Effects of Neuromodulation and Cognitive Training on Brain Networks Associated with Relapse in Alcohol Use Disorder

神经调节和认知训练对与酒精使用障碍复发相关的大脑网络的影响

• 批准号: 10189450
• 负责人: Yuclyn Jazmin Camchong
• 金额: $ 14.88万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10189450
• 关键词: Abstinence; Address; Affect; Alcohol consumption; Alcohols; Animals; Base of the Brain; Behavior; Brain; Clinical; Clinical Trials; Cognition; Corpus striatum structure; Crime; Custom; Data; Development Plans; Double-Blind Method; Family; Fostering; Functional Magnetic Resonance Imaging; Future; Goals; Health; Human; Individual; Intervention; K-Series Research Career Programs; Knowledge; Lead; Measures; Mentors; National Institute on Alcohol Abuse and Alcoholism; Neurologic; Outcome; Participant; Patients; Population; Productivity; Public Health; Recovery; Relapse; Research; Research Personnel; Research Proposals; Rest; Sample Size; Societies; Standardization; Substance Use Disorder; Techniques; Therapeutic Uses; Time; Treatment outcome; United States National Institutes of Health; alcohol abstinence; alcohol abuse therapy; alcohol craving; alcohol use disorder; base; binge drinking; career development; cognitive training; cost; follow-up; improved; improved outcome; interest; neural network; neuroimaging; neuromechanism; neuroregulation; novel; post intervention; predictive marker; prevent; psychosocial; randomized trial; recruit; relating to nervous system; research and development; skills; success; therapy development; treatment program

Relapse rates in psychosocially-based treatment programs for alcohol use disorder (AUD) remain high. Novel brain-based interventions are needed to improve outcomes. Interventions that target the underlying neural networks associated with relapse hold significant promise in reducing this critical public health problem. My resting-state functional connectivity (RSFC) data showed that individuals with AUD (i) who have achieved long- term abstinence have higher prefrontal-striatal RSFC, and (ii) who subsequently relapse show low prefrontal- striatal RSFC during early abstinence. I am interested in investigating whether prefrontal-striatal RSFC can be modified during early abstinence as a form of treatment to prevent subsequent relapse. We have evidence that transcranial direct current stimulation (tDCS) interventions paired with cognitive training can significantly increase brain RSFC and modify behavior. We will conduct a double-blind randomized trial including 75 participants receiving treatment for AUD to determine whether a tDCS intervention combined with cognitive training can increase prefrontal-striatal RSFC and reduce amount of alcohol use during a follow-up period. We will also investigate whether RSFC changes are related to clinical outcomes. The central hypothesis is that active-tDCS combined with cognitive training will increase prefrontal-striatal RSFC and reduce amount of alcohol use during a 6-month follow-up period. This research proposal will address the following specific aims: SA1. Compare the effect of active- vs. sham-tDCS intervention on RSFC. Hypothesis: Active-tDCS, compared to sham-tDCS will produce greatest increase in prefrontal-striatal RSFC. SA2. Determine whether RSFC changes during early abstinence affect alcohol use during a follow-up period (FC changes independent of tDCS intervention). Hypothesis: Degree of prefrontal-striatal FC increases will correspond to reduction in alcohol use 6-months after intervention. SA3. Compare the effects of active- vs. sham-tDCS intervention on abstinence over 6-month follow-up period. Hypothesis: Active-tDCS, compared to sham tDCS will produce lower alcohol use 6-months after intervention. Findings will provide crucial evidence supporting the therapeutic use of customized brain-based interventions targeting underlying neural mechanisms to support alcohol abstinence. T his research will provide preliminary data for a properly powered clinical trial, a future R01 application with larger sample sizes and more neuroimaging time points to inform validated new interventions. Combined with my career development plan and strong mentoring team, this K award will foster my successful transition to independence as an investigator with the knowledge and skills to lead a team that converges neuroimaging findings with novel treatment interventions to improve outcomes in substance use disorders.

基于心理的酒精使用障碍治疗计划（AUD）的复发率仍然很高。小说 需要采取基于大脑的干预措施来改善预后。针对潜在神经的干预措施 与复发相关的网络在减少这一关键的公共卫生问题方面具有巨大的希望。我的 静止状态功能连接性（RSFC）数据表明，AUD（i）的个人已达到长期 条款禁欲的前额叶纹状体RSFC较高，（ii）随后复发显示前额叶较低 - 早期戒酒期间的纹状体RSFC。我有兴趣调查前额叶纹状体RSFC是否可以 在戒酒期间修改为一种治疗形式，以防止随后复发。我们有证据表明 与认知训练配对的经颅直流刺激（TDCS）干预措施可以显着 增加大脑RSFC并改变行为。我们将进行一项双盲随机试验，包括75 接受AUD治疗的参与者确定TDCS干预是否与认知结合 培训可以增加前额叶纹状体RSFC，并在随访期内减少饮酒量。我们 还将研究RSFC变化是否与临床结果有关。中心假设是 与认知训练相结合的Active-TDC将增加前额叶纹状体RSFC并减少 在6个月的随访期间使用饮酒。该研究建议将解决以下特定的 目标：SA1。比较Active- Active-与Sham-TDCS干预对RSFC的影响。假设：Active-TDC， 与Sham-TDC相比，前额叶纹状体RSFC的增加最大。 SA2。确定RSFC在早期节制期间是否会改变随访期间的饮酒 （FC独立于TDCS干预而变化）。假设：前额叶 - 纹状体FC的增加程度将 干预后6个月的酒精使用量相对应。 SA3。比较活动vs的效果。 Sham-TDCS在6个月的随访期内禁止禁欲。假设：与Active-TDC相比 Sham TDC在干预后将产生较低的酒精使用量6个月。调查结果将提供至关重要的证据 支持针对基础神经的定制基于大脑的干预措施的治疗使用 支持戒酒的机制。 t 他的研究将为适当的动力提供初步数据 临床试验，一种未来的R01应用，具有较大样本量和更多神经成像时间点，以告知 验证了新的干预措施。结合我的职业发展计划和强大的指导团队，这个K 奖项将促进我成功过渡到独立的调查员，并具有知识和技能 领导一个通过新颖的治疗干预措施融合神经影像学的团队 物质使用障碍。