THE IMPACT OF PUBERTAL SUPPRESSION ON ADOLESCENT NEURAL AND MENTAL HEALTH TRAJECTORIES - Resubmission - 1

青春期抑制对青少年神经和心理健康轨迹的影响 - 重新提交 - 1

• 批准号: 10442698
• 负责人: Diane Chen
• 金额: $ 73.81万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10442698
• 关键词: Adolescence; Adolescent; Adolescent Development; Affective; Agonist; Amygdaloid structure; Anxiety; Attenuated; Behavior; Benefits and Risks; Birth; Brain; Brain region; Caring; Characteristics; Child; Cognitive; Data; Data Collection; Development; Dimensions; Distress; Early treatment; Emotional; Endocrine; Enrollment; Estrogens; Family; Family health status; Feminization; GNRH1 gene; GNRH2 gene; Gender Identity; Gonadal Hormones; Gonadotropin Hormone Releasing Hormone; Health; Health Benefit; Hospitals; Link; Literature; Maps; Masculine; Measures; Medical Care Team; Mental Depression; Mental Health; Methods; National Institute of Mental Health; Neurocognitive; Neuropsychology; Operative Surgical Procedures; Outcome; Parents; Pattern; Pediatric Hospitals; Persons; Prefrontal Cortex; Process; Professional Organizations; Puberty; Quality of life; Recording of previous events; Reporting; Research Domain Criteria; Rewards; Risk; Sampling; Severities; Site; Societies; Standardization; Structure of superior temporal sulcus; Substance abuse problem; Suicide; Suicide attempt; Symptoms; System; Task Performances; Testosterone; Time; Treatment Protocols; Ventral Striatum; Visit; Vulnerable Populations; Youth; behavioral response; cognitive development; cohort; executive function; gender dysphoria; health assessment; high risk; multimodality; neural circuit; neurodevelopment; neuroimaging; neurotransmission; overtreatment; personalized medicine; personalized predictions; psychologic; relating to nervous system; response; secondary analysis; sex; side effect; social; social cognition; standard of care; substance use; transgender; treatment effect; treatment group; treatment optimization; white matter; young adult

Project Summary The proposed project examines the effects of pubertal suppression treatment on the mental health of transgender adolescents over time. The physical changes brought on by puberty often amplify gender dysphoria in transgender youth. Administering gonadotropin releasing hormone agonists (GnRHa) is an effective means of suppressing puberty to provide transgender youth, their families, and health care teams more time to consider whether partially and/or fully irreversible treatments are indicated. Pubertal suppression is endorsed by the World Professional Association for Transgender Health and the Endocrine Society as standard of care. Preliminary reports suggest that treatment with GnRHa may confer mental health benefits for transgender youth. However, GnRHa may also disrupt puberty-signaled neural maturation in ways that can undermine mental health gains over time and impact quality of life in other ways. The overall impacts of GnRHa treatment have not been systematically studied. In order to probe these effects, this project focuses on the assessment of dimensional mental health and three neural systems that map onto the NIMH RDoC matrix: cognitive/emotional control, social cognition, and reward responsiveness. Existing literature documents marked maturation in these systems during normative adolescent development, and gonadal hormones are thought to contribute to this maturation. We will take a multimodal approach, in which self- and parent-report, standardized neuropsychological assessments, and neuroimaging methods are used to assess the effects of GnRHa treatment over a two-year study period. We will enroll 132 transgender adolescents across three sites: Nationwide Children’s Hospital; Children’s National Hospital; and Lurie Children’s Hospital. Half will be undergoing pubertal suppression with GnRHa and the other half will be transgender youth not undergoing treatment. Evaluating the impact of GnRHa treatment on mental health functioning as well as puberty-linked RDoC system maturation will clarify its potential protective and risk effects to support optimization and personalization of treatment protocols.

项目摘要 拟议的项目检查青春期抑制治疗对心理健康的影响 跨性别青少年随着时间的流逝。青春期带来的身体变化通常会扩大性别烦躁不安 在变性青年中。施用促性腺激素释放骑马激动剂（GNRHA）是有效的手段 抑制青春 是否指示部分和/或完全不可逆的治疗。青春期的压制得到了世界的认可 跨性别卫生专业协会和内分泌社会作为护理标准。初步的 报告表明，GNRHA的治疗可能会给跨性别青年提供心理健康益处。然而， Gnrha还可能以破坏心理健康增长的方式破坏青春期信号的神经饱和 随着时间的流逝和影响生活质量的其他方式。 GNRHA治疗的总体影响尚未 系统地研究。为了探究这些效果，该项目着重于评估维度 心理健康和三个映射到NIMH RDOC矩阵的神经元系统：认知/情绪控制，社会 认知和奖励响应能力。现有的文献文献在这些系统中标志着这些系统的成熟 正常的青少年发展和性腺恐怖症被认为有助于这种成熟。我们将 采用多模式的方法，其中自我报告，标准化的神经心理学评估， 并使用神经影像学方法来评估两年的研究期内GNRHA治疗的影响。 我们将在三个地点介绍132名跨性别青少年：全国儿童医院；孩子们的 国家医院；和卢里儿童医院。一半将在Gnrha和 另一半将是不接受治疗的变性青年。评估GNRHA治疗对 心理健康功能以及青春期连接的RDOC系统的成熟将阐明其潜在的保护 以及支持治疗方案的优化和个性化的风险效果。