Neural Substrates of Approach-Avoidance Conflict
Condition: Alcoholism; fMRI; Rewarding Mediating System
MeSH terms: Alcoholism
Study type: Observational

Summary: 
      Background:

      - People who are dependent on alcohol drink even when they know something bad might happen.
      Researchers want to learn more about why they do this.

      Objectives:

      - To study brain response when a person plays a game in different threat conditions.

      Eligibility:

        -  Healthy right-handed adult heavy drinkers age 21 60

        -  Healthy right-handed adult light drinkers age 21 60

      Design:

        -  Participants will be screened with medical history, physical exam, and blood and urine
           tests. They will have an EKG and psychiatric interview.

        -  Participants will have one or two clinic visits.

        -  Participants will be asked about their alcohol drinking.

        -  They will choose a snack and alcoholic beverage that they must drink in 5 minutes. After
           their breath alcohol content (BrAC) is zero, they will play a game in the MRI scanner.

        -  The scanner is a metal cylinder that takes pictures of the brain. Participants lie on a
           table that slides in and out of the cylinder. They will be in it for about 90 minutes,
           lying still for up to 20 minutes.

        -  During the MRI, participants will play a simple computer game to earn food or drink
           points under different threats of electric shock. Points can be exchanged for food or
           alcohol after the game. Sometimes, participants will receive a mild electric shock
           through a metal disk on the wrist. Electric shocks will only happen if the participant
           tries to earn a reward point.

        -  After the MRI, participants use their points for another drink and snack. They will stay
           at the clinic until their BrAC is low, usually within 3 hours. Participants cannot drive
           themselves home.

        -  Participants will have a follow-up phone call the next day.
    

Detailed description: 
      Objective: Continued drug seeking despite knowledge of adverse consequences is a hallmark of
      addiction. To model this behavior, we will refine the parameters of a modified Monetary
      Incentive Delay (MID) task that will allow us to investigate neural substrates of
      approach-avoidance conflict resolution. We will then use this task to investigate functional
      magnetic resonance imaging (fMRI) brain activation during pursuit of reward in heavy and
      light drinkers.

      Study Population: Healthy non-treatment-seeking heavy drinkers and healthy light drinkers
      aged 21 to 60.

      Design: The study will require 1 to 2 visits. Subjects will play a modified MID task called
      Reward Incentive Delay with Shock (RIDS) to measure motivation to earn cue reward points in
      conditions that are signaled to be safe or associated with a threat. After playing the RIDS
      task subjects will be able to self-administer alcohol and/or food based on the reward points
      earned during the task.

      Outcome measures: The outcome measures are differences in behavioral task performance and in
      blood oxygenation dependent level (BOLD) signal measured using standard fMRI techniques and
      analyzed using AFNI software.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Healthy non-treatment-seeking heavy drinkers and healthy light drinkers aged 21 to 60.@@@
      
Keywords: Neural Networks; Alcoholism; fMRI; Reward; Addiction