Brain Correlates of Self-Focused Processing as a Biomarker of Treatment Response

大脑与自我聚焦处理的相关性作为治疗反应的生物标志物

基本信息

批准号：
10203631
负责人：
Angela Fang
金额：
$ 10.07万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-07-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10203631
关键词：
Address Advisory Committees Algorithms Anterior Antidepressive Agents Anxiety Area Attention Behavioral Belief Biological Markers Body Dysmorphic Disorder Brain Categories Classification Clinical Cognitive Cognitive Therapy Competence Data Data Analyses Development Diagnosis Dimensions Disease Eating Disorders Ensure Event Feeling Formulation Functional Magnetic Resonance Imaging Future Goals Health Care Costs Image Impaired cognition Individual Individual Differences Intervention Link Maps Measures Mental Depression Mental disorders Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods National Institute of Mental Health Neurosciences Obsessive compulsive behavior Obsessive-Compulsive Disorder Outcome Outcomes Research Pathology Patients Prediction of Response to Therapy Predictive Value Prefrontal Cortex Psychotherapy Response Latencies Rest Sampling Scanning Scientist Self-Direction Social Anxiety Disorder Social Environment Statistical Methods Surrogate Markers Symptoms Task Performances Techniques Testing Thinking Training Treatment outcome Work anxiety symptoms base behavior measurement career development cingulate cortex connectome design directed attention indexing neural circuit neural correlate neuroimaging personalized medicine physical state predict clinical outcome recruit relating to nervous system response response biomarker social success trait treatment optimization treatment planning treatment response

项目摘要

First-line interventions for psychiatric disorders do not work for everyone and factors impacting treatment response are poorly understood. There is a clear need to identify reliable predictors of treatment response in order to optimize treatment outcomes, provide more targeted referrals, and reduce healthcare costs. Neuroimaging-based predictors of treatment response offer better predictive utility than clinical variables alone, yet these predictors are largely lacking. This 5-year mentored patient-oriented research career development award will address this need. Specifically, this project will test the hypothesis that individual differences in maladaptive self-focused processing predict treatment response and that neuroimaging-based markers are better predictors than behavioral ones. Each aim of the study corresponds to specific training goals, which will map onto competency in four main areas: (1) fMRI neuroimaging techniques in terms of event-related design, image acquisition, and data analysis, (2) neuroscience-informed treatment outcome research, (3) statistical methods involving multidimensional classification, and (4) career development. Such training will transform the applicant into an independent translational clinical scientist who examines the neural basis of cognitive dysfunction in anxiety and obsessive-compulsive spectrum disorders to inform personalized formulations of pathology and aid in individual treatment decisions. Training goals will be implemented with the expert guidance of Dr. Sabine Wilhelm (primary mentor), Dr. Dara Manoach (co-mentor), and the advisory team consisting of Drs. Luan Phan, Jamie Feusner, and Mark Vangel. First, we propose to identify the neural correlates of self-focused processing. We will assess baseline resting state connectivity within the default network, as well as regional brain activation using a well-validated event-related fMRI task that manipulates self-focused processing in patients with body dysmorphic and socially anxious symptoms, compared to healthy controls. We selected this clinical sample because such patients display heightened self-focused attention, and sampling individuals across these symptom dimensions will ensure greater variability on this dimension of maladaptive self-focused processing. Second, we will examine the neural correlates of self-focused processing as a predictor of treatment response. Neuroimaging data will be acquired from patients with body dysmorphic and socially anxious symptoms during two scan sessions, before and after 12 weeks of individual cognitive- behavioral therapy, and compared with healthy controls scanned twice at a 12-week interval. Finally, we will compare the prediction of treatment response between neural measures and behavioral measures of self- focused processing. We will assess the behavioral correlates of self-focused processing using a self-reference effect paradigm, and assess their relation to treatment response. If our hypotheses are borne out, we will have new targets for treatment, a method to identify promising candidates for treatment, and sensitive surrogate markers of treatment response.

精神疾病的一线干预措施并不适合所有人以及影响治疗的因素的回应知之甚少。显然需要确定治疗反应的可靠预测因子以优化治疗结果、提供更有针对性的转诊并降低医疗成本。基于神经影像的治疗反应预测因子比单独的临床变量提供更好的预测效用，然而，这些预测因素在很大程度上是缺乏的。这个为期 5 年的以患者为导向的研究职业发展指导奖项将满足这一需求。具体来说，该项目将检验以下假设：个体差异适应不良的自我聚焦处理可以预测治疗反应，并且基于神经影像的标记物比行为预测更好的预测。每个研究目的都对应于特定的培训目标，这将映射到四个主要领域的能力：（1）事件相关设计方面的功能磁共振成像神经成像技术，图像采集和数据分析，(2) 神经科学指导的治疗结果研究，(3) 统计涉及多维分类的方法，以及（4）职业发展。此类培训将改变申请人成为一名独立的转化临床科学家，研究认知的神经基础焦虑症和强迫症谱系障碍的功能障碍，为个性化配方提供信息病理学并帮助个体治疗决策。培训目标将与专家一起实施 Sabine Wilhelm 博士（主要导师）、Dara Manoach 博士（共同导师）和顾问团队的指导由博士组成。潘栾、杰米·福斯纳和马克·万格尔。首先，我们建议识别神经网络自我聚焦处理的相关性。我们将评估默认情况下的基线静息状态连接网络，以及区域大脑激活，使用经过充分验证的事件相关功能磁共振成像任务来操纵与健康人相比，患有身体畸形和社交焦虑症状的患者的自我聚焦处理控制。我们选择这个临床样本是因为此类患者表现出高度的自我关注，并且对这些症状维度的个体进行抽样将确保在这个维度上有更大的变异性适应不良的自我聚焦处理。其次，我们将检查自我聚焦处理的神经相关性作为治疗反应的预测因子。神经影像数据将从身体畸形患者身上获取在 12 周的个人认知测试之前和之后的两次扫描期间出现社交焦虑症状行为疗法，并与每隔 12 周扫描两次的健康对照进行比较。最后，我们将比较神经测量和自我行为测量之间的治疗反应预测集中处理。我们将使用自我参照来评估以自我为中心的处理的行为相关性效果范式，并评估它们与治疗反应的关系。如果我们的假设得到证实，我们将得到新的治疗目标、识别有希望的治疗候选者的方法以及敏感的替代物治疗反应的标志物。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

State and Trait Risk and Resilience Factors Associated with COVID-19 Impact and Obsessive-Compulsive Symptom Trajectories.

与 COVID-19 影响和强迫症状轨迹相关的状态和特质风险和弹性因素。

DOI：
发表时间：
2022
期刊：
影响因子：
0
作者：
Fang, Angela;Berman, Noah Chase;Hoeppner, Susanne S;Wolfe, Emma C;Wilhelm, Sabine
通讯作者：
Wilhelm, Sabine

Conformity to masculine norms and symptom severity among men diagnosed with muscle dysmorphia vs. body dysmorphic disorder.

被诊断患有肌肉畸形与身体畸形障碍的男性对男性规范的遵守情况和症状严重程度。

DOI：
发表时间：
2020
期刊：
影响因子：
3.7
作者：
Blashill, Aaron J;Grunewald, William;Fang, Angela;Davidson, Eliza;Wilhelm, Sabine
通讯作者：
Wilhelm, Sabine

COVID-19 and obsessive-compulsive symptoms in a large multi-site college sample.

大型多地点大学样本中的 COVID-19 和强迫症状。

DOI：
发表时间：
2022-04
期刊：
影响因子：
0
作者：
Berman, Noah Chase;Fang, Angela;Hoeppner, Susanne S;Reese, Hannah;Siev, Jedidiah;Timpano, Kiara R;Wheaton, Michael G
通讯作者：
Wheaton, Michael G