Affective Neuroscience of Pediatric Bipolar Disorder

小儿双相情感障碍的情感神经科学

基本信息

批准号：
8391267
负责人：
Mani N Pavuluri
金额：
$ 36.36万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-01-01 至 2013-08-01
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8391267
关键词：
16 year old Achievement Acute Adolescence Affect Affective Aftercare Age Algorithms Amygdaloid structure Anterior Area Attention Attentional deficit Behavior Behavioral Biological Models Bipolar Disorder Brain Brain region Child Childhood Clinical Cognition Cognitive Cognitive deficits Color Corpus striatum structure Development Disease susceptibility Dorsal Down-Regulation Drug usage Early Intervention Early identification Effectiveness Emotional Emotions Exhibits FDA approved Failure Functional Magnetic Resonance Imaging Functional disorder Future Goals Health Impaired cognition Impairment Individual K-Series Research Career Programs Knowledge Laboratories Life Link Lithium Lithium Carbonate Longitudinal Studies Manic Measures Memory impairment Methods Modeling Mood stabilizers Moods NIH Program Announcements Nature Neurobiology Neurocognitive Normalcy Patients Performance Pharmaceutical Preparations Pharmacotherapy Phase Prefrontal Cortex Preventive Process Public Health Publishing Recovery Recruitment Activity Regulation Relative (related person)Research Research Design Safety Schools Series Short-Term Memory Specific qualifier value Structure Substance abuse problem System Time Work Youth affective neuroscience aged base childhood bipolar disorder cognitive control cognitive function cognitive neuroscience computerized design double-blind placebo controlled trial effective therapy executive function improved innovation interest mood regulation neural circuit neuroimaging novel operation prototype relating to nervous system response selective attention suicide rate tool trait

项目摘要

DESCRIPTION (provided by applicant): Pediatric Bipolar Disorder (PBD) is a serious public health concern associated with mood instability, high suicide rates, substance abuse, academic failure and poor interpersonal relationships. The illness is also associated with significant affect dysregulation and cognitive dysfunction. Onset of this bipolar diathesis early in life may adversely impact the development of brain structures affecting the regulation of mood and cognition known to mature during childhood and adolescence. For that reason, it is particularly important to understand pathophysiological processes affecting the affective and cognitive neural systems during development. Our preliminary findings in the PBD patients, relative to healthy controls, suggest reduced top down regulation of affective brain systems, indicated by decreased activation of dorsolateral and ventrolateral prefrontal cortex and increased activation of amygdala and peri-amygdaloid structures during emotional processing. Therefore, our first and central aim of the current study is to clarify the systems-level pathophysiology during manic states to better identify the interlinked affective and cognitive neural circuitry function. Our secondary aim is to examine the affective and cognitive circuitry function following symptomatic recovery. We plan to use a longitudinal study design, examining brain function in 100 narrowly defined medication naove PBD patients aged 13-16 years at two time points: (1) At baseline in manic state, and (2) After 8 weeks of treatment with the prototypic mood stabilizer lithium carbonate in medicated euthymic responders and non-responders. Additionally, at baseline and at the end of 8 weeks, we will also characterize the brain function in 50 typically developing IQ and demographically matched healthy youths who will be compared with the PBD patients. We will use innovative neurocognitive and fMRI paradigms to probe the affective and cognitive circuitry function at each time point. This work will help to establish a model that characterizes the functional pathophysiology of PBD and provides reliable and objective understanding of the neural systems in illness and on recovery. This model will serve as a prototype in providing future opportunities for preventive efforts by facilitating early identification, moving a step closer to safer, more effective and neurobiologically informed early interventions for youths that would potentially reverse the pathophysiology in PBD patients.

描述（由申请人提供）：小儿双相情感障碍（PBD）是一种严重的公共卫生问题，与情绪不稳定、高自杀率、药物滥用、学业失败和人际关系不佳有关。该疾病还与显着的情感失调和认知功能障碍有关。这种双相情感在生命早期的出现可能会对大脑结构的发育产生不利影响，从而影响在儿童期和青春期成熟的情绪和认知的调节。因此，了解发育过程中影响情感和认知神经系统的病理生理过程尤为重要。我们在PBD患者中的初步发现，相对于健康对照，表明情感大脑系统自上而下的调节减少，表现为情绪处理过程中背外侧和腹外侧前额皮质的激活减少以及杏仁核和杏仁核周围结构的激活增加。因此，我们当前研究的首要目标是阐明躁狂状态下的系统级病理生理学，以更好地识别相互关联的情感和认知神经回路功能。我们的次要目标是检查症状恢复后的情感和认知回路功能。我们计划采用纵向研究设计，在两个时间点检查 100 名年龄在 13-16 岁、未曾接受药物治疗的狭窄定义的 PBD 患者的脑功能：(1) 处于躁狂状态的基线，以及 (2) 经过 8 周的治疗后原型情绪稳定剂碳酸锂用于药物治疗的正常反应者和无反应者。此外，在基线和 8 周结束时，我们还将描述 50 名智商典型发展且人口统计匹配的健康年轻人的大脑功能，并将他们与 PBD 患者进行比较。我们将使用创新的神经认知和功能磁共振成像范例来探讨每个时间点的情感和认知回路功能。这项工作将有助于建立一个表征 PBD 功能病理生理学的模型，并提供对疾病和恢复中神经系统的可靠和客观的理解。该模型将作为原型，通过促进早期识别，向更安全、更有效和神经生物学信息丰富的青少年早期干预措施迈进，为未来的预防工作提供机会，从而有可能扭转 PBD 患者的病理生理学。

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Trials and tribulations of conducting medication trials: pediatric bipolar disorder as prototype.

进行药物试验的考验和磨难：以儿科双相情感障碍为原型。

DOI：
10.4155/cli.14.85
发表时间：
2014
期刊：
Clinical investigation
影响因子：
0
作者：
Pavuluri,Mani
通讯作者：
Pavuluri,Mani

Altered affective, executive and sensorimotor resting state networks in patients with pediatric mania.

DOI：
10.1503/jpn.120073
发表时间：
2013-07
期刊：
Journal of psychiatry & neuroscience : JPN
影响因子：
0
作者：
Minjie Wu;Lisa H. Lu;A. Passarotti;E. Wegbreit;J. Fitzgerald;M. Pavuluri
通讯作者：
Minjie Wu;Lisa H. Lu;A. Passarotti;E. Wegbreit;J. Fitzgerald;M. Pavuluri

Differentiating low- and high-grade pediatric brain tumors using a continuous-time random-walk diffusion model at high b-values.

DOI：
10.1002/mrm.26012
发表时间：
2016-10
期刊：
Magnetic resonance in medicine
影响因子：
3.3
作者：
Karaman MM;Sui Y;Wang H;Magin RL;Li Y;Zhou XJ
通讯作者：
Zhou XJ

Where, when, how high, and how long? The hemodynamics of emotional response in psychotropic-naïve patients with adolescent bipolar disorder.

地点、时间、高度和时间？

DOI：
10.1016/j.jad.2012.11.025
发表时间：
2013
期刊：
Journal of affective disorders
影响因子：
6.6
作者：
Wegbreit,Ezra;Passarotti,AlessandraM;Ellis,JamesA;Wu,Minjie;Witowski,Nicole;Fitzgerald,JacklynnM;Stevens,MichaelC;Pavuluri,ManiN
通讯作者：
Pavuluri,ManiN

Brain functional domains inform therapeutic interventions in attention-deficit/hyperactivity disorder and pediatric bipolar disorder.

大脑功能域为注意力缺陷/多动障碍和小儿双相情感障碍的治疗干预提供信息。