Neural basis of smoking relapse

吸烟复吸的神经基础

• 批准号: 9412447
• 负责人: CARYN LERMAN
• 金额: $ 61.32万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9412447
• 关键词: Abstinence; Affect; Anterior; Behavioral; Behavioral Sciences; Brain; Charge; Classification; Clinical; Cognitive; Counseling; Cues; Economic Burden; Evaluation; Exhibits; Functional Magnetic Resonance Imaging; Future; Hour; Impairment; Insula of Reil; Investigation; Left; MRI Scans; Machine Learning; Measures; Medial; Mediating; Mediation; Memory impairment; Methods; Modeling; Monitor; Neurocognitive; Nicotine Withdrawal; Nucleus Accumbens; Outcome; Participant; Pathologic; Pathway interactions; Patient Self-Report; Pattern; Performance; Pharmacotherapy; Prefrontal Cortex; Process; Protocols documentation; Psychological Stress; Relapse; Resources; Rest; Risk; Role; Satiation; Short-Term Memory; Signal Transduction; Smoke; Smoker; Smoking; Smoking Status; Stress; Symptoms; Task Performances; Testing; Time; Ventral Striatum; base; behavior change; behavior measurement; behavioral response; biological adaptation to stress; blood oxygen level dependent; brain behavior; cingulate cortex; cognitive control; cognitive neuroscience; craving; cue reactivity; high dimensionality; human subject; imaging study; improved; mortality; multimodality; neurobehavioral; neuroimaging; neuromechanism; nicotine patch; nicotine replacement; novel; primary outcome; prospective; psychologic; public health relevance; relapse risk; relating to nervous system; response; secondary outcome; smoking abstinence; smoking cessation; smoking cue; smoking relapse; stress reactivity; tool

 DESCRIPTION (provided by applicant): Smoking is the greatest preventable cause of mortality and a significant economic burden. Even with the best available treatments, most smokers relapse within days or weeks after a quit attempt. To improve quit rates significantly, we need a more refined mechanistic understanding of why so many smokers who attempt to quit will relapse quickly. The proposed functional magnetic resonance imaging (fMRI) study integrates concepts and tools from the fields of cognitive neuroscience and behavioral science to determine how brain states in early abstinence influence clinical outcomes among treatment-seeking smokers. The primary aims of this hypothesis-driven study are: (1) to identify brain mechanisms that increase vulnerability to smoking relapse, and (2) to test an integrated brain-behavior model of smoking relapse. Using our validated fMRI-based abstinence challenge paradigm, 200 treatment-seeking smokers will complete two 1-hour pre- treatment fMRI scans: after smoking satiety and after 24 hours of confirmed abstinence. We will examine neural and behavioral responses during performance of validated tasks probing working memory, cue reactivity, and stress response as well as resting state functional connectivity. Participants will then set a target quit date, receive smoking cessation counseling, and be monitored for 6-months to assess time (days) to relapse, using a validated smoking relapse protocol. The primary outcome is time to relapse. Secondary outcomes include abstinence symptoms and smoking status at 30 days. For human subjects reasons, relapsing smokers will be offered an opportunity to receive 8 weeks of nicotine patch treatment and counseling free of charge following study completion. Although neuroimaging is not likely to become a standard pre- cessation assessment the near future, this study will elucidate pathological neurobehavioral processes and specific neurocognitive domains that can be targeted in new treatments to aid smoking cessation.

 描述（由适用提供）：吸烟是死亡率和巨大经济负担的最大预防原因。即使采用最好的治疗方法，大多数吸烟者都会在戒烟尝试后几天或几周内传播。为了显着提高戒烟率，我们需要更精致的机械理解，以了解为什么这么多试图退出的吸烟者会迅速重置。提出的功能磁共振成像（fMRI）研究整合了认知神经科学和行为科学领域的概念和工具，以确定早期戒酒中的大脑状态如何影响寻求治疗的吸烟者之间的临床结果。这项假设驱动的研究的主要目的是：（1）确定增加吸烟中继脆弱性的大脑机制，以及（2）测试吸烟中继的综合大脑行为模型。使用我们经过验证的基于功能磁共振毒的禁欲挑战范式，200名寻求治疗的吸烟者将完成两次1小时的FMRI扫描：吸烟后饱腹感和24小时确认的禁欲。我们将在探索工作记忆，提示反应性和压力响应以及静止状态功能连接的经过验证的任务执行过程中检查神经元和行为反应。参与者会 然后设置目标退出日期，接受戒烟咨询，并使用经过验证的吸烟中继协议进行监视6个月以评估时间（天）。主要结果是该释放的时间。次要结果包括30天后的禁欲和吸烟状况。出于人类受试者的原因，将为接力吸烟者提供一个机会，可以在研究完成后免费获得8周的尼古丁补丁治疗和咨询。尽管神经影像不太可能在不久的将来成为标准的账单前评估，但这项研究将阐明病理神经行为过程和特定的神经认知领域，这些过程可以针对新的治疗方法，以帮助戒烟。