ENHANCING TREATMENT OUTCOMES IN DEPRESSION

改善抑郁症的治疗效果

• 批准号: 6330204
• 负责人: ANDREW F LEUCHTER
• 金额: $ 14.49万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-12-01 至 2004-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6330204
• 关键词: antidepressants; behavioral /social science research tag; clinical depression; clinical research; electroencephalography; fluoxetine; human subject; human therapy evaluation; magnetic resonance imaging; mental disorder chemotherapy; outcomes research; positron emission tomography; prognosis; psychometrics

In this competing renewal application for a K02 award, Dr. Andrew Leuchter proposes a line of research and career enhancement aimed at improving outcomes of treatment for depression. Between 25 - 40 percent of patients with depression fail to respond to the first antidepressant prescribed, and these patients may suffer a protracted course of depression. Preliminary studies indicate that brain function measured with quantitative electroencephalographic (QEEG) cordance may be used prior to treatment, to predict which antidepressant medication is most likely to benefit an individual patient, as well as after treatment has started, to detect antidepressant effectiveness before symptoms improve. This application has three specific aims: 1) to verify the discriminative power of cordance in predicting and detecting treatment response for two antidepressants with different mechanisms of action; 2) to establish the relationship of cordance measurements to other putative predictors of antidepressant response, including cerebral metabolism and structure as well as clinical factors (age and symptom type); and, 3) in a developmental aim, to enhance Dr. Leuchter's skill in the areas of measuring treatment outcome and assessing the impact of predictors on treatment effectiveness. For his primary research study, Dr. Leuchter proposes a plan which will enroll 96 younger and older adult subjects in a double-masked protocol. Subjects will be treated with either fluoxetine 20/40 mg. or venlafaxine 150/225 mg., to determine whether cordance measurements are reliably associated with differential short-term response to antidepressant medications. Putative predictors of response such as pre- and post-treatment FDG-PET, volumetric MRI measurements, and clinical symptoms will be examined to identify the physiologic processes and structural features which contribute to the association between cordance and short-term treatment outcome. This study is part of an overall plan to enhance Dr. Leuchter's research activities and skills in interventions outcomes research. He will work with two consultants, Drs. Kenneth Wells and Lynn Fairbanks, to implement new methods and enhance his skills in intervention outcomes research. He will expand his research to include new methods to examine patterns of response, and will utilize additional functional outcome measures. In a developmental phase of this study, he also will initiate projects to examine the effectiveness of cordance and other putative predictors in improving long-term treatment outcomes. These effectiveness projects will include introduction of predictors into the usual treatment setting, and examination of cost-effectiveness and long-term treatment outcomes.

在这一竞争性续签K02奖的申请中，安德鲁·莱克特（Andrew Leuchter）博士提出了一系列研究和职业增强，旨在改善抑郁症治疗的结果。 25-40％的抑郁症患者无法对处方的第一种抗抑郁药反应，这些患者可能会遭受长期的抑郁症病程。 初步研究表明，可以在治疗前使用定量脑电图（QEEG）绳索测量的大脑功能，以预测哪种抗抑郁药最有可能使单个患者受益，以及治疗后开始治疗，以检测症状提高之前的抗抑郁药效果。 该应用具有三个特定的目的：1）在预测和检测两种具有不同作用机制的抗抑郁药的治疗反应时验证绳索的判别能力； 2）建立绳索测量与抗抑郁反应的其他推定预测指标的关系，包括脑代谢和结构以及临床因素（年龄和症状类型）； 3）在发展目的中，以提高莱克特博士在测量治疗结果领域的技能并评估预测因子对治疗效果的影响。 在他的主要研究研究中，Leuchter博士提出了一项计划，该计划将通过双掩盖方案招募96名年轻和老年人。 受试者将用两种氟西汀20/40 mg治疗。或Venlafaxine 150/225 mg。，以确定绳索测量是否与抗抑郁药的短期反应可靠相关。 将检查假定的反应预测因素，例如治疗前和后FDG-PET，体积MRI测量以及临床症状，以确定生理过程和结构特征，这有助于有助于山脉和短期治疗结果之间的关联。 这项研究是增强莱克特博士在干预结果研究中的研究活动和技能的总体计划的一部分。 他将与两名顾问Drs合作。肯尼斯·威尔斯（Kenneth Wells）和林恩·费尔班克斯（Lynn Fairbanks），以实施新方法并提高他在干预结果研究方面的技能。 他将扩大自己的研究，以包括研究响应模式的新方法，并将采用其他功能结果指标。 在本研究的发展阶段，他还将启动项目，以检查绳索和其他推定预测因子在改善长期治疗结果方面的有效性。 这些有效性项目将包括将预测因子引入通常的治疗环境，以及检查成本效益和长期治疗结果。