Primary Research Project: Functional MRI

主要研究项目：功能性核磁共振成像

• 批准号: 7645104
• 负责人: Helen S Mayberg
• 金额: $ 23.28万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7645104
• 关键词: Acute myocardial infarction; Algorithms; American; Anterior; Antidepressive Agents; Base of the Brain; Behavioral; Biochemical Genetics; Brain; Brain Stem; Brodmann' s area; Caliber; Cardiac; Cardiology; Classification; Clinical; Clinical Management; Cognitive Therapy; Complex; Condition; Coronary artery; Corpus striatum structure; Data; Depressed mood; Development; Diabetes Mellitus; Diagnosis; Diagnostic tests; Disease; Disease remission; Escitalopram; Evaluation; Family Physicians; Functional Magnetic Resonance Imaging; Genetic; Goals; Health Professional; Hippocampus (Brain); Hyperlipidemia; Hypertension; Hypothalamic structure; Image; Individual; Intervention; Lateral; Life Style; Magnetic Resonance Imaging; Major Depressive Disorder; Measurement; Measures; Medial; Medical; Mental Depression; Mental Health; Methods; Modeling; Multivariate Analysis; Myocardial Ischemia; Organ; Outcome; Patients; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Psychiatrist; Psychologist; Psychosocial Factor; Psychotherapy; Randomized; Recording of previous events; Research Project Grants; Rest; Risk Factors; Role; Scanning; Selection Bias; Selective Serotonin Reuptake Inhibitor; Smoking; Standards of Weights and Measures; Testing; Time; Training; Treatment outcome; Week; base; cohort; college; diet and exercise; duloxetine; interest; research study; response; single episode major depressive disorder; tool

Although there are several effective treatments for a major depressive episode, there are no reliable predictors of the likelihood of remission, response or non-response with an initial trial of either an antidepressant medication or psychotherapy. In prioritizing a role for direct measures of brain functioning in the development of new algorithms for clinical management of depressed patients, a systematic characterization of pretreatment patterns predictive of unambiguous remission to standard treatments is a necessary first step. This project will characterize imagingbased brain subtypes that distinguish groups of never-treated depressed patients who subsequently respond to pharmacotherapy or cognitive behavior therapy (CBT), respectively. A prospectively-treated cohort of 400 never-treated depressed patients randomized to receive either escitalopram, duloxetine or CBT for 1.2 weeks will define these subtypes. Resting-state BOLD functional magnetic resonance imaging (fMRI) scans will be acquired prior to initiating antidepressant therapy and at a fixed, early time point specific for each treatment. Pre-treatment scan patterns derived using multivariate analyses and associated with the six possible response outcomes (3 types of response; 3 types of nonresponse) will be used to determine whether pretreatment brain patterns can distinguish among outcome groups. A second fMRI scan, acquired early in the treatment course, will be used to assess the likelihood of response to the specific treatment assigned. The proposed studies are a first step towards defining brain-based subtypes predictive of differential treatment outcome in major depression. The data from these studies will also be entered into more complex algorithms integrating imaging findings with behavioral, environmental, biochemical and genetic information for individual patients.

尽管对重大抑郁症发作有几种有效的治疗方法，但没有 可靠预测缓解，反应或无响应的可能性，并初步试验 抗抑郁药或心理治疗。在优先级的角色来直接衡量 大脑在开发新算法的临床管理方面的功能 患者，一种预处理的预处理模式的系统表征 缓解标准治疗是必要的第一步。该项目将表征基于成像的 大脑亚型区分从未治疗过的抑郁症患者组 随后，分别对药物治疗或认知行为疗法（CBT）做出反应。一个 前瞻性治疗的队列由400名从未治疗过的抑郁症患者随机接受 依依西更，杜洛西汀或CBT 1.2周将定义这些亚型。静止状态大胆 在启动之前将获得功能磁共振成像（fMRI）扫描 抗抑郁药治疗，在每种治疗方面的固定早期时间点。预处理 使用多元分析得出的扫描模式并与六个可能的响应相关联 结果（3种响应的3种类型； 3种无响应类型）将用于确定是否是否 预处理大脑模式可以区分结果组。第二次fMRI扫描， 在治疗课程的早期获得，将用于评估对响应的可能性 分配的具体处理。拟议的研究是定义基于大脑的第一步 亚型可预测严重抑郁症的差异治疗结果。这些数据 研究还将进入更复杂的算法，将成像发现与 个人患者的行为，环境，生化和遗传信息。