The Cognitive and Neural Basis of Apathy in Frontotemporal Degeneration

额颞叶退化中冷漠的认知和神经基础

基本信息

批准号：
8252414
负责人：
Lauren M Massimo
金额：
$ 4.18万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-01-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8252414
关键词：
Advanced Practice Nurse Anatomy Anterior Area Behavior Behavioral Behavioral Symptoms Belief Biological Brain Brain imaging Caregiver Burden Caregivers Cessation of life Cognitive Corpus striatum structure Data Databases Disease Emotions Family Caregiver Family Nursing Fellowship Frontotemporal Dementia Functional disorder Geriatric Nursing Goals Health Professional Human Impairment Individual National Research Service Award Interruption Intervention Knowledge Laboratory Study Lead Literature Magnetic Resonance Imaging Medial Modeling Morbidity - disease rate Motivation National Institute of Nursing Research National Research Service Awards Neurobiology Neurodegenerative Disorders Neurological Nursing Neurologist Neurosciences Nurses Nursing Research Outcome Pain Patients Philadelphia Physiological Prefrontal Cortex Process Quality of life Reaction Time Reporting Research Research Personnel Research Priority Research Proposals Research Training Rewards Risk Scientist Social Behavior Staging Strategic Planning Symptoms Syndrome System Task Performances Temporal Lobe Testing Training Variant Work base cingulate cortex computerized diagnostic accuracy effective intervention effective therapy experience frontal lobe illness length improved innovation insight mortality neurobehavioral neuroimaging neuron loss neuropsychiatry neuropsychological novel pre-doctoral relating to nervous system response skills social neuroscience tool

项目摘要

The purpose of this individual National Research Service Award (NRSA) is to provide research training for a neuroscience nurse to become an independent investigator focusing on the biological mechanisms that contribute to neurobehavioral changes such as apathy in patients with neurodegenerative disease (ND). In addition to scholarly coursework and the acquisition of research skills, I propose to focus this NRSA on impairments of goal-directed behavior that are very common but understudied in ND. The syndrome of apathy, defined as a reduction in self-generated or voluntary behavior,1 has profound consequences for morbidity and mortality in the patient and for family caregiver burden. Apathy is one of the primary neuropsychiatric syndromes associated with the disruption of the frontal-striatal system, but the behavioral and biological mechanisms underlying apathy are not well understood. Apathy is especially prevalent in behavioral variant Frontotemporal Degeneration (bvFTD), where it is reported in up to 90.5% of mild stage patients.2 I hypothesize three subtypes of apathy that compromise distinct components of goal-directed behavior, and that each of these subtypes of apathy are associated with a specific neuroanatomic substrate. I will investigate these empirically using a novel computerized reaction time test and neuroimaging. I have had more than 5 years experience as an Advanced Practice Nurse and Research Nurse Coordinator in a nationally ranked laboratory that studies the neural basis for behavior in ND and have direct access to a large database of neuropsychological and neuroimaging data. My research training will be guided by two internationally known scientists, Dr. Lois Evans, a well-known gerontological nurse expert and leader, and Dr. Murray Grossman, a highly acclaimed cognitive neurologist and experienced scientist. The long-term impact of this research training will be profound for patients with ND, their caregivers, and families. Current treatment of apathy has been hindered because of our poor understanding of the mechanisms underlying this condition. The precise characterization of apathy will allow us to implement the most appropriate therapy for a patient. Consistent with the National Institute of Nursing Research (NINR) priorities, this work will lead to a better understanding of why these behaviors occur and with this knowledge, tailored interventions can be implemented by professional and lay caregivers.

该国家研究服务奖 (NRSA) 的目的是为神经科学护士提供研究培训，使其成为一名独立研究者，重点研究导致神经行为变化的生物机制，例如神经退行性疾病 (ND) 患者的冷漠。除了学术课程和获得研究技能之外，我建议将 NRSA 的重点放在目标导向行为的损伤上，这种损伤在 ND 中很常见但尚未得到充分研究。冷漠综合症被定义为自发或自愿行为的减少1，对患者的发病率和死亡率以及家庭护理人员的负担具有深远的影响。冷漠是与额叶纹状体系统破坏相关的主要神经精神综合征之一，但冷漠背后的行为和生物学机制尚不清楚。冷漠在行为变异型额颞叶变性 (bvFTD) 中尤其普遍，据报道，高达 90.5% 的轻度期患者出现冷漠。2 我假设冷漠的三种亚型会损害目标导向行为的不同组成部分，并且每种亚型冷漠的表现与特定的神经解剖学基础有关。我将使用新颖的计算机反应时间测试和神经影像学对这些进行实证研究。我在一家国家排名实验室担任高级实践护士和研究护士协调员，拥有超过 5 年的经验，该实验室研究 ND 行为的神经基础，并可以直接访问神经心理学和神经影像数据的大型数据库。我的研究培训将由两位国际知名科学家指导：Lois Evans 博士（著名老年学护理专家和领导者）和 Murray Grossman 博士（备受赞誉的认知神经学家和经验丰富的科学家）。这项研究培训将对 ND 患者、其护理人员和家人产生深远的长期影响。由于我们对冷漠的机制了解甚少，目前对冷漠的治疗受到了阻碍。冷漠的精确表征将使我们能够为患者实施最合适的治疗。与国家护理研究所 (NINR) 的优先事项一致，这项工作将有助于更好地理解这些行为发生的原因，并且有了这些知识，专业和非专业护理人员就可以实施量身定制的干预措施。