Cranial electrotherapy stimulation: Piloting a road to PTSD prevention in first responders

颅脑电疗刺激：在急救人员中试行预防 PTSD 的道路

• 批准号: 10853457
• 负责人: BENJAMIN D GREENBERG
• 金额: $ 66.08万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10853457
• 关键词: Address; Administrative Supplement; Affect; Arousal; Automobile Driving; Award; Biometry; Brain; Centers of Research Excellence; Cephalic; Chronic; Clinic; Clinical Psychology; Cognitive; Collaborations; Development; Distress; Early Intervention; Ecological momentary assessment; Economics; Effectiveness; Electric Stimulation Therapy; Emotions; Environmental Monitoring; Exposure to; FDA approved; Fatigue; Frequencies; Future; Goals; Grant; Homeostasis; Hormones; Hospitals; Hydrocortisone; Individual; Infrastructure; Intervention; Knowledge; Limbic System; Literature; Measures; Medical; Memory; Mental Depression; Mental disorders; Methodology; Nature; Occupations; Opioid; Outcome; Overdose; Parents; Pathogenesis; Persons; Pharmacotherapy; Physiologic pulse; Physiological; Physiology; Pilot Projects; Post-Traumatic Stress Disorders; Prevention; Prevention strategy; Principal Investigator; Process; Protocols documentation; Psychiatry; Psychotherapy; Recurrence; Research Personnel; Resources; Rhode Island; Risk; Sampling; Schedule; Scientist; Signal Transduction; Sleep; Sleeplessness; Source; Stress; Structure; System; Techniques; Testing; Thalamic structure; Time; Training; Trauma; Work; acceptability and feasibility; allostatic load; anxiety symptoms; anxiety treatment; biological adaptation to stress; brain research; career; clinical translation; comorbidity; disorder prevention; effective intervention; effective therapy; experience; feasibility testing; fighting; fire fighter; first responder; heart rate variability; high risk; hormonal signals; indexing; innovation; insight; neural; neural circuit; neuropsychiatric disorder; neuropsychiatry; neuroregulation; noninvasive brain stimulation; novel strategies; positive emotional state; prevent; preventive intervention; resilience; side effect; skills; sleep quality; stem; stress reduction; success; symptomatic improvement; traumatic event; traumatic stress

PROJECT SUMMARY The goal of the Butler Hospital COBRE Center for Neuromodulation parent award is to support interdisciplinary clinical-translational brain research by creating the key infrastructure to support the careers of interdisciplinary investigators with as overall objective to advance the use of noninvasive neuromodulation in circuit-based therapies for neuropsychiatric disorders, including posttraumatic stress disorder. In doing so, the COBRE Center for Neuromodulation addresses the pressing need for innovative and effective treatments for people struggling with psychiatric disorders. The current proposal builds upon this overarching objective. Specifically, the proposed administrative supplement aims to test the feasibility and acceptability of a four-week course of noninvasive cranial electrotherapy stimulation (CES) as well as establish an early signal of CES effects on homeostatic functioning in a sample of firefighter first responders. Firefighters are at ultra-high risk for developing posttraumatic stress disorder due to the nature of their occupation which has both dire personal as well as economic, workforce- related consequences. Therefore, there is an urgent need for an effective preventative intervention for posttraumatic stress disorder. This is scientifically challenging, and current intervention strategies that aim to prevent the development of posttraumatic stress disorder have either had little to modest success (e.g., pharmacotherapy) or are unrealistic to implement when the source of trauma is one's occupation and thus unavoidable (e.g., psychotherapy). The repeated exposure to traumatic events regularly faced by firefighters puts them at risk for homeostatic dysregulation, contributing to the pathogenesis of posttraumatic stress disorder. CES is thought to reestablish physiological homeostasis, thus reducing the negative consequences of (repeated) traumatic stress. However, despite literature on CES effectiveness to improve symptoms of anxiety, insomnia, and depression, the mechanism of CES effects on homeostatic functioning remains rather hypothetical with little direct evidence to date. In addition, the application of CES should be carefully integrated with firefighter work schedules. Even though CES carries little to no side effects and can be done safely outside the clinic, its usage would be restricted to off-duty days which raises important questions about CES feasibility and acceptability in firefighters. Ultimately, the long-term goal of this line of work is to develop an effective, easily deployable, proactive intervention to prevent the development of posttraumatic stress disorder in first responders. To test feasibility, acceptability, and early signal of CES homeostasis, we have assembled a collaborative partnership between investigators of the Butler Hospital COBRE for Neuromodulation and the Rhode Island Hospital COBRE on Opioids and Overdose. Both the COBRE for Neuromodulation and the COBRE on Opioids and Overdose are in Rhode Island within a 10-minute driving distance. This proximity permits a close partnership between investigators. The proposed complimentary and interdisciplinary team will leverage expertise on the pathogenesis of posttraumatic stress disorder and methodological strengths from the fields of psychiatry (Dr. Fukuda), cognitive neuropsychiatry (Dr. van ’t Wout-Frank), and clinical psychology (Dr. Weiss) to propose the use of CES as a novel approach to posttraumatic stress disorder prevention. Dr. Fukuda, Principal Investigator on a pilot project supported through the COBRE Center for Neuromodulation, and Dr. van ’t Wout-Frank, Project Leader within the COBRE Center for Neuromodulation, provide the expertise in posttraumatic stress disorder, infrastructure to support the administration of CES as a noninvasive brain stimulation technique, and in assessing its effects via measuring brain activity and (psycho)physiology, including the stress hormone cortisol and heart rate variability. However, the COBRE Center for Neuromodulation at Butler Hospital does not currently include investigators with the combined expertise in posttraumatic stress disorder and advanced skills to assess the effects of noninvasive brain stimulation techniques in a naturalistic and near real-time manner. This additional critical expertise comes from Dr. Weiss, a Project Leader affiliated with the COBRE on Opioids and Overdose through Rhode Island Hospital, who will lead the implementation of ecological momentary assessments to naturalistically and in near real-time assess the effects of CES. This team is uniquely poised to preliminarily, yet comprehensively, assess whether and how CES would be beneficial for prevention of posttraumatic stress disorder based on ecological monitoring of subjective (i.e., negative and positive affect, fatigue) and objective biometric indices of stress responses (i.e., heart rate variability, cortisol, quality of sleep) and neural circuit changes (i.e., thalamic functioning and default mode network structural and functional connectivity). The proposed project allows the building and strengthening of new collaborations between investigators from two distinct Centers of Biomedical Research Excellence to expand and strengthen scientific resources and expertise for future grant submissions to address the critical need to prevent posttraumatic stress disorder in those in high-risk occupations such as firefighter first responders.

项目摘要 巴特勒医院柯布雷神经调节父母奖的目标是支持跨学科 通过创建关键基础设施来支持跨学科的职业，临床翻译大脑研究 研究人员的总体目的是推进基于电路的非侵入性神经调节的使用 神经精神疾病的疗法，包括创伤后应激障碍。这样，毛绒 神经调节中心解决了人们对人们的创新和有效治疗的迫切需求 与精神疾病斗争。 当前的提议建立在这个总体目标的基础上。具体而言，拟议的行政 补充旨在测试为期四周的无创颅骨课程的可行性和可接受性 电疗刺激（CES），并建立了CES对稳态功能的早期信号 在消防员的急救人员样本中。消防员有产生创伤后压力的超高风险 由于其发生的性质而引起的混乱，既有个人和经济，劳动力 - 相关后果。因此，迫切需要进行有效的预防性干预 创伤后应激障碍。这是科学挑战的，目前的干预策略旨在 防止创伤后应激障碍的发展几乎没有成功到适度的成功（例如， 药物疗法）或当创伤来源是占领而不是现实的 不可避免的（例如，心理治疗）。一再暴露于消防员经常面对的创伤事件 使他们处于稳态失调的风险，导致创伤后压力的发病机理 紊乱。 CES被认为可以重新建立身体稳态，从而减少了负面后果 （重复）创伤应力。然而，尽管有关CES有效性以改善动画症状的文献，但 失眠和抑郁症，CES对稳态功能的影响仍然相当 假设，迄今为止很少有直接证据。此外，应仔细整合CES的应用 使用消防员工作时间表。即使CES几乎没有副作用，也可以安全完成 在诊所外，其使用将仅限于下班日，这引发了有关CES的重要问题 消防员的可行性和可接受性。最终，这项工作的长期目标是开发 有效，易于部署，主动干预以防止创伤后应激障碍的发展 在急救人员中。 为了测试CES稳态的可行性，可接受性和早期信号，我们组装了协作 Butler医院的研究人员与神经调节的研究人员与罗德岛岛之间的伙伴关系 医院的阿片类药物和药物过量。神经调节的毛线和阿片类药物的毛线 用药过量在10分钟的车程内。这种接近允许接近 研究人员之间的伙伴关系。拟议的免费和跨学科团队将利用 关于创伤后应激障碍和方法学强度的发病机理的专业知识 精神病学（Fukuda博士），认知神经精神病学（Van't Wout-Frank博士）和临床心理学（Weiss博士） 提出将CEs用作创伤后应激障碍预防的新方法。福田博士， 通过毛绒神经调节中心支持的试点项目的首席研究员和博士 远处的货物货车是毛bre神经调节中心的项目负责人，提供了专业知识 创伤后应激障碍，基础设施，以支持CE作为无创大脑的给药 刺激技术，以及通过测量大脑活动和（心理）生理学评估其影响时， 包括应力同性皮质醇和心率变异性。但是， 巴特勒医院的神经调节目前不包括具有联合专业知识的调查员 创伤后应激障碍和高级技能，以评估无创脑刺激的影响 以自然主义和近实时的方式采用技术。韦斯博士，这一额外的关键专业知识， 与阿片类药物的毛刺公司的项目负责人，穿过罗德岛医院过量，他将 领导生态瞬时评估的实施自然和实时评估 CES的影响。该团队被唯一的毒品中毒，但要全面地评估是否和 基于生态监测，CES如何有益于预防创伤后应激障碍 主观（即负面影响和积极影响，疲劳）和应力反应的客观生物识别指数（即 心率变异性，皮质醇，睡眠质量）和神经回路变化（即丘脑功能和默认 模式网络结构和功能连接）。拟议的项目允许建筑物和 加强来自两个不同生物医学研究中心的研究人员之间的新合作 卓越的扩展和加强科学资源和专业知识，以供未来的赠款提交以解决 防止高风险吞噬者（例如消防员）中创伤后应激障碍的关键需求 第一响应者。

项目成果

Exploring response inhibition and error monitoring in obsessive-compulsive disorder.

• DOI: 10.1016/j.jpsychires.2020.04.002
• 发表时间: 2020-04
• 期刊: Journal of psychiatric research
• 影响因子: 4.8
• 作者: Vitor Portella Silveira;I. Frydman;Leonardo Franklin Fontenelle;P. Mattos;R. de Oliveira-Souza;J. Moll;M. Hoexter;E. Miguel;N. McLaughlin;E. Shephard;M. Batistuzzo

Limitations of performance validity tests in dementia evaluations: The role of base rates.

• DOI: 10.1037/pas0001166
• 发表时间: 2022-11
• 期刊: PSYCHOLOGICAL ASSESSMENT
• 影响因子: 3.6
• 作者: Gaudet, Charles E;Castelluccio, Brian;Gold, Dov;McLaughlin, Nicole C R;Correia, Stephen
• 通讯作者: Correia, Stephen

Practice makes plasticity: 10-Hz rTMS enhances LTP-like plasticity in musicians and athletes.

• DOI: 10.3389/fncir.2023.1124221
• 发表时间: 2023
• 期刊: FRONTIERS IN NEURAL CIRCUITS
• 影响因子: 3.5
• 作者: Kweon, Jamie;Vigne, Megan M.;Jones, Richard N.;Carpenter, Linda L.;Brown, Joshua C.
• 通讯作者: Brown, Joshua C.

The COBRE Center for Neuromodulation (CCN) at Butler Hospital: Clinical-Translational Research in Human Brain Stimulation.

• 发表时间: 2021-03
• 期刊: Rhode Island medical journal
• 作者: B. Greenberg;N. Philip;Kristen Fortin-Ashburne;L. Carpenter

Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response.

• DOI: 10.1038/s41398-023-02425-2
• 发表时间: 2023-04-26
• 期刊: TRANSLATIONAL PSYCHIATRY
• 影响因子: 6.8
• 作者: McLaughlin, N. C. R.;Magnotti, J. F.;Banks, G. P.;Nanda, P.;Hoexter, M. Q.;Lopes, A. C.;Batistuzzo, M. C.;Asaad, W. F.;Stewart, C.;Paulo, D.;Noren, G.;Greenberg, B. D.;Malloy, P.;Salloway, S.;Correia, S.;Pathak, Y.;Sheehan, J.;Marsland, R.;Gorgulho, A.;De Salles, A.;Miguel, E. C.;Rasmussen, S. A.;Sheth, S. A.
• 通讯作者: Sheth, S. A.