Translational approaches to TMS treatment development for smoking

吸烟 TMS 治疗开发的转化方法

基本信息

批准号：
10152574
负责人：
Merideth A. Addicott
金额：
$ 62.53万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-11-06 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10152574
关键词：
Abstinence Acute Address Affect Attenuated Behavior Behavior Therapy Behavioral Behavioral Mechanisms Brain Cessation of life Chemosensitization Cigarette Cigarette Smoker Cognitive Therapy Corpus striatum structure Cues Data Dorsal Double-Blind Method FDA approved Gender Goals Hyperactivity Impaired cognition Impulsivity Individual Intervention Investigation Knowledge Left Limbic System Link Long-Term Depression Longitudinal Studies Measures Mental Depression Morbidity - disease rate Motivation Neurobiology Nucleus Accumbens Odds Ratio Outcome Pathway interactions Patients Pattern Pharmaceutical Preparations Pharmacotherapy Prefrontal Cortex Procedures Protocols documentation Randomized Relapse Research Rewards Self Administration Self Efficacy Site Smoke Smoker Smoking Smoking Cessation Intervention Smoking History Socioeconomic Status Specific qualifier value System Systems Theory Testing Time Tobacco Dependence Tobacco use Transcranial magnetic stimulation Translating United States Ventral Striatum Vision addiction base behavioral economics cigarette craving cigarette smoking cognitive control craving critical period demographics depressive symptoms design discounting evidence base executive function improved outcome mortality neural circuit neurobehavioral neurodevelopment neuroimaging novel preference relating to nervous system response smoking cessation smoking cue success therapy development tool translational approach treatment strategy

项目摘要

PROJECT SUMMARY/ABSTRACT Smoking is the leading preventable cause of mortality and morbidity in the United States, each year contributing to approximately 443,000 deaths. Smoking and high relapse rates are likely due to factors that affect both limbic and executive circuits in the brain, including vulnerability to salient smoking-related cues and loss of cognitive control. Accumulating evidence indicates that in addiction, the frontal-striatal circuits involved in limbic reward and impulsive action are relatively hyperactive, while the executive control circuits are relatively hypoactive. Thus, intervention efforts should be directed at either decreasing the relative activity of the impulsive reward circuit or increasing the relative activity of the executive control circuits. Transcranial magnetic stimulation (TMS) is a non-invasive, FDA-approved treatment for depression which is also being investigated for as a possible treatment for smoking cessation. The goal of this project is to use the novel theta burst stimulation (TBS) protocol to induce sustainable decreases and increases in the impulsive and executive control circuits, respectively. To do so, we will apply an attenuating form of TBS to the ventromedial prefrontal cortex to target the impulsive reward circuit and a potentiating form of TBS to the dorsolateral prefrontal cortex to target the executive control circuit. We will then investigate the efficacy of these protocols for reducing a range of smoking measures, including cigarette valuation, delay discounting, cigarette self-administration, and brain reactivity to smoking cues. The results from these investigations will pave a clear pathway for the systematic development of neural-circuit based strategies as treatments for tobacco use and dependence.

项目摘要/摘要吸烟是美国每年可预防死亡率和发病率的主要原因大约443,000人死亡。吸烟和高复发率可能是由于因素影响大脑中的边缘和行政电路，包括易于吸烟相关的线索和认知控制的丧失。积累的证据表明，涉及额叶的额叶电路在边缘奖励和冲动行动中相对多动，而执行对照电路则是相对低血压。因此，干预工作应致力于降低冲动奖励电路或增加执行控制电路的相对活动。经颅磁刺激（TMS）是一种非侵入性，FDA批准的抑郁症治疗方法，也在被调查是作为戒烟的可能治疗方法。该项目的目的是使用小说Theta 爆发刺激（TBS）方案诱导可持续的降低和冲动和高管的增加控制电路分别。为此，我们将向腹侧前额叶应用衰减形式的TBS 皮层靶向冲动奖励电路和向背外侧前额叶皮层的TBS的增强形式针对行政控制电路。然后，我们将研究这些方案减少A的功效吸烟措施的范围，包括香烟估值，延迟折扣，香烟自给自足和大脑对吸烟提示的反应性。这些调查的结果将为基于神经电路的策略的系统发展作为烟草使用和依赖性的治疗方法。