Depression and executive function in multiple sclerosis

多发性硬化症的抑郁和执行功能

• 批准号: 7117018
• 负责人: LAURA J JULIAN
• 金额: $ 16.5万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7117018
• 关键词: behavioral /social science research tag; bioimaging /biomedical imaging; biomarker; clinical research; comorbidity; depression; diffusion magnetic resonance imaging; executive function; human subject; magnetic resonance imaging; multiple sclerosis; neuroimaging; neuropsychological tests; neuropsychology; phenotype; psychometrics; questionnaires; sign /symptom

DESCRIPTION (provided by applicant): This is an application for a Mentored Clinical Scientist Development Award for Dr. Laura Julian to develop a program of research evaluating neuroimaging correlates of depression and executive dysfunction (ED) in multiple sclerosis (MS). MS is the most common disabling neurological disease affecting young and middle aged adults; affecting approximately 350,000, people in the United States alone. Depression and cognitive impairment are the two most common neuropsychiatric symptoms in MS, each conferring significant disability. Among MS patients with depression, ED may be a clinical marker of a specific etiologically distinct subtype of depression that is (a) precipitated by neurodegenerative changes in fronto-subcortical brain regions, and (b) characterized by a poor or protracted course of depression. Evaluations of ED as a clinical marker have been conducted in other depressed populations, but this has not been investigated in MS. Preliminary evidence suggests that depression and ED predict underlying white matter lesion burden and a poorer course of depression in MS. The initial aims of this study are to evaluate depression and ED as predictors of underlying neuroimaging markers in MS. This investigation will confirm preliminary findings using traditional imaging techniques (T2-weighted MRI) to detect MS lesion volume. We will extend these findings to also explore changes in normal appearing white matter using a new imaging tool, diffusion tensor imaging. A second aim of this proposal is to evaluate ED and neuroimaging markers as predictors of the course of depression in MS over a period of 18 months. This reseach aims to identify a useful clinical marker that will identify patients with a specific subtype of depression. Identification of such markers holds promise in the future development of targeted therapies for specific subtypes of depression. This study is part of a larger mentored training program which includes structured mentorship, coursework, and other training activities to facilitate Dr. Julian's development as an independent clinical researcher.

描述（由申请人提供）：这是为劳拉·朱利安（Laura Julian）博士提供指导的临床科学家发展奖的申请，以开发一项研究计划，评估抑郁症和执行功能障碍（ED）的神经成像相关性（MS）。 MS是影响年轻和中年成年人的最常见的残疾神经系统疾病。仅在美国，就会影响约35万。抑郁症和认知障碍是MS中最常见的两种神经精神症状，每种神经精神症状都赋予了严重的残疾。在MS抑郁症患者中，ED可能是特定病因学上不同抑郁症的临床标志物，该抑郁症是（a）由额叶皮质脑区域的神经退行性变化沉淀而来的，（b）以抑郁症的较差或持久性为特征。在其他抑郁症人群中，对ED作为临床标志物进行了评估，但这尚未在MS中进行研究。初步证据表明，抑郁症和ED预测MS中潜在的白质病变负担和抑郁症的较差。这项研究的最初目的是评估抑郁症和ED作为MS中潜在神经影像标记的预测指标。这项研究将使用传统成像技术（T2加权MRI）确认初步发现，以检测MS病变量。我们将扩展这些发现，还使用新成像工具，扩散张量成像探索正常出现白质的变化。该提案的第二个目的是评估ED和神经影像标记，作为18个月内MS抑郁症进程的预测指标。该研究旨在确定一个有用的临床标记，该标记将鉴定患有特定抑郁症亚型的患者。此类标记物的识别在未来开发针对抑郁症特定亚型的靶向疗法的发展中有希望。这项研究是一项更大的指导培训计划的一部分，其中包括结构化指导，课程工作和其他培训活动，以促进朱利安博士作为独立临床研究人员的发展。