中使用可能特别有效，并且对 强烈的刺激，显示出在患有精神分裂症的吸烟者中增强。组合认知的子集 增强疗法称为认知补救(CR)，有另一种安全有效的技术， 经颅直流电刺激(TDCS)，我们提出了一种新的认知训练方法 使患有精神分裂症的吸烟者能够更好地控制吸烟和刺激诱导的反应 (例如，渴望)。最近的研究发现，tdcs诱导的认知增强以及 健康吸烟者中线索诱导的渴望和吸烟行为的减少。这与此相结合 对精神分裂症患者存在的认知缺陷的了解，以及明确的证据表明 认知功能与吸烟治疗成功之间的关系，为测试提供了理论基础 针对精神分裂症患者吸烟潜在机制的新型CR+tDCs。 具体地说，拟议的研究将检查CR+在多大程度上有针对性地增强认知 Tdcs，导致认知控制、线索诱发的渴求、反应时和事件相关电位的改变。 注意偏差；以及这些变化对吸烟行为、意图和信心的影响 在80名患有精神分裂症的吸烟者中戒烟。这项研究的目的是为新的发展提供信息 针对吸烟患者的非药物、非侵入性治疗技术 精神分裂症。我们的长期目标是建立一种有效的治疗辅助手段，帮助吸烟者 精神分裂症患者成功实现了戒毒。

PROJECT SUMMARY/ ABSTRACT Adults with severe mental illness (SMI) are three times more likely to smoke than non-SMI adults, consuming 35-44% of all cigarettes in the U.S.; and, the highest rates of tobacco-related illnesses and death are among smokers with schizophrenia. Unfortunately, not only are patients with schizophrenia less likely to receive smoking treatments, but cessation medications are only modestly effective in helping this subset of smokers quit. Therefore, it is vital to discover new treatment adjuncts that specifically aid this high- risk subset of smokers to achieve successful abstinence. Toward that end, we propose a novel non- pharmacologic technique that directly targets both cognitive impairment, an avenue considerable past research suggests may be particularly effective to exploit in smokers with schizophrenia, and reactivity to prepotent stimuli, shown to be enhanced in smokers with schizophrenia. Combining a subset of cognitive enhancement therapy known as Cognitive Remediation (CR), with another safe and effective technique, Transcranial Direct Current Stimulation (tDCS), we propose a new cognitive training method aimed at enabling smokers with schizophrenia to gain greater control over smoking and stimuli-induced reactivity (e.g., craving). Recent studies have found significant tDCS-induced cognitive enhancement, as well as reduction in both cue-induced craving and smoking behavior among healthy smokers. This combined with knowledge of the cognitive deficits that exist among individuals with schizophrenia, and clear evidence of a relationship between cognitive function and smoking treatment success, provides the rationale for testing novel CR + tDCS to target underlying mechanisms of smoking among individuals with schizophrenia. Specifically, the proposed study will examine the extent to which targeted cognitive enhancement with CR + tDCS, leads to changes in cognitive control, cue-provoked craving, reaction time and ERP measures of attentional bias; as well as the impact of these changes on smoking behavior and intention and confidence to quit among 80 smokers with schizophrenia. The goal of this study is to inform the development of new non-medication, noninvasive, therapeutic techniques to specifically target smoking among patients with schizophrenia. Our long term goal is to establish an effective treatment adjunct to help smokers with schizophrenia successfully achieve abstinence.