Alcohol-Related Impairment and Reinforcement after Gastric Bypass Surgery

描述(申请人提供)：最近我们的研究小组在《美国医学会杂志》上发表的一篇论文显示，Roux-en-Y胃旁路手术(RYGB)后，患者患酒精使用障碍的风险显著增加。有几项研究与这一发现一致：1)来自RYGB患者的轶事信息表明他们喝醉的速度要快得多，2)有大量关于RYGB患者在喝少量酒精后醉酒驾车导致的车祸的报道，以及3)RYGB后酒精的药代动力学发生了很大的变化。药代动力学的变化是我们非常感兴趣的，因为它们可能导致显著的损害和强化的变化。这些变化可能是随后发展为酒精使用障碍的潜在原因机制。在目前的研究中，我们建议采用前瞻性的纵向设计来调查RYGB患者。我们将检查手术后的认知和驾驶障碍，并研究RYGB患者可能发生的强化变化。最后，我们的目标是更好地描述减肥手术后酒精药代动力学发生的变化，并检查可能在酒精使用障碍的发展中发挥作用的关键变量。

DESCRIPTION (provided by applicant): Recently our research group published a paper in JAMA which showed that after Roux-en-Y gastric bypass surgery (RYGB), patients are at significantly increased risk for developing an alcohol use disorder. Several lines of research are consistent with this finding: 1) anecdotal information from RYGB patients suggests that they become intoxicated much more quickly, 2) there are numerous reports of automobile accidents that have resulted from RYGB patients driving while intoxicated after drinking a small amount of alcohol, and 3) the pharmacokinetics of alcohol change considerably after RYGB. The pharmacokinetic changes are of considerable interest to us as they likely lead to significant impairments and changes in reinforcement. These changes may serve as a potential causal mechanism for the subsequent development of an alcohol use disorder. In the current study we propose to investigate RYGB patients with a prospective, longitudinal design. We will examine cognitive and driving impairment after surgery as well as study the changes in reinforcement that may occur in RYGB patients. Finally, we aim to better characterize the changes that occur in the pharmacokinetics of alcohol following bariatric surgery and examine key variables which may play a role in the development in alcohol use disorders.