Cocaine use disorder (CUD) is a complex, devastating disorder that is difficult to treat, emphasizing the need to improve treatment-individual fit. The goal of this award is to prepare Dr. Soder for a career in addiction research through both a relevant training plan and the proposed research project that aims to determine biomarkers of treatment outcomes for CUD. Dr. Soder?s long term goal is to become an independent researcher in a large academic or medical setting using neurocognitive measures to elucidate individual differences that contribute to risk, maintenance, and treatment outcomes in addictions. The current proposal builds on Dr. Soder?s prior cognitive neuroscience background by expanding her expertise in 1) research on addicted populations and clinical trials, 2) advanced data analysis and biostatistics, and 3) activities related to primary investigator responsibilities. The research program compliments this training plan by utilizing event- related potentials (ERPs) to predict CUD treatment outcomes. Measuring ERPs is a practical and economical alternative to other neuroimaging methods, as it is relatively cost-effective and can be easily implemented in a clinical setting. Additionally, it is likely that different ERP components can map onto different key processes required of specific treatments. The current project will use ERPs to assess cognitive, attentional, and reward functioning to predict treatment outcomes in contingency management (CM), a validated treatment for CUD. While CM is moderately effective, there is individual variability in achieving abstinence, suggesting that no single treatment is likely to be appropriate for all cocaine users. Measuring ERPs can help identify both individual and treatment characteristics that predict and explain treatment outcomes. CM specifically involves reinforcement of non-drug related behaviors, suggesting that alterations in pleasure from non-drug behaviors (anhedonia) and increased attention to drug cues (motivated attention) are involved in non-response to treatment. The current project aims to investigate this by 1) testing the relationship of anhedonia (assessed by ERPs) to treatment outcomes in CM for CUD, 2) testing the relationship of motivated attention (assessed by ERPs) to treatment outcomes in CM for CUD, and 3) performing exploratory analyses to determine the optimal set of ERPs to predict treatment outcomes in CM for CUD. This proposal utilizes a biomarker approach to predict and explain why some individuals respond to CM, lays the groundwork for future studies that can test the same ERP components across different substances and different treatments, and allows Dr. Soder to gain the necessary training in order to apply this approach in the future to drastically improve interventions for addictions. Ultimately, this work will lead to the development of cost-effective and accessible ways to personalize treatment for CUD and other addictions.
Cocaine use disorder is a severe health issue that is has been moderately resistant to psychological intervention and has no current FDA approved medications. Using event-related potentials (ERPs) as prognostic biomarkers of treatment outcomes is both economical and practical as measuring ERPs can cost- effectively be implemented in a clinical setting. Determining biological mechanisms of treatment success or failure will help develop novel, more effective interventions, help individualize treatment, and ultimately increase abstinence rates, lowering the health burden on society.
