Cerebral Energy Metabolism in Geriatric Bipolar Depression

老年双相抑郁症的大脑能量代谢

• 批准号: 8016112
• 负责人: Brent Peter Forester
• 金额: $ 17.94万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8016112
• 关键词: Aftercare; Age; Aging; Aging-Related Process; Animals; Anterior; Area; Belief; Biochemical; Biochemical Markers; Biometry; Bipolar Depression; Bipolar Disorder; Brain; Brain imaging; Brain-Derived Neurotrophic Factor; Cerebrum; Chronic; Clinical; Clinical Pharmacology; Clinical Skills; Clinical Trials; Collaborations; Complex; Cross-Sectional Studies; Data; Defect; Dementia; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Elderly; Energy Metabolism; Evaluation; Functional disorder; Future; Genes; Glutamates; Glutamine; Goals; Health; Health Services; Health system; Healthcare; Hospitals; Image; Imaging Techniques; Imaging technology; Individual; Institutes; Interview; Laboratories; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measures; Mentors; Montgomery and Asberg depression rating scale; Moods; Morphologic artifacts; N-acetylaspartate; Neuropsychological Tests; Occipital lobe; Pathology; Patients; Performance; Pharmaceutical Preparations; Phase; Protons; Psychotic Mood Disorders; Public Health; Recording of previous events; Reporting; Research; Research Personnel; Scanning; Semantics; Severities; Site; Sorting - Cell Movement; Structure; Symptoms; Techniques; Testing; Therapeutic; Therapeutic Intervention; Training; Wisconsin; burnout; career; cingulate cortex; depressive symptoms; disability; early onset; effective therapy; executive function; functional decline; inclusion criteria; information processing; lamotrigine; meetings; mitochondrial dysfunction; mortality; neuropsychological; older patient; open label; processing speed; programs; response; responsible research conduct; treatment response; young adult

DESCRIPTION (provided by applicant): Dr. Forester aims to become an independent investigator in the field of geriatric bipolar disorder using magnetic resonance spectroscopy (MRS) to study biochemical markers of treatment response. Long-term career goals include collaboration with other centers employing MR imaging (MRI) technologies to study geriatric bipolar disorder with a focus on developing safe and effective therapeutic interventions. Dr. Forester will be mentored at McLean Hospital by Dr. Bruce Cohen, past President of McLean Hospital and current Director of the Frazier Institute, an interdisciplinary consortium studying bipolar disorder using clinical pharmacology, MRS, functional MR and laboratory techniques, and co-mentored by Dr. Perry Renshaw, of the McLean Hospital Brain Imaging Center. Dr. Forester will enhance his clinical skills with formal training in MRI techniques and applications, biostatistics and the responsible conduct of research. The proposed research plan will employ MRS to study measures of brain energy metabolism in 35 older adults with bipolar depression and 25 healthy age-matched controls. Subjects meeting inclusion criteria will be clinically characterized at baseline with a structured psychiatric interview and neuropsychological testing and will undergo proton (1H) MRS study at 4 Tesla. Subjects with bipolar depression will then receive open label treatment with lamotrigine as monotherapy or adjunctive therapy for eight weeks. At the end of 8 weeks, both groups will undergo a second 1H MRS scan at 4 Tesla. Group differences in the brain energy metabolites, glutamate, glutamine, N-acetyl aspartate and lactate, among control subjects and subjects with bipolar disorder will be analyzed at baseline and after treatment. PUBLIC HEALTH RELEVANCE: Bipolar disorder is a significant health care issue for elderly individuals, which is associated with disability, functional decline, mortality and increased demands on the public health system. The treatment of bipolar depression in later life is complex and challenging, with little systematic research available to guide therapeutic interventions. This study will examine biochemicals associated with brain energy metabolism before and after treatment with a mood stabilizing medication. Information from this and future related studies of geriatric bipolar depression might help inform the development of more effective and safe treatments.

描述（由申请人提供）：Forester 博士的目标是成为老年双相情感障碍领域的独立研究者，利用磁共振波谱 (MRS) 研究治疗反应的生化标志物。长期职业目标包括与其他中心合作，利用 MR 成像 (MRI) 技术来研究老年双相情感障碍，重点是开发安全有效的治疗干预措施。 Forester 博士将在麦克莱恩医院接受麦克莱恩医院前任院长、弗雷泽研究所现任所长 Bruce Cohen 博士的指导，弗雷泽研究所是一个跨学科联盟，利用临床药理学、MRS、功能性 MR 和实验室技术研究双相情感障碍，并共同指导由麦克莱恩医院脑成像中心的 Perry Renshaw 博士撰写。 Forester 博士将通过 MRI 技术和应用、生物统计学和负责任的研究行为方面的正式培训来提高他的临床技能。拟议的研究计划将采用 MRS 研究 35 名患有双相抑郁症的老年人和 25 名健康年龄匹配的对照者的大脑能量代谢测量结果。符合纳入标准的受试者将通过结构化精神病学访谈和神经心理学测试进行基线临床表征，并将在 4 特斯拉下接受质子 (1H) MRS 研究。然后，患有双相抑郁症的受试者将接受拉莫三嗪的开放标签治疗，作为单一疗法或辅助疗法，为期八周。 8 周结束时，两组都将在 4 特斯拉下进行第二次 1H MRS 扫描。将在基线和治疗后分析对照组受试者和双相情感障碍受试者脑能量代谢物、谷氨酸、谷氨酰胺、N-乙酰天冬氨酸和乳酸的组间差异。公共卫生相关性：双相情感障碍是老年人的一个重要的医疗保健问题，与残疾、功能衰退、死亡率和对公共卫生系统的需求增加有关。双相抑郁症的晚年治疗既复杂又具有挑战性，很少有系统研究可以指导治疗干预。这项研究将检查情绪稳定药物治疗前后与大脑能量代谢相关的生化物质。本次研究以及未来老年双相抑郁症相关研究的信息可能有助于开发更有效、更安全的治疗方法。