Long-Term Abstinence Clinical Issues and CNS Disinhibition

长期戒酒的临床问题和中枢神经系统抑制解除

基本信息

批准号：
7683910
负责人：
George Fein
金额：
$ 74.76万
依托单位：
NEUROBEHAVIORAL RESEARCH, INC.
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-01 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7683910
关键词：
4-aminospiroperidol Abstinence Affect Age Alcohol abuse Alcohol dependence Alcoholism Alcohols Amygdaloid structure Antisocial Personality Disorder Anxiety Area Arts Behavior Brain Cerebellum Characteristics Chronic Clinical Cognitive Communities Comorbidity Corpus Callosum Data Decision Making Dependence Diagnosis Diagnostic Diffusion Disease Disinhibition Drug Addiction Drug abuse Drug usage EP300 gene Equilibrium Event Face Family history of Future Gait Gambling Gender Goals Hippocampus (Brain)Image Impairment Impulsivity Individual Inherited Iowa Laboratories Light Longitudinal Studies Magnetic Resonance Imaging Measurement Measures Mental disorders Mood Disorders Moods Neurobiology Neurologic Nicotine Pharmaceutical Preparations Population Predisposition Prevalence Procedures Process Psychiatric Diagnosis Public Health Recording of previous events Recovery Recruitment Activity Research Rewards Role Sampling Sampling Studies Socialization Societies Structure Subgroup Substance Addiction Suggestion Symptoms System Testing Tissues Visual Visuospatial Woman Work addiction anti social base behavior test cognitive function cognitive recovery cohort deviant disability drinking drug/alcohol abstinence executive function gray matter improved information processing meetings men problem drinker psychologic success

项目摘要

DESCRIPTION (provided by applicant): Over the past years, our laboratory has been studying long-term abstinent alcoholics (LTAAs). The data from those studies are unique and of potential great importance. We have found: 1) essentially normal cognitive functioning, 2) decision- making impairments and reduced gray matter volumes in an area (the amygdala) implicated in decision making impairments in neurologic samples, 3) reduced visual P300 amplitudes and delayed latencies, 4) greater lifetime and current prevalence of psychiatric disorders, suggesting that alcoholics can achieve and maintain long-term abstinence in the face of an ongoing psychiatric disorder, 5) substantial comorbid psychiatric illness that consisted primarily of sub-diagnostic symptoms and abnormal scores on psychological measures, 6) greater comorbid psychiatric disturbance in LTAAs vs. normal controls, even if individuals with lifetime or current psychiatric diagnoses were excluded, 7) that current symptoms of Antisocial Personality Disorder were minimal despite evidence of deviance proneness, impulsivity and poor decision- making, and 8) very recent data that the LTAAs have reduced cortical gray matter volumes compared than controls. The goals of the proposed research are to replicate and extend the above findings in larger samples, expanding the studies to include individuals with comorbid SUDs, who may differ substantially from LTAAs without comorbid SUDs with regard to cognitive recovery, comorbid psychiatric disturbance, and the function of disinhibitory brain systems. We have modified the psychiatric symptom assessment procedure to obtain a much clearer picture of ongoing psychiatric illness and changes in ASPD symptoms with long-term abstinence. Finally, we will also study individuals in the very first months of abstinence. A focus of the proposed research is whether the neurobiological disinhibitory underpinnings of externalizing illness have changed with abstinence, or whether the predisposition is unchanged, but is kept under wraps by higher cognitive functions. The study of individuals in early abstinence will enable us to compare long-term abstinence with early abstinence to see if there are suggestions that disinhibitory function is different in long-term vs. the first months of abstinence. PUBLIC HEALTH RELEVANACE This project will examine long-term abstinent alcoholics to replicate and extend our earlier findings with regard to cognitive recovery, comorbid psychiatric disturbance, and the neurobiological underpinnings of the disinhibition/externalizing continuum, including whether, how, and to what extent these phenomena are modified in long-term abstinence. A major extension of the work will be to study samples with alcohol dependence alone vs. with alcohol dependence and other substance dependence. The proposed studies should help elucidate the clinical and neurobiological picture of long- term abstinence. We believe such data is essential. It is only by understanding the successes in dealing with chronic alcoholism among treated samples with significant comorbidity that society will be able to make significant progress in facilitating such successes in the future.

描述（由申请人提供）：在过去的几年里，我们的实验室一直在研究长期戒酒者（LTAA）。这些研究的数据是独一无二的，并且具有潜在的重要意义。我们发现：1) 认知功能基本正常，2) 神经系统样本中与决策障碍有关的区域（杏仁核）决策障碍和灰质体积减少，3) 视觉 P300 振幅减少和延迟延迟，4)更长的寿命和当前精神疾病的患病率，表明酗酒者可以在面对持续的精神疾病时实现并保持长期戒酒，5）实质性主要包括亚诊断症状和心理测量得分异常的共病精神疾病，6) LTAA 中与正常对照组相比，共病精神障碍更大，即使排除了终生或当前有精神疾病诊断的个体，7) 当前的反社会症状尽管有证据表明存在越轨倾向、冲动和糟糕的决策，但人格障碍很少，并且 8) LTAA 的最新数据与对照组相比，皮质灰质体积减少。拟议研究的目标是在更大的样本中复制和扩展上述发现，将研究范围扩大到包括患有共病 SUD 的个体，这些人在认知恢复、共病精神障碍和功能方面可能与没有共病 SUD 的 LTAA 有很大不同。去抑制性大脑系统。我们修改了精神症状评估程序，以便更清楚地了解正在进行的精神疾病以及长期戒酒后 ASPD 症状的变化。最后，我们还将研究禁欲最初几个月的个体。拟议研究的一个重点是外化疾病的神经生物学去抑制基础是否随着禁欲而改变，或者倾向是否没有改变，但被更高的认知功能所隐藏。对早期禁欲个体的研究将使我们能够比较长期禁欲和早期禁欲，看看是否存在长期禁欲与最初几个月禁欲的去抑制功能不同的迹象。公共健康相关性该项目将检查长期戒酒的酗酒者，以复制和扩展我们早期关于认知恢复、共病精神障碍以及去抑制/外化连续体的神经生物学基础的发现，包括是否、如何以及在何种程度上这些长期禁欲可以改变现象。这项工作的一个主要延伸将是研究仅酒精依赖的样本与酒精依赖和其他物质依赖的样本。拟议的研究应有助于阐明长期禁欲的临床和神经生物学情况。我们认为此类数据至关重要。只有了解在处理具有严重合并症的样本中处理慢性酒精中毒的成功情况，社会才能在未来促进此类成功方面取得重大进展。