Using event-related potentials to longitudinally track cue-induced craving incubation in cocaine addicted individuals

利用事件相关电位纵向追踪可卡因成瘾个体中线索诱导的渴望孵化

• 批准号: 9240618
• 负责人: Rita Z Goldstein
• 金额: $ 65.44万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 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/9240618
• 关键词: Abate; Abstinence; Acute; Aftercare; Alcohol dependence; Animal Model; Animals; Attention; Behavioral; Chronic; Cigarette; Cocaine; Cocaine Dependence; Cross-Sectional Studies; Cues; Data; Disease; Drug Addiction; Drug usage; Electroencephalography; Event-Related Potentials; Exposure to; Future; Goals; Health Personnel; Heroin; Heroin Dependence; Human; Incubated; Individual; Intervention; Investigation; Knowledge; Laboratories; Magnetic Resonance Imaging; Measures; Methamphetamine; Methamphetamine dependence; Modality; Modeling; Monitor; Nicotine; Nicotine Dependence; Outcome; Patient Self-Report; Pharmaceutical Preparations; Prevention; Process; Psychophysiology; Regulation; Relapse; Reporting; Research; Research Design; Resistance; Scanning; Self Administration; Social Desirability; Stimulus; Substance Use Disorder; Testing; Time; Translations; Withdrawal; Withdrawal Symptom; Work; addiction; bench to bedside; biobehavior; cocaine use; cost; craving; drug addict; drug craving; drug relapse; expectation; follow-up; imaging study; improved; infancy; neuroimaging; outcome prediction; personalized intervention; preclinical study; preempt; prospective; public health relevance; relapse prediction; relapse risk; relating to nervous system; smoking cessation

 DESCRIPTION (provided by applicant): Among the many addictions, cocaine addiction is particularly treatment-resistant, with estimated relapse rates greater than 45%. While most abstaining individuals with cocaine use disorders (iCUD) relapse within the first few weeks of abstinence, relapse continues to occur long after acute withdrawal has abated. Re-exposure to cues previously associated with drug use that evoke craving is a major contributing factor in relapse to drug use. Pre-clinical studies using several animal models of drug addiction (including in cocaine, heroin, alcohol, nicotine, and methamphetamine addiction models) have shown that, contrary to common expectations for the reduction of craving and drug-seeking with abstinence, cue-induced drug craving increases progressively (i.e., incubates) in the first several months of abstinence. Primarily using a cross-sectional study design and subjective measures of craving assessed at different periods of abstinence (from 7 days post abstinence onset up to 24 months of abstinence), several human studies have shown similar effects in nicotine, methamphetamine and heroin use disorders. Together, these studies show highest cue-induced craving at 3 to 6 months of abstinence, suggesting that such incubation of craving renders abstaining drug addicted individuals vulnerable to relapse. However, a systematic investigation that uses objective markers and a within- subjects approach to quantify and longitudinally track the trajectory of cue-induced craving and its incubation for relapse monitoring and prediction is lacking. The late positive potential (LPP) component of the electroencephalography has been shown to objectively track motivated attention to salient stimuli including drug-cues, correlating with cue-induced craving and predicting relapse in cocaine and nicotine addicted individuals. Using LPP, our preliminary data suggests that cue-induced craving increases at 6-months and then decreases at 12-months follow-up compared to a treatment-seeking baseline in initially abstinent iCUD. Thus, we aim to use LPPs to assess cue-induced craving at carefully selected abstinence durations [at 7, 14, 30 days (assessed cross-sectionally) and at 3, 6, 9, and 12 months (assessed longitudinally)] to objectively measure the dynamics of craving incubation in human cocaine addiction. The hypothesized inverted-U shaped trajectory will be elucidated via changes in LPP amplitude, and will be supplemented by measures of simulated drug-seeking and self-reported craving. Our second aim is to use the longitudinal dynamics of craving incubation to monitor and prospectively predict relapse. Results could aid in developing time-sensitive personalized interventions to reduce risk of relapse in treatment-seeking individuals with substance use disorders.

 描述（由适用提供）：在许多成瘾中，可卡因成瘾尤其耐治疗，估计继电器率大于45％。虽然大多数弃用可卡因使用障碍（ICUD）继电器的人在禁欲的头几周内接力，但继电器在急性戒断后很长时间继续发生。 Re-exposure to cues previously associated with drug use that evoke craving is a major contributing Pre-clinical studies using several animal models of drug addiction (including in cocaine, heroin, alcohol, nicotine, and methamphetamine addiction models) have shown that, contrast to common expectations for the reduction of craving and drug-seeking with abstinence, cue-induced drug craving increases progressively (i.e., incubates) in禁欲的前几个月。主要使用在不同时期（节制后7天到禁欲的24个月开始）评估评估的渴望的横断面研究设计和主观测量值，几项人类研究表明，对尼古丁，甲基苯丙胺和海洛因使用障碍的影响相似。总之，这些研究表明，在节制的3到6个月时，提示引起的渴望最高，这表明这种渴望的渴望避免了避免容易受到缓解的吸毒的人。但是，缺乏使用目标标记和一种内部主题方法来量化和纵向跟踪提示引起的渴望的轨迹及其对中继监测和预测的孵化的轨迹。脑电图的晚期积极电位（LPP）成分已被证明可以客观地跟踪激发人们对包括药物的显着性刺激的关注，与提示引起的渴望和预测可卡因和尼古丁上瘾的个体中的继电器相关。使用LPP，我们的初步数据表明，与最初戒烟的ICUD中寻求治疗的基线相比，提示引起的渴望增加在6个月时增加，然后在12个月的随访中减少。因此，我们的目标是使用LPP在精心选择的节制持续时间（在7、14、30天（在横截面上）和3、6、9、9和12个月（纵向评估）[在7、14、30天（评估）时]评估提示引起的渴望。假设的倒立形状轨迹将通过LPP放大器的变化来阐明，并通过模拟毒品寻求药物和自我报告的渴望来补充。我们的第二个目的是利用渴望孵化的纵向动态来监测和预测继电器。结果可能有助于制定时间敏感的个性化干预措施，以降低患有药物使用障碍的寻求治疗的人的缓解风险。