Targeting Foundational Memory Processes in Nicotine Addiction: A Translational Clinical Neuroscience Study of a Retrieval-Extinction Intervention to Reduce Craving and Smoking Behavior

Date Added
September 5th, 2017
PRO Number
Pro00069355
Researcher
Michael Saladin

List of Studies


Keywords
Smoking
Summary

We recently published results from a NIDA-funded study of a brief behavioral treatment that was designed to reduce the troublesome cravings that smokers encounter when they attempt to quit smoking. This intervention was based on a growing body of neuroscience studies showing that memories for prior learning can be retrieved by the presentation of cues involved in that learning. Once retrieved, the memories enter into a brief period of vulnerability, during which they can be modified, but after which they are reconsolidated (restabilized) back into long-term storage. The treatment potential of this phenomenon was initially demonstrated in a Science report in which inpatient heroin addicts were briefly exposed to cues associated with heroin use in order to prompt the heroin use memories into a vulnerable state. Once the memories were in this state, the heroin addicts received extinction training consisting of protracted exposure to heroin associated cues. It was argued that extinction would change the memories such that the cues would no longer be associated with heroin administration and reward. Remarkably, after just two sessions of retrieval-extinction training (RET), the investigators found that craving in response to heroin cues was substantially reduced for up to 6-months post-treatment. This effect was observed relative to a control group that received retrieval involving non-heroin cues, followed by extinction. These impressive initial findings led us to replicate and extend the study in cigarette smokers. In our study, one group of smokers received two sessions of RET with smoking cues whereas a control group received the same training except that retrieval consisted of brief exposure to neutral, smoking-unrelated cues. Craving and other reactions to familiar and novel smoking cues were assessed in test sessions performed 24-hrs, 2-weeks and 1-month after intervention; smoking behavior was also assessed over 1-month follow-up. Remarkably, at 1-month follow-up, craving to both familiar and novel smoking cues was significantly lower in the group receiving R-E training vs. control. Even more striking was the 25% reduction in the number of cigarettes smoked per day in the RET group vs. control. [Also of significance was suggestive evidence that, relative to control participants, more participants in the RET group achieved a 60% reduction in smoking (from pretreatment levels)]. The proposed project will replicate and extend these findings by 1) increasing the dose of intervention so as to bolster the observed treatment effects, 2) employing brain imaging methods to identify patterns of brain activity uniquely associated with the intervention and potentially predictive of treatment outcome, 3) adding a control group that will enhance understanding of the effects of RET, and 4) extending follow-up period to more completely document the long-term effects of RET. Positive findings from this study could lead to the development of a brief, effective behavioral intervention to reduce the burden levied against society by smoking. Importantly, this intervention could be easily adapted to treat other forms of addiction and co-occurring anxiety disorders, such as PTSD.

Institution
MUSC
Recruitment Contact
Brittany Frasier
843-792-6984
frasibri@musc.edu

Impact of lofexidine on stress, craving and opioid use

Date Added
September 4th, 2018
PRO Number
Pro00081381
Researcher
Kathleen Brady

List of Studies


Keywords
Drug Studies, Psychiatry
Summary

The purpose of this study is to determine if the medication lofexidine, taken together with buprenorphine or methadone, is more effective at reducing opioid craving, use and stress response than buprenorphine or methadone alone, and to see if this effect is different for men and women. Participants are randomly assigned to add either lofexidine or placebo to their buprenorphine or methadone treatment for five weeks. They return at the end of five weeks to participate in an opioid imagery task and stress task. Throughout the study, participants complete "CREMA" sessions (Cue Reactivity Ecologic Momentary Assessment) using an iPhone app three times a day. These sessions include looking at stressful and neutral pictures and rating stress and craving.

Institution
MUSC
Recruitment Contact
Amanda Wagner
843-792-0484
wagne@musc.edu

Enhancing Prolonged Exposure Therapy for PTSD with Oxytocin

Date Added
October 1st, 2019
PRO Number
Pro00091548
Researcher
Julianne Flanagan

List of Studies


Keywords
Military
Summary

Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition that affects our nation's Veterans at staggering rates. The purpose of this study is to examine the ability of a medication (oxytocin) to enhance Prolonged Exposure (PE) therapy for Veterans with Posttraumatic Stress Disorder (PTSD). PE is a widely used cognitive behavioral intervention (talk therapy) for Posttraumatic Stress Disorder (PTSD). In order to accomplish this goal, we are recruiting participants for a clinical trial. Participants enrolled in this trial will complete 10 weeks of a treatment phase, that includes weekly doses of either the investigational study medication or an inactive placebo. In addition, all participants will receive 10 weekly sessions of PE talk therapy. Once per week before each therapy session, participants will take a dose of medication intranasally. This study has the potential to improve patient care practices, advance the science in this area, and decrease public health costs.

Institution
MUSC
Recruitment Contact
Stacey Sellers
843-792-5807
sellersst@musc.edu

Characterization of physiological changes induced through motor-evoked potential conditioning in people with spinal cord injury

Date Added
December 3rd, 2019
PRO Number
Pro00091457
Researcher
Aiko Thompson

List of Studies


Keywords
Central Nervous System, Nervous System, Rehabilitation Studies, Spinal Cord
Summary

We are currently recruiting volunteers who are interested in participating in a brain-spinal cord-muscle response training study that aims to better understand the changes that take place in the nervous system as a result of this type of training. After spinal cord injury, brain-to-muscle connections are often interrupted. Because these connections are important in movement control, when they are not working well, movements may be disturbed. Researchers have found that people can learn to strengthen these connections through training. Strengthening these connections may be able to improve movement control and recovery after injuries.

Research participants will be asked to stand, sit, and walk during the study sessions. Electrodes are placed on the skin over leg muscles for monitoring muscle activity. For examining brain-to-muscle connections, we use transcranial magnetic stimulation. The stimulation is applied over the head and will indirectly stimulate brain cells with little or no discomfort.

Participation in this study requires approximately three sessions per week for four months, followed by two to three sessions over another three months. Each session lasts approximately 1 hour. Participants will receive a mileage reimbursement.

Institution
MUSC
Recruitment Contact
Blair Dellenbach
843-792-6313
stecb@musc.edu

Oxytocin to Enhance Integrated Exposure-Based Treatment of Co-occurring Alcohol Use Disorder and PTSD

Date Added
November 3rd, 2020
PRO Number
Pro00103198
Researcher
Sudie Back

List of Studies


Keywords
Alcohol, Mental Health, Military, Psychiatry, Stress Disorders
Summary

The purpose(s) of the research is to test a new medication in combination with a talk therapy for Veterans experiencing posttraumatic stress disorder (PTSD) and who may have alcohol use disorder (AUD). The study consists of 12 weekly therapy sessions. Once per week before each therapy session, an intranasal dose of investigational medication will be administered. The study also involves 3 and 6-month follow-up appointments and the administration of questionnaires at each visit.

Institution
MUSC
Recruitment Contact
Stacey Sellers
843-792-5807
sellersst@musc.edu

Clinical Trial of the Fit Families Multicomponent Obesity Intervention for African American Adolescents and Their Caregivers: Next Step from the ORBIT Initiative

Date Added
January 5th, 2021
PRO Number
Pro00106021
Researcher
Phillippe Cunningham

List of Studies


Keywords
Adolescents, Minorities, Obesity
Summary

The purpose of this study is to test the effectiveness of a comprehensive treatment for African-American adolescents with obesity and their overweight or obese caregiver (e.g., parent). Families who decide to participate in this study will be randomly assigned to one of two intervention groups: the FIT Families group or the Home-Based Family Support (HBFS) group. This means participants have a 50/50 chance (like flipping a coin) of being in either group. Participants randomized to FIT Families will have sessions with a community health worker (CHW) in the home or community once or twice weekly based on the family's preference for the first three months, and weekly for the second three months. Some of the sessions might occur virtually (online) if needed. Participants randomized to HBFS will receive six months of weekly family counseling in their home or community with a community health worker (CHW). Some of these sessions might occur virtually (online) if needed. Participants in both groups will receive education and support for healthier lifestyles.
The study will last 18 months. During the 18-month study period, youth and caregivers will wear a FitBit activity tracker during the six months of the intervention and then for 2 weeks at the fourth assessment, complete study assessments, have their height, weight, and blood pressure measured, and provide finger prick blood samples to be tested for blood sugar and cholesterol levels.
Potential benefits to caregivers and youth who participate in the study include: positive changes in healthy lifestyle behaviors and weight loss, decrease in health risks associated with obesity, and improved family relations, though these cannot be guaranteed.

Institution
MUSC
Recruitment Contact
Elizabeth O'Brien
843-876-0219
obriene@musc.edu

Development and Feasibility Testing of an Integrated PTSD and Adherence Intervention Cognitive Processing Therapy-Lifesteps (CPT-L) to Improve HIV Outcomes

Date Added
February 2nd, 2021
PRO Number
Pro00106801
Researcher
Cristina Lopez

List of Studies


Keywords
Anxiety, Depression, HIV / AIDS
Summary

The purpose of this study is to explore the use of a new treatment program to improve medication adherence for people with HIV and PTSD for patients at local HIV care clinics. Participants will be assigned to one of two groups. Participants in Group A will be asked to attend 12 clinic sessions (twice a week for 6 weeks, 90-minute sessions) via telehealth or in person at a HIV care clinic. Participants in Group B will receive a one session adherence intervention (60 minutes) and get the same standard treatment that someone with a trauma history and co-occurring HIV and PTSD symptoms would receive at a local HIV care clinic. The study is provided at no-cost, and participants may learn useful information and coping skills while being in the study. It is hoped the information that we get from this study will help researchers and clinicians better design treatment programs for people living with HIV and PTSD. Participants will receive study compensation for their time.

Institution
MUSC
Recruitment Contact
Cristina Lopez
843 876-1034
lopezcm@musc.edu

rTMS for Stimulant Use Disorders

Date Added
March 2nd, 2021
PRO Number
Pro00107688
Researcher
Kathleen Brady

List of Studies


Keywords
Brain, Mental Health, Psychiatry, Substance Use
Summary

The study will compare Repetitive Transcranial Magnetic Stimulation (rTMS) with placebo rTMS in reducing Cocaine and/or Methamphetamine use. Study participants will be adults who currently use Cocaine and/or Methamphetamine. Eligible participants will receive multiple sessions of repetitive Transcranial Magnetic Stimulation (rTMS) or placebo rTMS over the course of an 8-week treatment period and will complete follow-up assessments for 8 weeks post-treatment. Participants will be compensated for participating.

Institution
MUSC
Recruitment Contact
Alexandra Herron
843-214-4496
herronal@musc.edu

Internet-delivered Management of Pain Among Cancer Treatment Survivors (IMPACTS)

Date Added
April 12th, 2021
PRO Number
Pro00109105
Researcher
Sarah Marrison

List of Studies


Keywords
Cancer, Pain
Summary

The study is being done to find out if this approach (8 sessions of the Internet-based program with education) is better or worse than the usual approach plus education only for cancer-related pain. The usual approach is defined as care most people get for cancer-related pain.

Institution
MUSC
Recruitment Contact
HCC Clinical Trials Office
(843) 792-9321
hcc-clinical-trials@musc.edu

Gender and Sex Hormone Influences on Cannabis Use Disorder Remission

Date Added
June 1st, 2021
PRO Number
Pro00110801
Researcher
Rachel Tomko

List of Studies


Keywords
Hormones, Mental Health, Psychiatry, Substance Use
Summary

Adults (ages 18+) who would like to reduce their cannabis use (N=224) will be enrolled in an 8-week treatment program. All participants will receive counseling (1 goals session with a therapist followed by 7 weekly computerized cognitive-behavioral therapy sessions). Detailed cannabis assessments (biological and self-report) will be conducted throughout treatment and at 1-, 2-, and 3-months post-treatment completion. Daily electronic diaries will be administered via text message to record detailed logs of cannabis use quantity and frequency. Salivary samples will be collected (and video observed) daily throughout treatment to analyze for progesterone.

Institution
MUSC
Recruitment Contact
Kevin Branson
843-792-9257
bransonk@musc.edu



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