The effects of stress on decision-making in alcohol use disorder: A translational approach

摘要 本翻译项目的目的是测试急性应激诱导对认知灵活性的影响。 与匹配的对照组相比，AUD患者之间的习惯学习。向澄清 酒精和压力之间的复杂相互作用，对于阐明大脑电路和机制是至关重要的 酒精和压力如何在一系列领域相互作用。到目前为止，我们对 这些机制仅限于临床前分析水平。以提高翻译的影响 应激与AUD的科学，该应用程序建议对患有AUD的临床样本进行调查，结合 仔细的应力诱导、功能磁共振成像(FMRI)和 对决策进行明确的评估。我们建议测试急性应激诱导对 认知灵活性(即，威斯康星卡片分类任务；WCST)和习惯学习(即，顺序决策 任务；SDMT)在个人样本中，32名未寻求治疗的澳门氏症患者和32名匹配的患者 控制(无AUD)。所有参与者都将完成一组慢性压力信息。基准衡量标准： 将收集认知灵活性和习惯学习(WCST和SDMT)。符合条件的参与者将完成一份 基于神经成像的压力诱导任务，紧接在认知评估之前和之后 灵活性和习惯学习(WCST和SDMT)。首要目标是测试对急性呼吸道感染的反应 压力诱导与认知灵活性的降低和习惯学习的增加有关 AUD患者与匹配对照组的比较。如果研究假设得到支持，急性应激 与匹配者相比，AUD患者的认知灵活性降低并增强了习惯学习 控制，我们将进行大规模(R01级)研究，在这些研究中，压力/神经状况和决策- 使用神经成像范式完成测量，以便两个应激反应的神经回路 决策是可以被审问的。

ABSTRACT The objective of this translational project is to test the effects of acute stress induction on cognitive flexibility and habit learning among individuals with AUD compared to matched controls. Towards elucidating the complex interplay between alcohol and stress, it is crucial to elucidate brain circuitry and mechanisms that underlie how alcohol and stress interact across a range of domains. To date, much of our understanding of such mechanisms is confined to the preclinical level of analysis. To advance the translational impact of the science of stress and AUD, this application proposes an investigation in a clinical sample with AUD, combining careful experimental manipulations of stress induction, functional magnetic resonance imaging (fMRI), and a well-defined assessment of decision making. We propose to test the effects of acute stress induction on cognitive flexibility (i.e., Wisconsin Card Sort Task; WCST) and habit learning (i.e., Sequential Decision-Making Task; SDMT) in a sample of 64 individuals, 32 non-treatment seeking individuals with AUD and 32 matched controls (no AUD). All participants will complete a chronic stress-informed battery. Baseline measures of cognitive flexibility and habit learning (WCST and SDMT) will be collected. Eligible participants will complete a neuroimaging-based stress-induction task, immediately preceded and followed by assessments of cognitive flexibility and habit learning (WCST and SDMT). The overarching goal is to test whether response to an acute stress induction is associated with decreases on cognitive flexibility and increases in habit learning in individuals with AUD compared to matched controls. If the study hypotheses are supported and acute stress decreases cognitive flexibility and enhances habit learning in individuals with AUD, compared to matched controls, we will undertake large scale (R01-level) studies in which both stress/neural conditions and decision- making measures are completed using neuroimaging paradigms so that neurocircuitry of both stress response and decision-making can be interrogated.