Neural Mechanisms of Behavior Change in a Community Sample of Drinkers

描述（由申请人提供）：尽管对酒精使用障碍的药理学和心理社会治疗进行了深入研究，但高达75%的符合酒精使用障碍（AUD）标准的人从未寻求正式治疗。然而，这些不寻求治疗的人中有很大一部分能够自己减少饮酒甚至戒酒。因此，更好地了解在没有治疗的情况下自我改变的人的行为改变机制（MOBC）可能会为最关键的改变机制提供一些关键的见解，这些机制可能成为干预发展的潜在目标。虽然在过去十年中，关于自我改变者MOBC的行为/心理社会研究数量有所增加，但明显缺乏研究有助于行为改变的神经认知机制。大量的动物和人类研究已经调查了AUD发展和维持的神经相关性，但缺乏关于AUD恢复的文献。横断面研究发现，参与酒精线索反应和压力反应的网络似乎在AUD严重程度越高时越活跃，而参与认知控制的网络则随着AUD严重程度的增加而减少。因此，可以预期，随着饮酒量/频率和AUD严重程度的降低，这些变化可能会逆转。虽然一些横断面神经影像学研究表明，长期禁欲后确实会出现功能恢复，但迄今为止，缺乏纵向研究功能性脑反应的变化。为了解决这一差距，目前的建议旨在研究一个社区样本的酗酒者在纵向设计，以研究的心理社会，行为和神经机制的变化或维持酗酒。多模态神经成像（功能性磁共振成像（fMRI）和脑磁图（MEG））将用于识别发生变化的区域和网络（即fMRI）以及与随时间减少饮酒相关的神经网络的时间参与（即MEG）。将在基线时，然后在3个月、9个月和18个月随访时获得心理社会和行为功能的综合评估。此外，受试者将在每次访视（基线、3、9和18个月）时完成MRI检查，并在基线和18个月时完成MEG检查，在此期间，受试者将完成测量认知控制、线索反应和压力/负面情绪反应的任务。行为变化的心理社会，行为和神经机制将使用最先进的数据分析技术进行检查，其中许多技术是由研究团队开创的。通过对自行改变的重度饮酒者进行多层次分析，我们将能够全面了解潜在的治疗机制，并为未来的MOBC研究提供关键的比较组。

DESCRIPTION (provided by applicant): Although there has been intense study of pharmacological and psychosocial treatments for alcohol use disorders, up to 75% of individuals meeting criteria for an alcohol use disorder (AUD) never seek formal treatment for their drinking. However, a large proportion of these non-treatment seeking individuals are able to reduce their drinking or even quit drinking on their own. Thus, gaining a better understanding of the mechanisms of behavior change (MOBC) among people who self-change in the absence of treatment may provide some key insights into the most critical change mechanisms that could become potential targets for intervention development. While the amount of behavioral/psychosocial research on MOBC in self-changers has increased over the past decade, there has been a notable absence of research examining the neurocognitive mechanisms that contribute to behavior change. A significant body of animal and human work has investigated the neural correlates of the development and maintenance of AUDs, but there is a dearth of literature on AUD recovery. Cross-sectional research has found that networks involved in alcohol cue reactivity and stress reactivity appear to become more engaged with greater AUD severity, and those networks involved in cognitive control tend to decrease with increased AUD severity. Thus, it could be expected that as drinking quantity/frequency and AUD severity decrease, there may be a reversal of these changes. While some cross-sectional neuroimaging research suggests that recovery of function does occur after long-term abstinence, to date there is a lack of studies investigating change in functional brain response longitudinally. To address this gap, the current proposal aims to examine a community sample of heavy drinkers in a longitudinal design in order to study the psychosocial, behavioral, and neural mechanisms that underlie changes in or maintenance of heavy drinking. Multi-modal neuroimaging (functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG)) will be used to identify the regions and networks in which change occurs (i.e. fMRI) and the temporal engagement of neural networks (i.e. MEG) related to reductions in drinking over time. Comprehensive assessments of psychosocial and behavioral functioning will be obtained at baseline, and then at 3-, 9-, and 18-month follow-ups. In addition, participants will complete MRI sessions at each visit (baseline, 3, 9, and 18 months) as well as an MEG session at baseline and 18 months, during which participants will complete tasks measuring cognitive control, cue reactivity, and stress/negative affect reactivity. Psychosocial, behavioral, and neura mechanisms of behavior change will be examined using state-of-the-art data analytic techniques, many of which have been pioneered by the research team. Examining the MOBC at multiple levels of analysis in heavy drinkers who change on their own, we will be able to develop a comprehensive understanding of potential mechanisms on which to focus treatments and will provide a key comparison group for future MOBC studies.