Primary Research Project: Functional MRI

主要研究项目：功能性磁共振成像

• 批准号: 7113525
• 负责人: CHARLES B NEMEROFF
• 金额: $ 25.11万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7113525
• 关键词: antidepressants; behavioral /social science research tag; bioimaging /biomedical imaging; brain imaging /visualization /scanning; clinical trials; cognitive behavior therapy; functional magnetic resonance imaging; human subject; human therapy evaluation; major depression; mental disorder chemotherapy; patient oriented research

Although there are several effective treatments for a major depressive episode, there are no reliable predictors of the likelihood of remission, response or non-response with an initial trial of either an antidepressant medication or psychotherapy. In prioritizing a role for direct measures of brain functioning in the development of new algorithms for clinical management of depressed patients, a systematic characterization of pretreatment patterns predictive of unambiguous remission to standard treatments is a necessary first step. This project will characterize imagingbased brain subtypes that distinguish groups of never-treated depressed patients who subsequently respond to pharmacotherapy or cognitive behavior therapy (CBT), respectively. A prospectively-treated cohort of 400 never-treated depressed patients randomized to receive either escitalopram, duloxetine or CBT for 1.2 weeks will define these subtypes. Resting-state BOLD functional magnetic resonance imaging (fMRI) scans will be acquired prior to initiating antidepressant therapy and at a fixed, early time point specific for each treatment. Pre-treatment scan patterns derived using multivariate analyses and associated with the six possible response outcomes (3 types of response; 3 types of nonresponse) will be used to determine whether pretreatment brain patterns can distinguish among outcome groups. A second fMRI scan, acquired early in the treatment course, will be used to assess the likelihood of response to the specific treatment assigned. The proposed studies are a first step towards defining brain-based subtypes predictive of differential treatment outcome in major depression. The data from these studies will also be entered into more complex algorithms integrating imaging findings with behavioral, environmental, biochemical and genetic information for individual patients.

尽管有多种针对重度抑郁发作的有效治疗方法，但目前尚无有效的治疗方法。 初步试验缓解、缓解或无缓解可能性的可靠预测因素 抗抑郁药物或心理治疗。在优先考虑直接措施的作用时 开发抑郁症临床管理新算法中的大脑功能 患者，预处理模式的系统特征预测明确 缓解标准治疗是必要的第一步。该项目将描述基于成像的 区分从未接受过治疗的抑郁症患者群体的大脑亚型 随后分别对药物疗法或认知行为疗法（CBT）做出反应。一个 前瞻性治疗队列由 400 名从未治疗过的抑郁症患者组成，随机接受任一治疗 艾司西酞普兰、度洛西汀或 CBT 1.2 周将定义这些亚型。静息状态粗体 在开始之前将采集功能磁共振成像 (fMRI) 扫描 抗抑郁治疗，并在每种治疗特定的固定早期时间点进行。预处理 使用多变量分析得出的扫描模式并与六种可能的响应相关联 结果（3 种类型的响应；3 种类型的无响应）将用于确定是否 治疗前的大脑模式可以区分结果组。第二次功能磁共振成像扫描， 在治疗过程早期获得的数据将用于评估对治疗反应的可能性 指定的具体治疗。拟议的研究是定义基于大脑的第一步 预测重度抑郁症不同治疗结果的亚型。来自这些的数据 研究还将进入更复杂的算法，将成像结果与 个体患者的行为、环境、生化和遗传信息。