Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users

Anna B Konova, Silvia Lopez-Guzman, Adelya Urmanche, John Messinger, Soteri Polydorou, Stephen Ross, Kenway Louie, John Rotrosen, Paul W Glimcher

Resultado de la investigación: Contribución a RevistaResumen en Conferencia

Resumen

Antecedentes: El grado en que el reemplazo de opiáceos (p. ej., metadona), el patrón oro de los opiáceos la gestión de las adicciones, es eficaz para reducir el consumo de opioides ilícitos el uso un individuo. Sin embargo, los buenos predictores proximales de cuándo
una persona está en riesgo de recaída y, por lo tanto, necesita intervención adicional en el comportamiento y/o farmacológica no existen en la actualidad. Aquí, usamos la computación estándar
mediciones neuroeconómicas impulsadas para descomponer el riesgo
comportamiento de los usuarios de opiáceos que se someten a un reemplazo de opiáceos
como una forma de identificar marcadores de comportamiento que
podría predecir el uso ilícito de opiáceos.
Métodos: Tuvimos individuos comenzando el reemplazo de opiáceos
terapia (es decir, que estuvieron dentro de las 4 semanas del tratamiento)
iniciación) realizar operaciones monetarias simples y fáciles de automatizar.
tareas de toma de decisiones semanales (y luego cada dos semanas)
durante varios meses de tratamiento. Establecimos cuando nuestro
sujetos que volvieron a consumir opiáceos ilícitos (o cualquier droga) por ambos
autoinforme y administrado al azar (al menos 1/semana)
pruebas toxicológicas en orina. Una muestra emparejada de drogas libres
los controles comunitarios también completaron la toma de decisiones
tareas. Estos dos sujetos sirvieron como un grupo de control de línea de base
así como también nos permitió evaluar la fiabilidad de las pruebas de nuestros
medidas. Un subconjunto de temas de ambos grupos también
completaron las tareas mientras adquiríamos el sistema magnético funcional
de resonancia magnética (RMN) en dos puntos temporales: una vez en el
comienzo del tratamiento y de nuevo 8-12 semanas después. El
las medidas que usamos están basadas en un estándar neuroeconómico
modelo que descompone el comportamiento de cada sujeto
en dos parámetros: "actitud de riesgo" y "actitud ambigua",
la indexación de lo sensible que es ese tema a lo conocido y
riesgos desconocidos, respectivamente. Calculamos estos parámetros
para cada asignatura en cada sesión de estudio, y utilizando el
modelos lineales mixtos, examinamos cómo las fluctuaciones en estos
parámetros relacionados retrospectiva y prospectivamente con los ilícitos
eventos sobre el uso de opiáceos.
Resultados: Encontramos un alto grado de confiabilidad de prueba y prueba a través de
las sesiones de estudio para ambos parámetros. Atestiguando la
los distintos aspectos de la toma de decisiones arriesgadas capturados por estos
encontramos que sólo los aumentos repentinos en un opiáceo dependiente
la voluntad del sujeto de asumir riesgos en nuestra tarea
correlacionados con los opioides ilícitos y, en algunos casos, precedidos de ellos
uso. Pero lo más importante, encontramos que ambos parámetros no son
estacionario en los sujetos dependientes de opiáceos: ambos parámetros
fluctúan a medida que los individuos se acercan y se recuperan de los opiáceos
usar los eventos de una manera que no se ve en los controles. Tanto el riesgo como
la tolerancia a la ambigüedad aumenta el uso de opiáceos en el entorno, aunque
a ritmos diferentes.
Conclusiones: Estos datos sugieren que las actitudes de riesgo, que
puede ser medido rápida y fácilmente por nuestras tareas de comportamiento,
pueden ser marcadores de comportamiento adecuados, y quizás incluso
predictores de recaída en la adicción a los opiáceos. Nuestro programa
el trabajo busca examinar las bases neurobiológicas de esta
relación entre la toma de decisiones arriesgadas y el uso de drogas.
Basándonos en hallazgos previos en salud con estas tareas, nosotros
anticipar un mecanismo neural común del riesgo y
parámetros de ambigüedad para incluir la activación en regiones que
forman la red de valoración del cerebro (estriado, ventromedial, etc.).
córtex prefrontal), y mecanismos distintos que incluyen
activación en la corteza insular (para actitudes de riesgo) y
amígdala (para actitudes ambiguas).
Idioma originalEnglish (US)
Páginas (desde-hasta)S289-S454
PublicaciónNeuropsychopharmacology
Volumen41
N.ºS1
EstadoPublished - dic 6 2016

Citar esto

Konova, A. B., Lopez-Guzman, S., Urmanche, A., Messinger, J., Polydorou, S., Ross, S., ... Glimcher, P. W. (2016). Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users. Neuropsychopharmacology, 41(S1), S289-S454.
Konova, Anna B ; Lopez-Guzman, Silvia ; Urmanche, Adelya ; Messinger, John ; Polydorou, Soteri ; Ross, Stephen ; Louie, Kenway ; Rotrosen, John ; Glimcher, Paul W. / Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users. En: Neuropsychopharmacology. 2016 ; Vol. 41, N.º S1. pp. S289-S454.
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title = "Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users",
abstract = "Background: The degree to which opioid replacementtherapy (e.g., methadone), the gold standard in opioidaddiction management, is effective at reducing illicit opioiduse depends on how well titrated it is for the current needs ofan individual. However, good proximal predictors of whenan individual is at risk for relapse—and therefore in need ofadditional behavioral and/or pharmacological intervention—are currently lacking. Here, we use standard computationallydriven neuroeconomic measurements to decompose the risktaking behavior of opioid users undergoing opioid replacementtherapy, as a way to identify behavioral markers thatmight predict illicit opioid use.Methods: We had individuals starting opioid replacementtherapy (i.e., who were within 4 weeks of treatmentinitiation) perform simple and easy-to-automate monetarydecision making tasks weekly (and then every other week)over several months of treatment. We established when oursubjects returned to illicit opioid (or any drug) use by bothself-report and randomly administered (at least 1/week)urine toxicology tests. A matched sample of drug-freecommunity controls also completed the decision makingtasks. These subjects both served as a baseline control groupas well as allowed us to assess the test-retest reliability of ourmeasurements. A subset of subjects from both groups alsocompleted the tasks while we acquired functional magneticresonance imaging (MRI) data at two time points: once at thebeginning of the treatment and again 8-12 weeks later. Themeasurements we used are based on a standard neuroeconomicmodel that decomposes the behavior of each subjectinto two parameters: “risk attitude” and “ambiguity attitude”,indexing how sensitive that subject is to known andunknown risks, respectively. We computed these parametersfor each subject at each study session, and using generalizedlinear mixed models, we examined how fluctuations in theseparameters related retrospectively and prospectively to illicitopioid use events.Results: We find a high degree of test-retest reliability acrossthe study sessions for both parameters. Attesting to thedistinct aspects of risky decision making captured by theseparameters, we find that only sudden increases in an opioiddependentsubject’s willingness to take risks in our taskcorrelated with, and in some cases preceded, illicit opioiduse. But importantly, we find both parameters are notstationary in the opioid-dependent subjects: both parametersfluctuate as individuals approach and recover from opioiduse events in a way not seen in controls. Both risk andambiguity tolerance increases surrounding opioid use, albeitat different rates.Conclusions: These data suggest that risk attitudes, whichcan be quickly and easily measured by our behavioral tasks,might be suitable behavioral markers—and perhaps evenpredictors—of relapse in opioid addiction. Our ongoingwork seeks to examine the neurobiological basis of thisrelationship between risky decision making and drug use.Based on previous findings in health with these tasks, weanticipate a common neural mechanism of the risk andambiguity parameters to include activation in regions thatform the brain’s valuation network (striatum, ventromedialprefrontal cortex), and distinct mechanisms to includeactivation in the insular cortex (for risk attitudes) andamygdala (for ambiguity attitudes).",
author = "Konova, {Anna B} and Silvia Lopez-Guzman and Adelya Urmanche and John Messinger and Soteri Polydorou and Stephen Ross and Kenway Louie and John Rotrosen and Glimcher, {Paul W}",
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Konova, AB, Lopez-Guzman, S, Urmanche, A, Messinger, J, Polydorou, S, Ross, S, Louie, K, Rotrosen, J & Glimcher, PW 2016, 'Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users', Neuropsychopharmacology, vol. 41, n.º S1, pp. S289-S454.

Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users. / Konova, Anna B; Lopez-Guzman, Silvia; Urmanche, Adelya; Messinger, John; Polydorou, Soteri; Ross, Stephen; Louie, Kenway; Rotrosen, John; Glimcher, Paul W.

En: Neuropsychopharmacology, Vol. 41, N.º S1, 06.12.2016, p. S289-S454.

Resultado de la investigación: Contribución a RevistaResumen en Conferencia

TY - JOUR

T1 - Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users

AU - Konova, Anna B

AU - Lopez-Guzman, Silvia

AU - Urmanche, Adelya

AU - Messinger, John

AU - Polydorou, Soteri

AU - Ross, Stephen

AU - Louie, Kenway

AU - Rotrosen, John

AU - Glimcher, Paul W

PY - 2016/12/6

Y1 - 2016/12/6

N2 - Background: The degree to which opioid replacementtherapy (e.g., methadone), the gold standard in opioidaddiction management, is effective at reducing illicit opioiduse depends on how well titrated it is for the current needs ofan individual. However, good proximal predictors of whenan individual is at risk for relapse—and therefore in need ofadditional behavioral and/or pharmacological intervention—are currently lacking. Here, we use standard computationallydriven neuroeconomic measurements to decompose the risktaking behavior of opioid users undergoing opioid replacementtherapy, as a way to identify behavioral markers thatmight predict illicit opioid use.Methods: We had individuals starting opioid replacementtherapy (i.e., who were within 4 weeks of treatmentinitiation) perform simple and easy-to-automate monetarydecision making tasks weekly (and then every other week)over several months of treatment. We established when oursubjects returned to illicit opioid (or any drug) use by bothself-report and randomly administered (at least 1/week)urine toxicology tests. A matched sample of drug-freecommunity controls also completed the decision makingtasks. These subjects both served as a baseline control groupas well as allowed us to assess the test-retest reliability of ourmeasurements. A subset of subjects from both groups alsocompleted the tasks while we acquired functional magneticresonance imaging (MRI) data at two time points: once at thebeginning of the treatment and again 8-12 weeks later. Themeasurements we used are based on a standard neuroeconomicmodel that decomposes the behavior of each subjectinto two parameters: “risk attitude” and “ambiguity attitude”,indexing how sensitive that subject is to known andunknown risks, respectively. We computed these parametersfor each subject at each study session, and using generalizedlinear mixed models, we examined how fluctuations in theseparameters related retrospectively and prospectively to illicitopioid use events.Results: We find a high degree of test-retest reliability acrossthe study sessions for both parameters. Attesting to thedistinct aspects of risky decision making captured by theseparameters, we find that only sudden increases in an opioiddependentsubject’s willingness to take risks in our taskcorrelated with, and in some cases preceded, illicit opioiduse. But importantly, we find both parameters are notstationary in the opioid-dependent subjects: both parametersfluctuate as individuals approach and recover from opioiduse events in a way not seen in controls. Both risk andambiguity tolerance increases surrounding opioid use, albeitat different rates.Conclusions: These data suggest that risk attitudes, whichcan be quickly and easily measured by our behavioral tasks,might be suitable behavioral markers—and perhaps evenpredictors—of relapse in opioid addiction. Our ongoingwork seeks to examine the neurobiological basis of thisrelationship between risky decision making and drug use.Based on previous findings in health with these tasks, weanticipate a common neural mechanism of the risk andambiguity parameters to include activation in regions thatform the brain’s valuation network (striatum, ventromedialprefrontal cortex), and distinct mechanisms to includeactivation in the insular cortex (for risk attitudes) andamygdala (for ambiguity attitudes).

AB - Background: The degree to which opioid replacementtherapy (e.g., methadone), the gold standard in opioidaddiction management, is effective at reducing illicit opioiduse depends on how well titrated it is for the current needs ofan individual. However, good proximal predictors of whenan individual is at risk for relapse—and therefore in need ofadditional behavioral and/or pharmacological intervention—are currently lacking. Here, we use standard computationallydriven neuroeconomic measurements to decompose the risktaking behavior of opioid users undergoing opioid replacementtherapy, as a way to identify behavioral markers thatmight predict illicit opioid use.Methods: We had individuals starting opioid replacementtherapy (i.e., who were within 4 weeks of treatmentinitiation) perform simple and easy-to-automate monetarydecision making tasks weekly (and then every other week)over several months of treatment. We established when oursubjects returned to illicit opioid (or any drug) use by bothself-report and randomly administered (at least 1/week)urine toxicology tests. A matched sample of drug-freecommunity controls also completed the decision makingtasks. These subjects both served as a baseline control groupas well as allowed us to assess the test-retest reliability of ourmeasurements. A subset of subjects from both groups alsocompleted the tasks while we acquired functional magneticresonance imaging (MRI) data at two time points: once at thebeginning of the treatment and again 8-12 weeks later. Themeasurements we used are based on a standard neuroeconomicmodel that decomposes the behavior of each subjectinto two parameters: “risk attitude” and “ambiguity attitude”,indexing how sensitive that subject is to known andunknown risks, respectively. We computed these parametersfor each subject at each study session, and using generalizedlinear mixed models, we examined how fluctuations in theseparameters related retrospectively and prospectively to illicitopioid use events.Results: We find a high degree of test-retest reliability acrossthe study sessions for both parameters. Attesting to thedistinct aspects of risky decision making captured by theseparameters, we find that only sudden increases in an opioiddependentsubject’s willingness to take risks in our taskcorrelated with, and in some cases preceded, illicit opioiduse. But importantly, we find both parameters are notstationary in the opioid-dependent subjects: both parametersfluctuate as individuals approach and recover from opioiduse events in a way not seen in controls. Both risk andambiguity tolerance increases surrounding opioid use, albeitat different rates.Conclusions: These data suggest that risk attitudes, whichcan be quickly and easily measured by our behavioral tasks,might be suitable behavioral markers—and perhaps evenpredictors—of relapse in opioid addiction. Our ongoingwork seeks to examine the neurobiological basis of thisrelationship between risky decision making and drug use.Based on previous findings in health with these tasks, weanticipate a common neural mechanism of the risk andambiguity parameters to include activation in regions thatform the brain’s valuation network (striatum, ventromedialprefrontal cortex), and distinct mechanisms to includeactivation in the insular cortex (for risk attitudes) andamygdala (for ambiguity attitudes).

M3 - Meeting Abstract

VL - 41

SP - S289-S454

JO - Neuropsychopharmacology

JF - Neuropsychopharmacology

SN - 0893-133X

IS - S1

ER -

Konova AB, Lopez-Guzman S, Urmanche A, Messinger J, Polydorou S, Ross S y otros. Week-to-Week Fluctuations in Risky Decision Making Track Heroin Use in Treatment-Seeking Opioid Users. Neuropsychopharmacology. 2016 dic 6;41(S1):S289-S454.