Nonprofit Research Organization/Lovelace Biomedical and Environmental Research Institute , Albuquerque, NM, USA.
Department of Psychology, University of New Mexico , Albuquerque, NM, USA.
Am J Drug Alcohol Abuse. 2020 May 3;46(3):357-367. doi: 10.1080/00952990.2019.1671437. Epub 2019 Nov 15.
While attentional bias modification therapy (ABMT) alters drug-related behaviors in some substance users, results have been mixed in individuals with cocaine use disorders (CUD).
The current study examined whether ABMT affected brain functioning during independent measures of cue reactivity (i.e., cocaine versus food cues) and cognitive control (i.e., incongruent versus congruent trials), and whether brain activity was associated with baseline or post-intervention cocaine use.
37 participants (62% male) were randomly assigned to ABMT or control therapy. Clinical and neuroimaging assessments occurred at baseline and immediately post-intervention, with additional clinical testing at 2 weeks and 3 months following intervention. Cocaine use was assessed through self-report.
Slower reaction times and increased functional activation (prefrontal cortex, posterior parietal cortex) were observed for incongruent versus congruent stimuli and increased functional activation for cocaine relative to food videos (ventral striatum, dorsolateral prefrontal cortex and orbitofrontal cortex). The default-mode network (DMN) was not deactivated during exposure to cocaine videos. The degree of activation during cocaine relative to food cues was associated with baseline cocaine use (insula only) and reduction in use following treatment (insula and anterior DMN) above and beyond clinical variables. Cognitive control network activity was not associated with cocaine use at baseline or following treatment. ABMT therapy did not differentially affect cocaine use or functional activation during either task.
Current results suggest a relationship between cue reactivity network activation and cocaine use, but question the efficacy of ABMT in changing brain function during cue reactivity or cognitive control tasks.
尽管注意偏向修正治疗（ABMT）改变了一些药物使用者的药物相关行为，但可卡因使用障碍（CUD）患者的结果喜忧参半。
本研究旨在考察 ABMT 是否影响独立的线索反应（即可卡因与食物线索）和认知控制（即不一致与一致试验）期间的大脑功能，以及大脑活动是否与基线或干预后可卡因使用有关。
37 名参与者（62%为男性）被随机分配至 ABMT 或对照治疗组。在基线和干预后立即进行临床和神经影像学评估，并在干预后 2 周和 3 个月进行额外的临床测试。通过自我报告评估可卡因使用情况。
与一致刺激相比，不一致刺激的反应时间较慢，大脑活动增加（前额叶皮层、后顶叶皮层），而与食物视频相比，可卡因的大脑活动增加（腹侧纹状体、背外侧前额叶皮层和眶额皮层）。在暴露于可卡因视频时，默认模式网络（DMN）没有去激活。与基线可卡因使用（仅岛叶）和治疗后使用减少（岛叶和前 DMN）相关的可卡因与食物线索相比，大脑激活程度超出了临床变量。认知控制网络活动与基线或治疗后可卡因使用无关。ABMT 治疗并未对这两个任务中的可卡因使用或功能激活产生差异影响。
目前的结果表明，线索反应网络激活与可卡因使用之间存在关联，但对 ABMT 在改变线索反应或认知控制任务期间的大脑功能的疗效提出了质疑。
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