This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Dr. Parks proposes to use functional magnetic imaging (fMRI) to investigate decision-making ability of young African American women in whom sexual and alcohol use behaviors put them at risk for human immunodeficiency virus (HIV) acquisition. Preclinical imaging studies have demonstrated that dopaminergic (DA) brain centers activate in addicted patients upon exposure to visual cues associated with their substances of abuse. These cortical and limbic centers may also mediate reward-seeking and satiety associated with addiction, processes that are disrupted in alcohol-dependent individuals, for example. Dr. Parks's preliminary fMRI data in chronic alcohol-dependent patients demonstrates their difficulty in cognitively inhibiting task-irrelevant stimuli, and activated areas in this decision-making task implicate brain regions overlapping with those involved with cued exposure to alcohol-related stimuli. Epidemiologically, young African-American women represent a clinical health disparity as they exhibit alcohol use disorder (AUD) signs and symptoms at a greater frequency than their gender- and ethnic-diverse peers. As well, this same demographic also displays markedly increased risk for HIV acquisition through unprotected sexual intercourse. Though no studies in the literature have demonstrated the psycho-pathophysiologic bases for either disparity, one potential explanation for both may be that these individuals exhibit poor decision-making skills when confronted with irrelevant stimuli that disrupt cognitive discrimination. Though DA-related pathways, substance abuse may stimulate the urge to engage in continued alcohol use as well as risky sexuality because the physiological reward pathways for both are probably similar. Further, stimulation caused by urges might also prime motor activity brain centers to initiate pathological behavior. Dr. Parks' hypothesis is that young, at-risk AUD African-American women who admit to histories of sexual risk taking will demonstrate poor decision-making when cognitive inhibition is required, and fMRI during these tasks will demonstrate relatively increased activation in DA brain regions because these areas drive both reward-seeking and reward-satiation.
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