A Study of Preschool Irritability: Brain Imaging in the Clinic Setting

学龄前烦躁的研究：临床环境中的脑成像

• 批准号: 8807943
• 负责人: Susan B Perlman
• 金额: $ 19.25万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-02-17 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8807943
• 关键词: Adolescence; Adolescent; Adult; Age; Area; Attention deficit hyperactivity disorder; Behavior; Behavioral; Biological; Biological Markers; Bipolar Disorder; Brain; Brain imaging; Categories; Child; Child Mental Health; Childhood; Clinic; Clinical; Clinical Services; Communities; Computers; Conflict (Psychology); DSM-V; Development; Diagnosis; Diagnostic; Dimensions; Disease; Dorsal; Environment; Frustration; Functional Magnetic Resonance Imaging; Functional disorder; Future; Goals; Health; Imaging Techniques; Investigation; Lateral; Lead; MRI Scans; Manic; Measurement; Measures; Medial; Mental Health; Mental disorders; Moods; Movement; National Institute of Mental Health; Near-Infrared Spectroscopy; Neurophysiology - biologic function; Nursery Schools; Outcome; Painless; Personality; Population; Prefrontal Cortex; Preschool Child; Problem behavior; Psychiatric Diagnosis; Psychiatrist; Psychologist; Psychopathology; Reporting; Research; Research Domain Criteria; Research Project Grants; Risk Factors; Role; Sampling; Scanning; Schools; Secure; Severities; Staging; Support System; Symptoms; System; Techniques; Technology; Testing; Therapeutic Intervention; base; behavioral outcome; clinical Diagnosis; clinical care; design; early onset; executive function; interest; member; neural correlate; neuromechanism; neuroregulation; novel; novel diagnostics; optical imaging; psychologic; relating to nervous system; social

DESCRIPTION (provided by applicant): The goal of this research is to use functional Near Infrared Spectroscopy (fNIRS) to study the neural basis of irritability in a sample of preschool children (ages 3-5) who are being clinically treated for early onset psychopathology. Irritability exists on a dimension in every member of the population, however, it is also a significant mental health concern that is present in nearly every form of psychopathology. A new diagnostic category in the DSM-V revision has even been added in order to secure the research and clinical services that this symptom requires. The proposed study will be the first to examine brain mechanisms for frustration and inhibitory control, which signify key behavioral deficits, in young, highly irritable children. Obtaining these measures of functional abnormalities in the neural systems supporting frustration and inhibitory control in preschool children presenting with varying levels of irritability will first help us to identify which children show greater levels of dysfunction within these neural systems. It is also a first step toward the longer term goal of examining the extent to which these neural system abnormalities, identified at the age at which irritability first presents, may represent biological markers that can help distinguish relevant developmental trajectories of psychopathology, so that different treatments can be applied at this early stage of symptomatology. Children will be tested in the clinic setting using fNIRS, an optical imaging technique that is painless, non-restrictive, transportable, and allows for subject/experimenter interaction. Well-validated experimental paradigms will be employed. Primary analyses will probe the neural activity within specific regions related to frustration and inhibitory control, using state-of-the-art analysis techniques, in order to define brain deficits tat correlate with this symptom. Exploratory analyses will examine the extent to which these neural system abnormalities may predict symptom severity and clinical diagnosis by correlating activity in these neural systems with diagnostic report. Finally, long term plans for this research include a future proposal to complete a longitudinal R01 study, combining fNIRS and functional magnetic resonance imaging (fMRI). A large community sample of preschool children, across the range of irritability levels, will participate in yearly fNIRS measurement of neural systems fo frustration and inhibitory control using age appropriate tasks. In the later years of the project, when children have entered middle childhood, they will be scanned, using simultaneous fNIRS and fMRI to increase our understanding of the neural and clinical trajectories of this symptom. Our transdisciplinary research team unites developmental psychologists, neuroscientists, and child psychiatrists who are experts in their respective fields, but share a common interest in understanding the neural mechanisms for irritability as a predictor of child mental health outcomes.

描述（由申请人提供）：本研究的目标是使用功能性近红外光谱 (fNIRS) 来研究正在接受早发性精神病理学临床治疗的学龄前儿童（3-5 岁）样本中易激惹的神经基础。每个人都存在烦躁情绪，然而，它也是一个重要的心理健康问题，几乎存在于所有形式的精神病理学中。 DSM-V 修订版中甚至添加了一个新的诊断类别，以确保该症状所需的研究和临床服务。这项拟议的研究将是第一个检查挫败感和抑制控制的大脑机制的研究，这意味着易怒的年幼儿童的关键行为缺陷。获得这些神经系统功能异常的测量结果，支持表现出不同程度烦躁的学龄前儿童的挫败感和抑制控制，将首先帮助我们确定哪些儿童表现出更高水平的烦躁情绪。 这些神经系统内的功能障碍。这也是迈向更长期目标的第一步，即检查这些神经系统异常（在首次出现烦躁的年龄时发现）可能代表生物标记，有助于区分精神病理学的相关发展轨迹，以便不同的治疗方法可以在症状学的早期阶段应用。 儿童将在临床环境中使用 fNIRS 进行测试，这是一种无痛、非限制性、可移动的光学成像技术，并且允许受试者/实验者互动。将采用经过充分验证的实验范例。初步分析将使用最先进的分析技术来探测与挫败和抑制控制相关的特定区域内的神经活动，以便定义与这种症状相关的大脑缺陷。探索性分析将通过将这些神经系统的活动与诊断报告关联起来，检查这些神经系统异常在多大程度上可以预测症状的严重程度和临床诊断。最后，这项研究的长期计划包括未来建议完成纵向 R01 研究，结合 fNIRS 和功能磁共振成像 (fMRI)。大量社区样本的学龄前儿童，无论其烦躁程度如何，都将参加每年一次的 fNIRS 测量，通过使用适合年龄的任务来测量神经系统的挫败感和抑制控制。在该项目的后期，当儿童进入童年中期时，他们将使用同步 fNIRS 和 fMRI 进行扫描，以增加我们对这种症状的神经和临床轨迹的了解。 我们的跨学科研究团队由发展心理学家、神经科学家和儿童精神病学家组成，他们都是各自领域的专家，但对理解易怒的神经机制作为儿童心理健康结果的预测因素有着共同的兴趣。