Attaining control over specific neural processes can enable people to influence associated perceptions, behaviors, and cognitions, with potential clinical application to a range of brain- based disorders, including substance abuse (SA). Using real-time fMRI (rtfMRI), our team recently demonstrated that such control can be learned in the anterior cingulate cortex (ACC), leading to clinically significant reductions in pain. If this exciting initial finding can be generalized to SA, it would have major implications for clinical intervention. Our proposal attempts to take a major step in this direction, which seems likely to be productive given that during rtfMRI of the ACC, we identified activated brain regions involved in SA related reward driven behavior. To make rtfMRI a more useful clinical tool, we propose to resolve four potentially problematic issues identified in our prior rtfMRI studies. First, optimal regions for feedback control need to be determined. Second, subjects employ different cognitive strategies to modulate brain activity, producing variability in brain regions activated and subsequent efficacy in learned control. Third, the strength of connectivity between brain regions may influence cognitive processes and may be a better target for learned control. Fourth, there are significant individual differences in how well subjects are able to modulate their brain activity. We plan to address these issues in the following aims: (1) Enhance and test a system to perform real-time control of brain activity and strength of connectivity between multiple SA and pain related brain regions;(2) Determine optimal cognitive strategies (distraction and reappraisal), and individual differences in ability to control distributed brain regions;(3) Characterize the learned control of the strength of brain connectivity;and (4) Pilot the optimized rtfMRI parameters in a group of SA patients. Our overall goals are to develop rtfMRI as an efficacious clinical therapy for patients with SA and other brain disorders.

Public Health Relevance

Substance abuse is a highly prevalent and debilitating condition that presents a terrible burden to affected patients, their families, and society as a whole, resulting in enormous economic costs. Completion of the proposed aims will lead to an improved understanding of brain modulatory systems. This will also introduce a potentially novel clinical therapy for substance abuse patients as well as patients with overlapping central nervous system illnesses, including chronic pain conditions, depression, and anxiety.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21DA026092-02
Application #
7835592
Study Section
Special Emphasis Panel (ZAA1-GG (33))
Program Officer
Bjork, James M
Project Start
2009-05-15
Project End
2012-04-30
Budget Start
2010-05-01
Budget End
2012-04-30
Support Year
2
Fiscal Year
2010
Total Cost
$322,634
Indirect Cost
Name
Stanford University
Department
Anesthesiology
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Hamilton, J Paul; Glover, Gary H; Bagarinao, Epifanio et al. (2016) Effects of salience-network-node neurofeedback training on affective biases in major depressive disorder. Psychiatry Res 249:91-6
Bagarinao, Epifanio; Johnson, Kevin A; Martucci, Katherine T et al. (2014) Preliminary structural MRI based brain classification of chronic pelvic pain: A MAPP network study. Pain 155:2502-9
Ung, Hoameng; Brown, Justin E; Johnson, Kevin A et al. (2014) Multivariate classification of structural MRI data detects chronic low back pain. Cereb Cortex 24:1037-44
Kong, Jiang-Ti; Johnson, Kevin A; Balise, Raymond R et al. (2013) Test-retest reliability of thermal temporal summation using an individualized protocol. J Pain 14:79-88
Mackey, Sean; Carroll, Ian; Emir, Birol et al. (2012) Sensory pain qualities in neuropathic pain. J Pain 13:58-63
Chapin, Heather; Bagarinao, Epifanio; Mackey, Sean (2012) Real-time fMRI applied to pain management. Neurosci Lett 520:174-81
Brown, Justin E; Chatterjee, Neil; Younger, Jarred et al. (2011) Towards a physiology-based measure of pain: patterns of human brain activity distinguish painful from non-painful thermal stimulation. PLoS One 6:e24124
Lawrence, Jane M; Hoeft, Fumiko; Sheau, Kristen E et al. (2011) Strategy-dependent dissociation of the neural correlates involved in pain modulation. Anesthesiology 115:844-51
Carroll, Ian R; Younger, Jared W; Mackey, Sean C (2010) Pain quality predicts lidocaine analgesia among patients with suspected neuropathic pain. Pain Med 11:617-21
Parris, David; Fischbein, Nancy; Mackey, Sean et al. (2010) A novel CT-guided transpsoas approach to diagnostic genitofemoral nerve block and ablation. Pain Med 11:785-9

Showing the most recent 10 out of 11 publications