Neuromodulation Applications in Alcohol Use Disorder

1.功能磁共振神经反馈的研究进展 在过去的两年里，我们与NIMH的合作者合作，为西门子3T棱镜扫描仪开发和实施了几个神经反馈原型。我们已接近完成这项研究的第一阶段，并准备开始干预阶段。我们在科学会议上进行并提交了中期分析。我们发现，在跑步过程中，参与者自愿控制与线索反应相关的神经活动的能力有所提高，目的是降低对食欲和酒精饮料的渴望。在进行原型阶段时，我们开发了实时功能磁共振神经反馈的使用指南(Fede等人，2020) 2.负性紧迫症的TMS神经调节 我们正在启动另一项合作研究，以评估消极紧迫感与酒精使用障碍(AUD)患者冲动决策的关系；并使用功能性近红外光谱(FNIRS)成像来表征相关额叶区域的血流动力学反应。将招募健康志愿者和患有AUD的参与者的试点样本来开发和测试一项新任务，该任务旨在通过联合暴露于痛苦刺激和视觉厌恶刺激来激发强烈的负面情绪状态，并随后测试冲动决策。此外，我们将测试是否可以使用重复的经颅磁刺激(RTMS)通过额叶前部刺激来调节负性紧迫感，因为这项技术已被证明影响情绪调节和冲动决策过程中自上而下的调节电路(前额缘)，这是负性紧迫感的两个关键组成部分。

1. Development of fMRI Neurofeedback During the past two years we have worked with collaborators in NIMH and developed and implemented several neurofeedback prototypes for the Siemens 3T Prisma scanner. We have nearly completed the stage 1 of this study and preparing to start the intervention stage. We have conducted and presented interim analyses at scientific conferences. We found that across runs, participants improved their ability volitionally control cue reactivity related neural activity with the purpose of down-regulate craving for appetitive food and alcoholic beverages. In conducting the prototype stage, we developed a guideline for the utility of real time fMRI neurofeedback (Fede et al., 2020) 2. TMS Neuromodulation of Negative Urgency We are in the process of initiating another collaborative study in order to assess how negative urgency relates to impulsive decision-making in individuals with alcohol use disorder (AUD); and to characterize the associated hemodynamic response in prefrontal areas during using functional near infrared spectroscopy (fNIRS) imaging. A pilot sample of healthy volunteers and participants with AUD will be recruited to develop and test a novel task intended to induce negative urgency by provoking a strong negative emotional state via combined exposure to both painful stimuli and visual aversive stimuli, and subsequently testing impulsive decision-making. Moreover, we will test whether negative urgency can be modulated via prefrontal stimulation using repetitive transcranial magnetic stimulation (rTMS), as this technique has been shown to affect top-down regulatory circuits (prefrontal-limbic) during emotion regulation and impulsive decision-making, which are the two key components of negative urgency.