Course and Outcome of Bipolar Disorder in Youth - Supplement

青少年双相情感障碍的病程和结果 - 补充

基本信息

批准号：
10397801
负责人：
BORIS BIRMAHER
金额：
$ 6.43万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-19 至 2022-02-28
项目状态：
已结题

项目摘要

Project Summary/Abstract - no change from original The Course and Outcome of Bipolar Disorders in Youth (COBY) study has comprehensively characterized the clinical course of a large sample of youth with bipolar disorder (BD), and has identified demographic and clinical factors that are associated with different illness courses. To date, however, COBY has not included neuroimaging assessments. Including such assessments now will allow, for the first time, an evaluation of the impact of 13-year course of BD and treatment upon neural circuitry function and structure. Furthermore, the majority of COBY participants are currently between 18-30 years old, when the brain, and prefrontal cortex in particular, continues to develop. Including neuroimaging assessments in COBY participants now can thus take advantage of the neurodevelopmental processes occurring between 18-30 years where there are unique opportunities to intervene therapeutically to help normalize abnormalities in neural functioning and structure. Focusing on this age range will also provide a critically important opportunity to determine the extent to which neuroimaging measures predict future clinical course in adulthood. Having normal prefrontal cortical function and structure may predict better clinical course in adulthood, even in COBY participants with poor clinical course in youth, and may lead to decisions to reduce, or even stop, specific treatments in these individuals. In the proposed study, we will determine how previous BD clinical course (e.g., % time with mood symptoms vs. euthymic; % time with comorbid disorders) and treatment exposure from childhood into adulthood impacts neural circuitry functioning and structure supporting key NIMH RDoC information processing domains, and compare neuroimaging findings in COBY participants with those of demographically-matched healthy controls (Aim 1). We will also determine whether neuroimaging measures predict illness course in adulthood, beyond demographic and clinical factors, and previous clinical course in youth (Aim 2). We will use machine learning to explore patterns of wholebrain functioning, white and gray matter structure, and clinical and demographic measures, that most accurately predict future clinical course at the individual subject level. The proposed study also provides a valuable opportunity to inform the field regarding the clinical and functional course and outcome from youth into adulthood in a large, well-characterized sample of people with BD. This is important because the clinical outcome of BD youth in adulthood remains uncertain, as only two studies with a total of 72 subjects followed BD youth into their early twenties. Structural and functional neuroimaging techniques will be employed in a representative subsample of COBY participants (n=120), and healthy controls (n=50). Comprehensive assessments of psychopathology and functioning will be collected at the time of neuroimaging, and twice more during the proposed project period in the 120 COBY participants. This proposal accords with the NIMH’s mission to define developmental trajectories of mental disorders and develop strategies to better define risk and protective factors for disease trajectories across the lifespan, and with the RDoC initiative.

项目摘要/摘要 - 与原始版本相比没有变化青少年双相情感障碍 (COBY) 研究的过程和结果全面描述了青少年双相情感障碍的特征对大量双相情感障碍 (BD) 青年样本的临床病程进行了研究，并确定了人口统计学和然而，迄今为止，COBY 尚未包括与不同病程相关的临床因素。现在纳入此类评估将首次能够对神经影像学评估进行评估。 13 年 BD 病程和治疗对神经回路功能和结构的影响。大多数 COBY 参与者目前年龄在 18 至 30 岁之间，此时大脑和前额叶皮层处于特别是，COBY 参与者现在可以进行神经影像评估。 18-30 岁之间发生的神经发育过程的优势，其中有独特的进行治疗干预的机会，以帮助神经功能和结构的异常正常化。关注这个年龄段也将提供一个极其重要的机会来确定神经影像学测量可预测成年后的未来临床病程。和结构可以预测更好的成年临床过程，即使是临床表现不佳的 COBY 参与者年轻人的病程，并可能导致决定减少甚至停止对这些人的特定治疗。在拟议的研究中，我们将确定先前的 BD 临床过程（例如，出现情绪症状的时间百分比与出现情绪症状的时间百分比）。心境正常；患有共病的时间百分比）以及从童年到成年期间接受治疗的影响支持 NIMH RDoC 关键信息处理领域的神经回路功能和结构，以及将 COBY 参与者的神经影像学结果与人口统计匹配的健康对照组的神经影像学结果进行比较（目标 1）我们还将确定神经影像学测量是否可以预测成年后的疾病进程。人口统计和临床因素，以及青年人之前的临床病程（目标 2）。探索全脑功能、白质和灰质结构以及临床和人口统计学的模式措施，最准确地预测个体受试者水平的未来临床过程。还提供了一个宝贵的机会来向该领域通报临床和功能过程以及大量特征明确的 BD 患者从青年期到成年期的结果这一点很重要。因为 BD 青少年成年后的临床结果仍不确定，因为只有两项研究总共 72 BD 青年到二十岁出头的受试者将学习结构和功能神经影像技术。用于 COBY 参与者 (n=120) 和健康对照 (n=50) 的代表性子样本。将在神经影像学检查时收集精神病理学和功能的综合评估，在 120 名 COBY 参与者中，在提议的项目期间又增加了两次。 NIMH 的使命是定义精神障碍的发展轨迹并制定更好的策略通过 RDoC 计划，定义整个生命周期疾病轨迹的风险和保护因素。

项目成果

期刊论文数量（43）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Toward clinically applicable biomarkers in bipolar disorder: focus on BDNF, inflammatory markers, and endothelial function.

针对双相情感障碍的临床适用生物标志物：重点关注 BDNF、炎症标志物和内皮功能。

DOI：
发表时间：
2013-12
期刊：
影响因子：
6.7
作者：
Goldstein, Benjamin I;Young, L Trevor
通讯作者：
Young, L Trevor

Predictors of first-onset substance use disorders during the prospective course of bipolar spectrum disorders in adolescents.

青少年双相谱系障碍前瞻性病程中首次发作物质使用障碍的预测因素。

DOI：
发表时间：
2013-10
期刊：
影响因子：
13.3
作者：
Goldstein, Benjamin I;Strober, Michael;Axelson, David;Goldstein, Tina R;Gill, Mary Kay;Hower, Heather;Dickstein, Daniel;Hunt, Jeffrey;Yen, Shirley;Kim, Eunice;Ha, Wonho;Liao, Fangzi;Fan, Jieyu;Iyengar, Satish;Ryan, Neal D;Keller, Martin B
通讯作者：
Keller, Martin B

The Risks of Persistent Irritability.

持续烦躁的风险。

DOI：
发表时间：
2016-07
期刊：
影响因子：
13.3
作者：
Birmaher; Boris
通讯作者：
Boris

Debate: Fomenting controversy regarding pediatric bipolar disorder.

辩论：引发有关儿科双相情感障碍的争议。

DOI：
发表时间：
2019-02
期刊：
影响因子：
0
作者：
Goldstein, Benjamin I;Post, Robert M;Birmaher, Boris
通讯作者：
Birmaher, Boris

Clinical course of children and adolescents with bipolar spectrum disorders.

患有双相谱系障碍的儿童和青少年的临床过程。

DOI：
10.1001/archpsyc.63.2.175
发表时间：
2006-02-01
期刊：
Archives of general psychiatry
影响因子：
0
作者：
B. Birmaher;D. Axelson;M. Strober;M. Gill;S. Valeri;L. Chiappetta;N. Ryan;H. Leonard;J. Hunt;S. Iyengar;M. Keller
通讯作者：
M. Keller