EEG/ERP Risk Markers as Predictors and Outcomes of SUD Treatment in Adolescents

EEG/ERP 风险标记作为青少年 SUD 治疗的预测因素和结果

• 批准号: 8582231
• 负责人: Edward M. Bernat
• 金额: $ 23.76万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8582231
• 关键词: Adolescence; Adolescent; Affect; Alcohol or Other Drugs use; Attention; Awareness; Behavior; Behavioral; Brain; Chronic; Clinical; Cognitive; Computers; Conscious; Cues; Development; Drug usage; Effectiveness; Electroencephalography; Electrophysiology (science); Emotional; Etiology; Exhibits; Frequencies; Goals; Incentives; Intervention; Knowledge; Lateral; Left; Link; Maps; Measures; Medial; Methods; Modeling; Motivation; Neurobiology; Outcome; Patients; Perception; Pharmaceutical Preparations; Phase; Prefrontal Cortex; Procedures; Process; Randomized; Randomized Clinical Trials; Relative (related person); Research; Research Design; Research Personnel; Resolution; Rewards; Risk Marker; Role; Self Destructive Behavior; Severities; Source; Stimulus; Structure; Substance Use Disorder; Symptoms; System; Therapeutic; Thinking; Time; Treatment outcome; addiction; anti social; base; cognitive control; drug testing; early onset substance use; follow-up; improved; indexing; mental representation; motivational enhancement therapy; neurobiological mechanism; neurophysiology; public health relevance; standard care; therapy development; treatment as usual; treatment effect; treatment response

DESCRIPTION (provided by applicant): A paradoxical condition of addiction is that people persist in self-destructive behavior despite knowledge of the negative consequences. To better understand this paradox, dual process models of addiction have emerged that emphasize two interrelated systems: an "impulsive" or incentive salience system and a cognitive control system. The incentive salience system uses fast and automatic associations to evaluate stimuli for its emotional and motivational significance. The cognitive control system underlies slower, "reflective" processes to guide behavior, often overriding automatic action tendencies. As imbalances between the two systems increase, drug use becomes more involuntary and compulsive, leading to addiction. Cognitive approaches have shown that attention and approach biases to drugs and drug-related cues emerge after repeated drug use. There have been few attempts, however, to map the neurobiological basis of these attention and approach biases. Additionally, researchers have begun to implement bias retraining interventions in clinical settings, with initial results indicating such retraining procedures provide incremental improvement over traditional treatments that focus on cognitive control processes (e.g., CBT). Recently, researchers have begun to examine the validity of computer administered bias retraining treatments for SUDs, with initial positive results. We prose to examine the incremental benefit of bias retraining for SUDs while also examining the neurobiological mechanisms of change in these attention and approach. Specifically, to what extent can treatment affect changes in incentive salience and cognitive control processes associated with addiction? As these automatic processes occur on the order of fractions of a second, we will use sophisticated EEG/ERP methods (time-frequency, phase synchrony, source localization), as they provide the necessary temporal resolution and well-validated measures of electrocortical activity associated with the incentive salience and cognitive control systems. We also frame our analysis in the developmental context of adolescence. Adolescence is a period of substantial changes in incentive salience and cognitive control processes, while also the time when people tend to initiate substance use and early onset substance use disorders (SUDs) first emerge. Therefore, adolescence may be the key period to both study etiological mechanisms, and intervene to avert chronic SUDs. We will examine cognitive control and incentive salience functioning in adolescent patients in treatment for SUDs using EEG/ERP measures elicited in drug-specific and standard task paradigms. Patients will be randomly assigned to treatment as usual (TAU; focus on cognitive control) or TAU+ bias retraining (additional focus on attention and approach biases). Our specific aims are to (1) assess the utility of baseline EEG/ERP measures to predict severity and treatment response, (2) the efficacy of TAU+ bias retraining relative to TAU, and (3) whether EEG/ERP measures exhibit change as a function of treatment condition. We predict both treatment conditions will be associated with change in cognitive control, while TAU+ bias retraining will also be associated with change in incentive salience.

描述（由申请人提供）：成瘾的一个矛盾状况是，尽管人们知道其负面后果，但人们仍然坚持自我毁灭的行为。为了更好地理解这一悖论，出现了成瘾的双重过程模型，强调两个相互关联的系统：“冲动”或激励显着系统和认知控制系统。激励显着系统使用快速和自动的关联来评估刺激的情感和动机意义。认知控制系统是指导行为的较慢的“反思”过程的基础，通常会压倒自动行动倾向。随着两个系统之间的不平衡加剧，吸毒变得更加不自觉和强迫，从而导致成瘾。认知方法表明，重复使用药物后会出现对药物和药物相关线索的注意力和方法偏差。然而，很少有人尝试去绘制这些注意力和方法偏差的神经生物学基础。此外，研究人员已经开始在临床环境中实施偏见再训练干预措施，初步结果表明，与侧重于认知控制过程（例如 CBT）的传统治疗方法相比，这种再训练程序提供了渐进式的改进。最近，研究人员开始研究计算机管理的 SUD 偏差再训练治疗的有效性，并取得了初步的积极结果。我们试图研究 SUD 偏见再训练的增量益处，同时也研究这些注意力和方法变化的神经生物学机制。具体来说，治疗可以在多大程度上影响与成瘾相关的激励显着性和认知控制过程的变化？由于这些自动过程发生在几分之一秒的时间内，我们将使用复杂的 EEG/ERP 方法（时频、相位同步、源定位），因为它们提供了必要的时间分辨率和与相关电皮层活动相关的经过充分验证的测量。具有激励显着性和认知控制系统。我们还在青春期的发展背景下进行了分析。青春期是激励显着性和认知控制过程发生重大变化的时期，也是人们倾向于开始物质使用和早发性物质使用障碍（SUD）首次出现的时期。因此，青春期可能是研究病因机制和干预预防慢性SUD的关键时期。我们将使用特定药物和标准任务范式中引发的 EEG/ERP 测量来检查青少年患者在 SUD 治疗中的认知控制和激励显着功能。患者将被随机分配接受照常治疗（TAU；专注于认知控制）或 TAU+ 偏见再训练（额外关注注意力和方法偏见）。我们的具体目标是 (1) 评估基线 EEG/ERP 测量在预测严重程度和治疗反应方面的效用，(2) TAU+ 偏差再训练相对于 TAU 的功效，以及 (3) EEG/ERP 测量是否表现出变化治疗条件的作用。我们预测这两种治疗条件都将与认知控制的变化相关，而 TAU+ 偏差再训练也将与激励显着性的变化相关。