Neural Links of Approach Bias Modification in Heavy Drinking Veterans

酗酒退伍军人方法偏差修正的神经联系

• 批准号: 10291809
• 负责人: David L Pennington
• 金额: --
• 依托单位: VETERANS AFFAIRS MED CTR SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10291809
• 关键词: Adherence; Affect; Affective; Alcohol consumption; Alcohol dependence; Alcohols; Alleles; Amygdaloid structure; Anterior; Area; Award; Behavior; Behavior Therapy; Behavior assessment; Behavioral; Biological; Brain region; Caring; Characteristics; Chronic; Clinic; Clinical Research; Clinical Treatment; Cognitive; Communities; Data; Development; Disease; European; Family; Functional Magnetic Resonance Imaging; General Population; Goals; Heavy Drinking; Impairment; Individual; Investigation; Knowledge; Lead; Learning; Left; Link; Longitudinal observational study; Magnetic Resonance Imaging; Measures; Medical; Medical Care Costs; Medical center; Mental Health; Mentors; Methods; Military Personnel; Modification; Morbidity - disease rate; Nature; Neurobiology; Neurocognitive; Neurosciences; Neurosciences Research; Nucleus Accumbens; Outcome; Pharmacological Treatment; Population; Post-Traumatic Stress Disorders; Prefrontal Cortex; Process; Psyche structure; Recovery; Relapse; Research; Research Design; Research Personnel; Resolution; Rewards; San Francisco; Self-Injurious Behavior; Short-Term Memory; Single Nucleotide Polymorphism; Suicide; Symptoms; Testing; Time; Training; Training Programs; United States Department of Veterans Affairs; Veterans; Violence; Work; alcohol cue; alcohol misuse; alcohol relapse; alcohol response; alcohol use disorder; base; behavioral response; career development; cingulate cortex; cognitive process; cognitive training; common symptom; comorbidity; cue reactivity; design; drinking; executive function; follow up assessment; frontal lobe; heavy drinking students; high risk behavior; improved; mild traumatic brain injury; military veteran; mortality; neural circuit; neural network; neurobiological mechanism; neuromechanism; patient population; predicting response; psychiatric symptom; recruit; reduced alcohol use; relating to nervous system; research study; response; success; tool; translational neuroscience; treatment trial

The overall goal of the proposed project is to improve the care of Veterans who consume alcohol at heavy and unhealthy levels. Heavy alcohol use is highly prevalent among military Veterans, related to many other mental health and chronic medical conditions, contributes to high-risk behaviors such as violence and suicide, and is a leading preventable cause of morbidity and mortality. A tendency to automatically approach alcohol has been identified in heavy drinking students and European in-patient populations. This alcohol approach-bias contributes to continued alcohol use despite an explicit desire to quit. Alcohol approach-bias modification (AABM), a cognitive training program has been shown to remediate alcohol approach-bias and reduce alcohol relapse rates. However, we currently do not know the extent of alcohol approach-bias related neural activity in heavy drinking Veterans with highly prevalent comorbid conditions (i.e., PTSD and mild traumatic brain injury), or the extent to which these Veterans will respond to AABM training. Additionally, the mechanisms of functional connectivity in alcohol approach-bias reward neural circuitry remain largely unknown. Therefore, the proposed CSR&D CDA-2 seeks to fill these gaps by conducting a longitudinal observational study designed to evaluate the neural associations of alcohol approach-bias and AABM training. The research study has three overarching aims: Aim 1: To investigate neural activation and connectivity during an alcohol approach-avoidance task and an alcohol cue-reactivity task; Aim 2: To investigate neural change following AABM training; Aim 3: To measure and investigate neural, cognitive, and psychiatric predictors of behavioral response to AABM training. To test these aims, 50 heavy drinking Veterans and 20 healthy light/non-drinking Veteran controls will be recruited from the San Francisco Veterans Affairs Medical Center and affiliated clinics. We will compare baseline neural and behavioral characteristics between these two groups. Heavy drinking Veterans will then complete 3 weeks (9 sessions) of AABM training. Following training, heavy drinking Veterans will repeat the neural and behavioral assessments completed at baseline. Heavy drinking Veterans will also complete a follow-up assessment at 3 months post-baseline to evaluate sustained behavioral change (e.g., reduced alcohol use). The proposed work will directly harness the neuroanatomical precision and spatial resolution of functional magnetic resonance imaging (fMRI) data. The proposed CDA-2 will be the first to: 1) investigate the underlying neural and cognitive mechanisms of alcohol approach-bias in a population of heavy drinking Veterans, 2) examine functional connectivity during an alcohol approach-avoidance task, 3) investigate the extent to which both fMRI activation and connectivity data predict response to AABM, 4) investigate the extent to which neurocognitive and psychiatric symptoms common in heavy drinking Veterans predict behavioral change following AABM. Findings from the proposed project are expected to improve the care of Veterans with heavy and unhealthy alcohol use, and by extension, aid families and communities affected by the sequelae of these problems. Moreover, treatments that help Veterans with unhealthy alcohol use are also likely to be applicable to the general population of individuals with these problems.

拟议项目的总体目标是改善在大量饮酒和饮酒的退伍军人的护理 不健康的水平。大量饮酒在军事退伍军人中非常普遍，与许多其他精神有关 健康和慢性病状况，有助于高危行为，例如暴力和自杀，是一种 引起发病和死亡率的可预防原因。自动接近酒精的趋势已经 在大量饮酒的学生和欧洲住院人群中被确定。这种酒精接近偏见 尽管有明确的戒烟愿望，但仍有继续饮酒。酒精接近偏置的修改 （AABM），已显示一项认知培训计划可以补救酒精的偏见并减少酒精 复发率。但是，我们目前不知道酒精方法偏见与与神经活动相关的程度 重型饮酒退伍军人具有高度普遍的合并症（即PTSD和轻度创伤性脑损伤）， 或这些退伍军人对AABM培训做出反应的程度。另外，功能的机制 酒精方法偏见中的连通性奖励神经回路在很大程度上未知。 因此，拟议的CSR＆D CDA-2试图通过进行纵向观察来填补这些空白 旨在评估酒精方法偏见和AABM培训的神经关联的研究。研究 研究具有三个总体目的：目标1：研究酒精期间的神经激活和连通性 避免接近的任务和酒精提示反应任务；目的2：调查神经变化之后 AABM培训；目标3：衡量和研究行为的神经，认知和精神病预测指标 对AABM培训的反应。为了测试这些目标，有50名重型饮酒退伍军人和20名健康的光/不喝酒 退伍军人控制将从旧金山退伍军人事务医疗中心和附属诊所招募。 我们将比较这两组之间的基线神经和行为特征。大量饮酒 然后，退伍军人将完成AABM培训的3周（9次）。训练后，饮酒 退伍军人将重复在基线完成的神经和行为评估。大量饮酒的退伍军人 还将在基线后3个月完成后续评估，以评估持续的行为改变 （例如，降低酒精的使用）。拟议的工作将直接利用神经解剖学精度和空间 功能磁共振成像（fMRI）数据的分辨率。 提出的CDA-2将是：1）研究的基本神经和认知机制 酒精接近饮酒退伍军人的偏见，2）检查在一个期间检查功能连通性 酒精接近避免任务，3）研究fMRI激活和连通性数据的程度 预测对AABM的反应，4）研究神经认知和精神症状的程度 在AABM之后，大量饮酒的退伍军人预测行为改变。提议的发现 预计项目将通过大量和不健康的饮酒来改善退伍军人的护理，并扩展 受这些问题后遗症影响的援助家庭和社区。此外，有帮助的治疗 饮酒不健康的退伍军人也可能适用于 这些问题。