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 Laura Julian 博士申请指导临床科学家发展奖的申请，旨在开发一项研究计划，评估多发性硬化症 (MS) 中抑郁症和执行功能障碍 (ED) 的神经影像学相关性。 MS 是影响年轻人和中年人的最常见的致残性神经系统疾病；仅在美国就影响了大约 350,000 人。抑郁和认知障碍是多发性硬化症最常见的两种神经精神症状，每种症状都会导致严重的残疾。在患有抑郁症的多发性硬化症患者中，ED可能是一种特定病因学上不同的抑郁亚型的临床标志物，该亚型是（a）由额皮质下大脑区域的神经退行性变化引起的，以及（b）以抑郁病程不佳或长期为特征。 ED 作为临床标志物的评估已在其他抑郁人群中进行，但尚未在 MS 中进行研究。初步证据表明，抑郁症和 ED 可以预测 MS 中潜在的白质病变负担和较差的抑郁病程。本研究的最初目的是评估抑郁症和 ED 作为 MS 潜在神经影像标志物的预测因子。这项研究将证实使用传统成像技术（T2 加权 MRI）检测 MS 病变体积的初步结果。我们将扩展这些发现，使用新的成像工具——扩散张量成像来探索正常白质的变化。该提案的第二个目的是评估 ED 和神经影像标记物作为 MS 抑郁症 18 个月内病程的预测因素。本研究旨在确定一种有用的临床标志物，以识别患有特定抑郁症亚型的患者。这些标记物的鉴定为未来开发针对特定抑郁症亚型的靶向疗法带来了希望。这项研究是一个更大的指导培训计划的一部分，该计划包括结构化指导、课程作业和其他培训活动，以促进朱利安博士作为独立临床研究员的发展。