Project #3 Regulation of Craving: Brief Neurocognitive Training & Neural Mechanis

项目

• 批准号: 8742768
• 负责人: Hedy Kober
• 金额: $ 38.72万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8742768
• 关键词: Abstinence; Address; Aftercare; Behavioral; Biological; Brain region; Cigarette Smoker; Cognitive; Cognitive Therapy; Cues; Data; Development; Diagnostic and Statistical Manual of Mental Disorders; Disease; Exposure to; Failure; Freedom; Functional Magnetic Resonance Imaging; Gender; Hour; Individual; Individual Differences; Intervention; Judgment; Lead; Link; Measurement; Measures; Meta-Analysis; Modeling; Motivation; Neurobiology; Neurocognitive; Nicotine; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Prefrontal Cortex; Process; Psychotherapy; Randomized; Regulation; Reporting; Research; Rewards; Smoker; Smoking; Smoking Behavior; Staging; Stimulus; Training; Treatment outcome; Ventral Striatum; Withholding Treatment; abstracting; addiction; base; cigarette smoking; cognitive control; computerized; craving; design; efficacy testing; experience; follow-up; improved; indexing; mindfulness; neurobiological mechanism; neuromechanism; psychologic; relating to nervous system; research and development; skills; skills training; smoking cessation; smoking relapse; standard care; trial comparing

Abstract/Project Summary: Project #3 In addicted individuals, exposure to conditioned drug cues (e.g., paraphernalia) elicits craving: the desire to use drugs1. Craving is increasingly recognized as an important contributory factor in addiction in general, and in cigarette smoking in particular2-7. Indeed, it has been shown to predict smoking and relapse following abstinence8-16, suggesting that treatments to mitigate the effects of cue-induced craving are needed17. Consistently, skills training in regulation of craving (a form of cognitive control) is an important feature of many interventions7, 18-22, including cognitive-behavioral therapy23, 24 and mindfulness-based treatments25, 26. Craving and its regulation have distinct neurobiological mechanisms. The neural correlates of craving include the ventral striatum and ventromedial prefrontal cortex27-29. We developed the Regulation of Craving (ROC) task30-35 to investigate the neural mechanisms associated with the regulation of craving. In this task, nicotine-dependent smokers are exposed to smoking-related stimuli. In one condition they experience craving, and in another (the regulation condition), they are instructed to use a strategy to modulate their craving for cigarettes31. Research has shown that self-reported craving and craving-related neural activity are significantly reduced during the regulation condition32, 34, 36. However, the exact neural mechanisms by which regulation operates depend on the strategy used. Specifically, regulation of craving with cognitive strategies depends on activation in prefrontal regions, typically associated with cognitive control, such as dorsolateral and ventrolateral prefrontal cortex32, 36-38. However, regulation with mindfulness strategies does not involve PFC34. We propose that brief training in regulation of craving may increase the efficacy of smoking cessation treatments, but that training in cognitive vs. mindfulness-based strategies may operate via different psychological and neural mechanisms. We propose to test the efficacy of such training by randomizing 126 cigarette smokers to the following conditions: 1) brief training in cognitive regulation of craving + standard treatment, 2) mindfulness-based training + standard treatment, and 3) standard treatment (no training). Training will be delivered in 4x1 hour computerized sessions over four weeks, with an 8-week follow-up. We will evaluate the effects of training on craving and regulation of craving measured by self-report and functional magnetic resonance imaging during the ROC task administered pre- and post- treatment, as well as smoking. This project promises to advance our psychological and neurobiological understanding of craving and its regulation, how these processes change during specific types of training, and how they relate to actual smoking behaviors. Results from this study hold potential to allow neurobiologically-targeted adaptation of current treatments, with an aim of discovering potentially precise biological predictions of treatment outcomes.

摘要/项目摘要：项目#3 在成瘾者中，接触条件性药物线索（例如用具）会引起渴望： 1. 使用药物的欲望。人们越来越认识到渴望是成瘾的一个重要因素 一般而言，特别是吸烟2-7。事实上，它已被证明可以预测吸烟和复吸 禁欲后8-16，表明需要采取治疗措施来减轻提示引起的渴望的影响17。 一致地，调节渴望（认知控制的一种形式）的技能训练是许多人的一个重要特征。 干预措施7, 18-22，包括认知行为治疗23, 24 和基于正念的治疗25, 26。 渴望及其调节具有独特的神经生物学机制。渴望的神经关联 包括腹侧纹状体和腹内侧前额皮质27-29。我们制定了贪欲调节法 （ROC）任务 30-35 研究与渴望调节相关的神经机制。在这个任务中， 尼古丁依赖型吸烟者会受到与吸烟相关的刺激。在一种情况下，他们体验到渴望， 在另一种情况下（调节条件），他们被指示使用一种策略来调节他们的渴望 香烟 31.研究表明，自我报告的渴望和与渴望相关的神经活动显着 在调节条件下减少32,34,36。然而，调节的确切神经机制 操作取决于所使用的策略。具体来说，用认知策略调节渴望取决于 前额叶区域的激活，通常与认知控制相关，例如背外侧和 腹外侧前额皮质32, 36-38。然而，正念策略的调节并不涉及 PFC34。 我们建议，短期的烟瘾调节训练可能会提高戒烟效果 治疗，但认知策略与正念策略的训练可能通过不同的方式进行 心理和神经机制。我们建议通过随机分组 126 来测试这种训练的效果 吸烟者要满足以下条件：1）烟瘾认知调节的简短训练+标准 治疗，2) 基于正念的训练 + 标准治疗，以及 3) 标准治疗（无训练）。 培训将在四个星期内以 4x1 小时的计算机化课程进行，并进行为期 8 周的后续培训。我们 将通过自我报告和功能性测量来评估训练对渴望和渴望调节的影响 在治疗前和治疗后进行的 ROC 任务期间进行磁共振成像，以及吸烟。 这个项目有望增进我们对渴望和渴望的心理和神经生物学的理解。 其监管，这些过程在特定类型的培训期间如何变化，以及它们与实际情况有何关系 吸烟行为。这项研究的结果有可能使神经生物学有针对性地适应 当前的治疗方法，旨在发现治疗结果的潜在精确生物学预测。