Brain Connectivity and Mindfulness Training in Youth with Bipolar Disorder NOS

双相情感障碍青少年的大脑连接和正念训练 NOS

基本信息

批准号：
8704420
负责人：
KIKI D CHANG
金额：
$ 17.87万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-19 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8704420
关键词：
18 year old Adolescence Adolescent Adult Adverse effects Affect Amygdaloid structure Anterior Area Award Awareness Biological Biological Neural Networks Bipolar Disorder Bipolar I Brain Breathing Child Childhood Chronic Clinical Clinical Research Collaborations Consultations Data Development Diagnostic Disease Dorsal Early Intervention Early identification Emotional Emotions Esthesia Event Faculty Family Family history of Functional Magnetic Resonance Imaging Funding Goals Group Therapy Health Care Costs Hippocampus (Brain)Individual Intervention Judgment Knowledge Lead Left Magnetic Resonance Imaging Major Depressive Disorder Mental Depression Mentors Methodology Methods Midcareer Investigator Award in Patient-Oriented Research Mood Disorders Moods Morbidity - disease rate National Institute of Mental Health Neurobiology Outcome Parents Pathway interactions Pharmaceutical Preparations Pilot Projects Population Populations at Risk Postdoctoral Fellow Prefrontal Cortex Prevention Public Health Randomized Controlled Trials Recording of previous events Recurrence Research Research Personnel Research Project Grants Resources Rest Risk Risk Factors Role Second Degree Relative Severities Specific qualifier value Strategic Planning Structure Students Symptoms System Teenagers Therapeutic Intervention Time Training Youth base career cingulate cortex daily functioning density depressive symptoms disorder prevention early onset emotional experience experience gray matter high risk improved innovation meetings mindfulness mindfulness meditation mindfulness-based stress reduction morphometry mortality neuromechanism next generation novel patient oriented patient oriented research public health relevance relating to nervous system response skills stressor therapy design young adult

项目摘要

DESCRIPTION (provided by applicant): The long-term objective of this Midcareer Investigator Award in Patient-Oriented Research (K24) Award is to provide time and resources to the candidate to continue and expand his mentoring activities of trainees in clinical research careers in the field of innovative methods for early identification and prevention of pediatric mood disorders. Furthermore, the candidate will develop his own career in the areas of advanced MRI methodologies and mindfulness-based therapies in order to use this knowledge to better investigate neural network abnormalities that create risk for early-onset bipolar disorder (BD) and how interventions can reverse these developmental abnormalities. The candidate will reach this goal through relevant coursework, scientific meetings, outside consultation, internal collaboration and mentoring, and completion of a proposed research project relating these fields to youth with BD, not otherwise specified (BD NOS). Bipolar disorder is a common, chronic, and often disabling disorder that carries significant public health burden and commonly begins in childhood or adolescence. Understanding how brain development leads to BD development would aid in developing targeted interventions for early intervention and prevention. Given the unclear adverse effects of psychotropic medications on developing brains, non-pharmacologic interventions in populations at risk for BD should also be explored. Mindfulness based therapies (MBT) have been successfully used to treat adults and children with depression, and adults with bipolar disorder. This application proposes examination of baseline resting state neural networks in youth at high-risk for BD, and the effects of a MBT intervention on these networks and on brain morphometry. First, we will study 30 adolescents (13-17 yo) who meet criteria for BD NOS, strictly defined per standardized research criteria. Subjects will also have a first- or second-degree relative with BD, creating a group at very high risk of progressing to bipolar I disorder within four years. We will use resting state-fMRI (rs-fMRI) to examine default mode networks (DMN) in these 30 subjects and compare with already acquired data from 20 healthy controls (HC). We hypothesize that youth with BD NOS will have altered subgenual anterior cingulate (sgACC) functional connectivity (FC) compared with HC: higher FC of sgACC with the DMN and lower FC of the sgACC with the dorsal anterior cingulate and dorsolateral prefrontal cortex. Second, these subjects will be treated with a 12-week Mindfulness Based Stress Reduction for Teens (MBSR-T) intervention, designed to increase daily mindfulness, meditation skills, and awareness of emotional dysregulation in response to stressors. We hypothesize that youth with BD NOS will experience decreases in depressive symptoms and degree of mood dysregulation, and increases in functioning and degree of mindfulness practice. Furthermore, we anticipate that FC of sgACC with DMN will decrease and FC of sgACC with dorsal structures will increase, as will left hippocampal volume. Consistent with the NIMH Strategic Plan, this study will examine neurobiological risk factors for mood disorder development in youth and neural mechanisms of a novel intervention that has potential for prevention, while creating additional opportunities for mentoring the next generation of clinical researchers in the field of pediatric mood disorder prevention.

描述（由申请人提供）：该以患者为导向的研究中的职业生涯中期研究员奖（K24）的长期目标是为候选人提供时间和资源，以继续和扩大他对临床研究职业培训生的指导活动早期识别和预防儿科情绪障碍的创新方法领域。此外，候选人将在先进的 MRI 方法和基于正念的疗法领域发展自己的职业生涯，以便利用这些知识更好地研究导致早发性双相情感障碍 (BD) 风险的神经网络异常以及如何通过干预措施逆转这些发育异常。候选人将通过相关课程、科学会议、外部咨询、内部合作和指导以及完成与患有双相障碍（BD NOS）的青少年相关的拟议研究项目来实现这一目标。双相情感障碍是一种常见、慢性且常常致残的疾病，带来重大的公共卫生负担，通常始于儿童或青少年时期。了解大脑发育如何导致双相情感障碍的发展将有助于制定有针对性的干预措施以进行早期干预和预防。鉴于精神药物对大脑发育的不良影响尚不清楚，因此还应该探索对双相情感障碍风险人群的非药物干预措施。基于正念的疗法（MBT）已成功用于治疗患有抑郁症的成人和儿童以及患有双相情感障碍的成人。该申请建议检查 BD 高危青少年的基线静息态神经网络，以及 MBT 干预对这些网络和大脑形态测量的影响。首先，我们将研究 30 名符合 BD NOS 标准的青少年（13-17 岁），该标准是根据标准化研究标准严格定义的。受试者还将有患有双相情感障碍的一级或二级亲属，从而形成一个在四年内进展为 I 型双相情感障碍的高风险群体。我们将使用静息态功能磁共振成像 (rs-fMRI) 检查这 30 名受试者的默认模式网络 (DMN)，并与 20 名健康对照 (HC) 已获取的数据进行比较。我们假设，与 HC 相比，BD NOS 青少年的膝下前扣带回 (sgACC) 功能连接 (FC) 会发生改变：sgACC 与 DMN 的 FC 较高，而 sgACC 与背侧前扣带回和背外侧前额叶皮层的 FC 较低。其次，这些受试者将接受为期 12 周的青少年正念减压 (MBSR-T) 干预，旨在提高日常正念、冥想技能以及对压力源情绪失调的认识。我们假设患有 BD NOS 的青少年的抑郁症状和情绪失调程度会减轻，而功能和正念练习的程度会增加。此外，我们预计具有 DMN 的 sgACC 的 FC 将减少，具有背侧结构的 sgACC 的 FC 将增加，左侧海马体积也会增加。根据 NIMH 战略计划，这项研究将研究青少年情绪障碍发展的神经生物学危险因素以及具有预防潜力的新型干预措施的神经机制，同时为指导儿科领域的下一代临床研究人员创造更多机会情绪障碍的预防。