Postpartum Intervention for Mothers with Opioid Use Disorders - Brain-Behavior Mechanisms

对患有阿片类药物使用障碍的母亲进行产后干预 - 大脑行为机制

基本信息

批准号：
10655295
负责人：
Maria Muzik
金额：
$ 38.93万
依托单位：
STATE UNIVERSITY NEW YORK STONY BROOK
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10655295
关键词：
Address Affect Aggressive behavior Amygdaloid structure Behavior Behavioral Mechanisms Biological Markers Brain Brain imaging Brain region Caring Child Child Abuse and Neglect Child Rearing Chronic Clinical Crying Data Data Reporting Drug usage Emotional Epidemic Event-Related Potentials Evoked Potentials Face Family Foundations Functional Magnetic Resonance Imaging Functional disorder Fusiform gyrus Goals Grant Hospitals Human Hyperactivity Hypothalamic structure Impairment Incidence Infant Interpersonal Relations Intervention Investigation Knowledge Magnetic Resonance Imaging Maternal Behavior Measures Mediating Mental Depression Mood Disorders Moods Mothers Neurosciences Research Opioid Outcome Measure Outcome Study Overdose Parents Patient Self-Report Perinatal Persons Phase Physiology Population Postpartum Period Postpartum Women Pregnant Women Public Health Publishing Randomized Relapse Research Rest Sampling Scientist Site Societies Specific qualifier value Stimulus Stress Substance Use Disorder Testing Withdrawal Woman Work biomarker development brain based brain behavior buprenorphine treatment caregiving child bearing clinical decision-making comorbidity cost craving drug craving evidence base flexibility foster care high risk high risk behavior improved innovation intervention effect maternal outcome midbrain central gray substance mood symptom multimodality neurobiological mechanism neuroimaging opioid epidemic opioid use opioid use disorder polysubstance use psychosocial response stress symptom therapy development translational potential treatment as usual usual care arm virtual virtual delivery

项目摘要

Project Summary Postpartum Intervention for Mothers with Opioid Use Disorders - Brain-Behavior Mechanisms Opioid use disorder (OUD) is a fast-growing and devastating epidemic in the US with many suffering comorbid mood disorders. Despite receiving “gold standard” buprenorphine treatment to reduce withdrawal, OUD mothers still suffer have cravings, depression, impaired interpersonal interactions and maladaptive parenting behaviors that may lead to child maltreatment and costly utilization of foster care. We know that parenting interventions improve parent mood and sensitive caregiving behaviors for high-risk non-OUD populations. We developed “Mom Power” (MP), an evidence-based 13-session psychosocial mother-child intervention. We have established that MP enhances emotionally sensitive caregiving, while concurrently reducing parental stress and depression for non-OUD mothers. We also have preliminary feasibility data for MP with substance use disorders. However, we do not know about parenting interventions for mothers with OUD – specifically how virtual MP (vMP) will work to reduce drug use or improve mood. We also know about how the brain regulates parenting. Recent work from our team has established that a parenting intervention for non-OUD mothers was associated with a larger enhancement of evoke potential responses (ERPs) for emotional faces relative to neutral faces and that the magnitude of ERP responses to emotional faces was associated with observed maternal sensitivity. Using magnetic resonance imaging (MRI) of the brain, we have also established a Maternal Behavior Neurocircuit (MBN) that regulates flexible responses to the demands of their own infant – such as to the unique, ethologically salient own-baby cry and face stimuli during the early postpartum period. We have established MRI maternal brain changes associated with MP in non-OUD mothers, and brain effects of OUD on mothers. However, we do not know about parental brain mechanisms through which parenting interventions may work for mothers with OUD – whether they will affect ERP responses to baby stimuli or affect the MBN. Central hypotheses: Mothers with OUD who receive virtual MP (vMP), compared to matched controls, will show improved drug craving, mood, and stress symptoms, via changes in pre-specified MBN brain regions. In the high-risk R61 phase, we will establish if vMP (n=25) for OUD can be implemented and improve mood, reduce drug use and affect ERP brain responses to baby pictures compared with control (n=25). If hypotheses in the R61 are confirmed, we will confirm and expand this breakthrough with the R33 Phase (n=160, 80/group), adding richer maternal outcome measures and MBN MRI. This research will elucidate the effects of parenting intervention MP on drug use and brain function for OUD mothers - with translational potential for biomarker and treatment development.

项目概要对患有阿片类药物使用障碍的母亲进行产后干预 - 大脑行为机制阿片类药物使用障碍 (OUD) 在美国是一种快速增长且具有毁灭性的流行病，许多人深受其害尽管接受“金标准”丁丙诺啡治疗以减少戒断， OUD 母亲仍然遭受渴望、抑郁、人际互动受损和适应不良等困扰可能导致虐待儿童和昂贵的寄养费用的养育行为。我们知道，育儿干预可以改善父母的情绪和敏感的照顾行为我们开发了“妈妈力量”(MP)，这是一项基于证据的 13 期课程。我们已经确定 MP 可以增强情绪敏感度。我们还提供护理服务，同时减少非 OUD 母亲的父母压力和抑郁症。患有药物滥用障碍的 MP 的初步可行性数据然而，我们不知道如何养育孩子。针对 OUD 母亲的干预措施 – 特别是虚拟 MP (vMP) 将如何减少吸毒或改善心情。我们还了解大脑如何调节养育子女。我们团队最近的工作证实了这一点。对非 OUD 母亲的育儿干预与诱发电位的更大增强有关情绪面孔相对于中性面孔的反应（ERP），以及 ERP 反应的幅度情绪面孔与磁共振成像（MRI）观察到的母亲敏感性有关。我们还建立了一个母性行为神经回路（MBN）来调节大脑的灵活性对自己婴儿的要求的反应——例如对自己婴儿独特的、在道德上显着的哭声和我们已经确定 MRI 与产后早期的面部刺激有关。 MP 对非 OUD 母亲的影响，以及 OUD 对母亲的大脑影响然而，我们尚不清楚。父母的大脑机制，通过这些机制，育儿干预可能对患有 OUD 的母亲起作用 – 它们是否会影响 ERP 对婴儿刺激的反应或影响 MBN。中心假设：与匹配的对照组相比，接受虚拟 MP (vMP) 的 OUD 母亲会通过预先指定的 MBN 大脑区域的变化，显示出药物渴望、情绪和压力症状的改善。在高风险R61阶段，我们将确定是否可以实施OUD的vMP（n=25）并改善情绪，与对照相比，减少药物使用并影响 ERP 大脑对婴儿照片的反应（n=25）。在R61阶段得到确认后，我们将在R33阶段确认并扩大这一突破（n=160，80/组），增加更丰富的产妇结局指标和 MBN MRI 这项研究将阐明养育子女的影响。针对 OUD 母亲吸毒和脑功能的干预 MP - 具有生物标志物和脑功能的转化潜力治疗的发展。