Neuropsychiatry of Traumatic Brain Injury

脑外伤的神经精神病学

• 批准号: 6783169
• 负责人: MARILYN F KRAUS
• 金额: $ 17.9万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6783169
• 关键词: amantadine; attention; behavioral /social science research tag; bioimaging /biomedical imaging; brain circulation; brain disorder chemotherapy; brain imaging /visualization /scanning; brain injury; clinical research; dopamine receptor; eye movements; frontal lobe /cortex; functional magnetic resonance imaging; human subject; memory; mental disorder chemotherapy; neuropsychological tests; neuropsychology; patient oriented research; quality of life; trauma; white matter

DESCRIPTION (provided by applicant): This revised application for an academic career development award for clinical research (K23) outlines a program for training and research focusing on the evaluation and treatment of neuropsychiatric disorders secondary to traumatic brain injury (TBI). The particular focus of the research is on prefrontal dysfunction, as the frontal lobes are the most common site of lesion in TBI. This can result in impaired executive cognitive function, mood disorders such as depression, and behavioral changes such as apathy, impulsivity and aggression. Over 2,000,000 cases of TBI occur per year in the US, resulting in significant long term disability. These patients often present to psychiatry, but there are no clear guidelines on treatment of these neurobehavioral disorders. Frontal dysfunction has been shown to play a role in other psychiatric illnesses as well, such that research into effective treatments to improve frontal function could be broadly beneficial. There is a significant need to train psychiatric clinical researchers in this area. Current technologies in MRI, including functional MRI and techniques to assess white matter such as DTI (diffusion tensor imaging) have the potential to further understanding of this brain disorder. There are two primary aims of the proposed career development plan. First, the PI will learn to utilize state of the art structural and functional imaging methods of MRI, along with neurophysiological (oculomotor studies) and neuropsychological procedures, for assessing effects of frontal lobe injury. This will allow for a thorough delineation of the anatomic and neurobehavioral sequelae of TBI. Second, the PI will develop expertise in pharmacologic clinical trials in this special population. The lack of effective treatments to improve quality of life underscores the need to train psychiatric researchers with the necessary skills to fill this void. Further, the need for neuropsychiatric investigators trained to evaluate the cognition-enhancing properties of new pharmacotherapies will be very great in coming years. During the proposed career development program, the PI will utilize MRI and neurobehavioral assessments in a controlled clinical trial with amantadine in patients with frontal lobe dysfunction following TBI. The PI will learn to integrate imaging findings into clinical trials, developing guidelines for selection of therapeutic interventions. This application is designed to enable the candidate to transition into an independent clinical investigator with the necessary research skills needed to study neuropathology, outcomes, and interventions.

描述（由申请人提供）：这份修订后的临床研究学术职业发展奖（K23）申请概述了一项培训和研究计划，重点是评估和治疗继发于创伤性脑损伤（TBI）的神经精神疾病。该研究的重点是前额叶功能障碍，因为额叶是 TBI 中最常见的病变部位。这可能会导致执行认知功能受损、情绪障碍（例如抑郁）以及行为改变（例如冷漠、冲动和攻击性）。美国每年发生超过 2,000,000 例 TBI 病例，导致严重的长期残疾。这些患者经常就诊于精神病学，但目前尚无治疗这些神经行为障碍的明确指南。额叶功能障碍已被证明在其他精神疾病中也发挥着作用，因此对改善额叶功能的有效治疗方法的研究可能会广泛有益。非常需要培训该领域的精神病学临床研究人员。目前的 MRI 技术，包括功能性 MRI 和 DTI（扩散张量成像）等白质评估技术，有可能进一步了解这种脑部疾病。拟议的职业发展计划有两个主要目标。首先，PI 将学习利用最先进的 MRI 结构和功能成像方法，以及神经生理学（动眼神经研究）和神经心理学程序，来评估额叶损伤的影响。这将有助于全面描述 TBI 的解剖学和神经行为后遗症。其次，PI 将在这一特殊人群中培养药理学临床试验的专业知识。由于缺乏有效的治疗方法来改善生活质量，因此需要培训精神病学研究人员具备必要的技能来填补这一空白。此外，未来几年将非常需要接受过培训以评估新药物疗法的认知增强特性的神经精神病学研究人员。在拟议的职业发展计划中，PI 将在一项针对 TBI 后额叶功能障碍患者的金刚烷胺对照临床试验中利用 MRI 和神经行为评估。 PI 将学习将影像学结果整合到临床试验中，制定治疗干预措施选择指南。该应用程序旨在使候选人能够转变为独立的临床研究者，并具备研究神经病理学、结果和干预措施所需的必要研究技能。