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）：该中期护理研究者奖的长期目标是以患者为导向研究（K24）奖（K24）奖，是为了向候选人提供时间和资源，以继续并扩大他在创新方法领域的临床研究职业中的学员的指导和扩展，以早期鉴定和预防儿科情绪障碍。此外，候选人将在先进的MRI方法论和基于正念的疗法领域发展自己的职业，以便利用这些知识来更好地研究神经网络异常，从而为早期发作的双相情感障碍（BD）带来风险，以及干预措施如何扭转这些发育异常。候选人将通过相关的课程，科学会议，外部咨询，内部协作和指导以及完成拟议的研究项目，将这些领域与BD的青年有关，没有其他指定（BD NOS）实现这一目标。躁郁症是一种常见，慢性且经常残疾的疾病，会带来巨大的公共卫生负担，通常始于儿童或青春期。了解大脑发展如何导致BD发展将有助于开发针对早期干预和预防的有针对性的干预措施。鉴于精神药物对发育大脑的不良不利影响，还应探讨对有BD风险的人群中的非药物干预措施。基于正念的疗法（MBT）已成功用于治疗抑郁症的成年人和儿童，以及患有躁郁症的成年人。该应用建议检查BD高风险的青年基线静止状态神经网络，以及MBT干预对这些网络和脑形态计量学的影响。首先，我们将研究符合BD NOS标准的30名青少年（13-17岁），根据标准化的研究标准严格定义。受试者还将拥有BD的一级或二级亲戚，从而在四年内创造出一个非常高的双相情感障碍风险的群体。我们将使用静止状态-FMRI（RS-FMRI）在这30个受试者中检查默认模式网络（DMN），并与已获得20个健康对照（HC）的已经获得的数据进行比较。我们假设患有BD NOS的年轻人将改变sGACC的HC：较高的SGACC的FC和SGACC的较高的SGACC和较低的SGACC的FC，而SGACC的较高和较低的FC则可以改变下扣带（SGACC）功能连通性（FC），而前侧扣带和背侧扣带前额叶前额叶前额叶前额叶。其次，这些受试者将通过12周的基于正念的青少年（MBSR-T）干预措施来治疗，旨在提高日常正念，冥想技能和对压力源的情绪失调的认识。我们假设BD NOS的年轻人会在抑郁症状和情绪失调程度下会降低，并增加了正念练习的功能和程度。此外，我们预计具有DMN的SGACC FC将减少，而SGACC的FC具有背面结构的增加，而海马体积将增加。与NIMH战略计划一致，本研究将检查具有预防潜力的新型干预措施的青少年情绪障碍发展的神经生物学风险因素，同时为预防儿科情绪障碍领域的下一代临床研究人员提供了更多机会。