Cue Reactivity Modulation in MSM with Methamphetamine Use Disorder

甲基苯丙胺使用障碍 MSM 的提示反应性调节

• 批准号: 10663559
• 负责人: Muhammad Adeel Parvaz
• 金额: $ 41.26万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663559
• 关键词: Abstinence; Arousal; Attenuated; Behavior Therapy; Behavioral; Clinical; Cocaine use disorder; Control Groups; Cues; Development; Drug usage; Electroencephalography; Emotional; Evidence based intervention; FDA approved; Foundations; HIV; Incubated; Individual; Informal Social Control; Intervention; Knowledge; Light; Measures; Mediating; Methamphetamine; Methamphetamine overdose; Methamphetamine use disorder; Outcome; Outcome Measure; Participant; Patient Self-Report; Patients; Pharmaceutical Preparations; Phase; Population; Prefrontal Cortex; Prevalence; Psychophysiology; Randomized; Regulation; Relapse; Research; Role; Sampling; Severities; Severity of illness; Substance Use Disorder; Techniques; Testing; Time; Training; Treatment outcome; Visit; Work; addiction; adverse outcome; cocaine cue; cognitive control; cognitive reappraisal; cohort; comparison control; craving; cue reactivity; design; drug seeking behavior; effectiveness testing; executive function; experience; follow-up; improved; men who have sex with men; methamphetamine use; methamphetamine user; neurophysiology; opioid epidemic; overdose death; relapse prediction; relapse prevention; remediation; secondary outcome; sexual minority; substance use; success; treatment adherence; treatment response

PROJECT SUMMARY In the midst of the opioid epidemic, methamphetamine use is emerging as the next substance use crisis with disproportionately increasing prevalence in men who have sex with men (MSM), high relapse rates and no FDA-approved treatments for individuals with methamphetamine use disorder (MUD). One of the major contributors to relapse is the enhanced motivated arousal (cue-reactivity) to drug-related cues, even after protracted abstinence that leads to an increase in craving and drug-seeking. Although cue-reactivity is studied widely in other substance use disorders, its study is scarce in MUD and non-existent in MSM with MUD, creating a critical gap in knowledge needed for unbiased assessment of disease severity and treatment outcomes in this rapidly growing clinical population. Therefore, in this bi-phased study, we propose to first identify a psychophysiological marker of methamphetamine cue-reactivity and its incubation with abstinence from methamphetamine use and examine group-differences between MSM and non-MSM MUD. Subsequently, in the second phase we propose to longitudinally assess incubation of cue-reactivity, its reduction with cognitive reappraisal (CR; a self-regulation technique) and examine the impact of CR on clinical outcomes in MSM with MUD. In light of preliminary findings from our group, we hypothesize that LPP, an electroencephalography-derived marker of drug cue-reactivity, will track the incubation of methamphetamine cue-reactivity and its CR-mediated reduction, which in turn will be associated with improved clinical outcomes in MSM with MUD. In the R61 phase, we will cross-sectionally compare the LPP-assessed cue-reactivity between currently using (Group 1) and abstinent (1-3 months; Group 2) individuals with MUD (50% MSM in each group, matched on HIV status), and examine in-task changes in cue-reactivity with CR technique. In the R33 phase, we will assign a cohort of MUD to either the CR+ (Cognitive Reappraisal training) or the CR- (no Cognitive Reappraisal training) group (all MSM, matched on HIV status), and cue-reactivity will be assessed longitudinally at <2 weeks, 2 months, to 3 months after abstinence initiation. Successful completion of these aims will identify an EEG-based, objective, and clinically useful marker of methamphetamine cue-reactivity, and will delineate the impact of CR on methamphetamine cue-reactivity in relation to treatment response in MSM with MUD. This work will be the beginning of mechanistic research into the role of incubation of methamphetamine cue-reactivity and its reduction as a reliable and clinically meaningful outcome measure, establishing an empirical foundation to develop an intervention for MUD and possibly in other addictions.

项目摘要 在阿片类药物流行中，甲基苯丙胺的使用正在出现，因为下一次使用危机 与男性发生性关系（MSM），高复发率和无的男性患病率不成比例 甲基苯丙胺使用障碍（MUD）的FDA批准治疗方法。专业之一 复发的贡献者是增强动机的唤醒（提示反应性），即使在 长期的禁欲导致渴望和寻求毒品的增加。尽管研究了提示反应性 在其他物质使用障碍中，其研究在泥浆中很少，在MSM中不存在泥浆， 在公正评估疾病严重程度和治疗所需的知识上造成关键的差距 这个快速增长的临床人群的结果。因此，在这项双期研究中，我们提议首先 确定甲基苯丙胺提示反应性的心理生理标志物及其与禁欲的孵化 从甲基苯丙胺的使用中，并检查MSM和非MSM泥浆之间的群体差异。 随后，在第二阶段，我们提出纵向评估提示反应性的孵育，它 通过认知重新评估（CR；一种自我调节技术）的减少并检查CR对临床的影响 MSM的结果与泥浆。鉴于我们小组的初步发现，我们假设LPP是 脑电图衍生的药物提示反应性标记物将跟踪甲基苯丙胺的孵育 提示反应性及其CR介导的降低，这反过来将与改善的临床结局有关 在MSM中带泥。在R61阶段，我们将在横截面上比较通过LPP评估的提示反应性 在当前使用（第1组）和戒酒（1-3个月；第2组）泥浆（50％MSM）之间 每个组都匹配HIV状态），并使用CR技术检查提示反应性的任务变化。在 R33阶段，我们将为CR+（认知重新评估训练）或CR-分配一组泥浆 认知重新评估培训）组（所有MSM，均与HIV状态匹配），并将评估提示反应性 在戒酒开始后的2周，2个月至3个月时，纵向纵向。这些成功完成 AIMS将确定甲基苯丙胺提示反应性的基于EEG，客观和临床上有用的标志物， 并将描述CR对甲基苯丙胺提示反应性的影响与治疗反应有关 MSM带泥。这项工作将是对孵化作用的机械研究的开始 甲基苯丙胺提示反应性及其降低是一种可靠且临床上有意义的结果指标， 建立一个经验基础，以开发泥浆和其他成瘾的干预措施。