Dynamic Inflammatory and Mood Predictors of Cognitive Aging in Bipolar Disorder

双相情感障碍认知老化的动态炎症和情绪预测因子

• 批准号: 9425179
• 负责人: LISA T EYLER
• 金额: $ 11.03万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-25 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9425179
• 关键词: Accounting; Address; Adult; Affect; Age; Aging; Anti-Inflammatory Agents; Anti-inflammatory; Behavior Therapy; Behavioral; Behavioral Mechanisms; Biological; Biological Response Modifier Therapy; Bipolar Disorder; Bipolar I; Characteristics; Cognition; Cognitive; Cognitive aging; Complex; Development; Diagnosis; Emotional; Future; Goals; Health; Home visitation; Immune; Immune response; Immune system; Impaired cognition; Individual; Inflammation; Inflammatory; Inflammatory Response; Intervention; Investigation; Lead; Longitudinal cohort; Measurement; Measures; Mediating; Mental disorders; Methods; Monitor; Moods; National Institute of Mental Health; Participant; Patients; Pharmacology; Play; Population; Process; Psyche structure; Role; Sampling; Severities; Societies; Technology; Variant; age related; aged; burden of illness; clinically relevant; cognitive change; cognitive function; cognitive performance; cohort; comparison group; cytokine; design; follow-up; functional decline; immune function; inflammatory marker; innovation; longitudinal design; middle age; mood symptom; novel; phase change; physical conditioning; portability; premature; severe mental illness

As the population ages, the burden on individuals and society due to the cognitive and health effects of serious mental illnesses, such as bipolar disorder (BD), will increase. Premature and accelerated aging trajectories in BD are beginning to be recognized in many health and cognitive domains, but specific mechanisms have not yet been identified, particularly for the course of cognitive aging. Markers of inflammatory function, such as cytokine levels, are known to affect cognition, change with age, and predict declines in mentally healthy individuals. Cytokine levels also appear to be abnormal in those with BD, but mood instability in BD makes measurement of short- and long-term changes in both inflammatory and cognitive measures challenging. Nonetheless, studies within this population afford a unique opportunity to better understand how variations in the degree of emotional and behavioral dysregulation may moderate or mediate immune-cognitive associations. We propose to use an innovative multi-cohort burst longitudinal design (MBLD) to characterize trajectories of cognitive and inflammatory response and identify: 1) relationships between cognition and inflammation in the short term while accounting for effects of mood variability, 2) baseline measures and levels of short-term variability in inflammatory markers that might predict long-term trajectories of cognitive change, and 3) relationships between inflammatory, cognitive, and mood variables in the long-term (i.e., mechanisms of change). We will assess 144 adults (35-60 years old) with clinically-relevant symptoms of mood dysregulation, as indicated by Bipolar I diagnosis, and 115 similarly aged non-BD comparison (NC) participants without mental illnesses. Cognition, cytokine levels, and mood (along with other potential contributing variables) will be measured weekly or daily over a two week period using intensive remote monitoring and home visits (burst assessment). Burst assessments will be repeated annually (longitudinal assessment) for three years in the BD group, and at one year in the NC group. This project addresses NIMH Strategic Objective # 2: charting mental illness trajectories to determine when, where, and how to intervene. Specifically, using an innovative design that allows us to account for, and measure the impact of, variability in mood symptoms, we can discover inflammatory markers (both static and dynamic) that predict the course of cognitive change among individuals with mood instability. By understanding the complex and dynamic interplay between inflammation, cognition, and mood, pharmacologic and behavioral interventions can be designed to slow or reverse the trajectory of declining function in bipolar disorder.

随着人口的年龄，由于严重的认知和健康影响，个人和社会的负担 精神疾病（例如躁郁症（BD））将增加。过早和加速的衰老轨迹 BD在许多健康和认知领域都开始得到认可，但是具体机制却没有 但是被确定了，特别是在认知衰老的过程中。炎症功能的标记，例如 已知细胞因子水平会影响认知，随着年龄的变化并预测精神健康的下降 个人。 BD的细胞因子水平似乎也异常，但BD中的情绪不稳定 炎症和认知措施的短期和长期变化的衡量。 尽管如此，该人群中的研究提供了一个独特的机会，可以更好地了解如何变化 情绪和行为失调的程度可能适度或介导免疫认知 协会。我们建议使用创新的多方爆发纵向设计（MBLD）来表征 认知和炎症反应的轨迹并确定：1）认知与认知之间的关系 在考虑情绪变异性的影响时，短期内发炎，2）基线措施和水平 炎症标记中短期可变性可能可以预测认知变化的长期轨迹， 3）长期炎症，认知和情绪变量之间的关系（即 改变）。我们将评估144名成年人（35-60岁），患有与临床相关的情绪失调症状， 如双极I诊断所示，有115个类似年龄的非BD比较（NC）参与者 精神疾病。认知，细胞因子水平和情绪（以及其他潜在的变量）将是 使用密集的远程监控和家庭访问（爆发）在两周内每周或每天测量 评估）。 BD将每年重复三年的爆发评估（纵向评估） 小组，以及在NC组的一年。该项目解决了NIMH战略目标＃2：绘制精神 疾病轨迹确定何时，何地和如何干预。具体而言，使用创新设计 这使我们能够考虑情绪症状变异性的影响并测量的影响，我们可以发现 预测个体认知变化的过程（静态和动态）的炎症标记 与情绪不稳定。通过了解炎症，认知， 情绪，药理和行为干预措施可以设计为减慢或逆转的轨迹 双相情感障碍的功能下降。