Positive Valence System Function and Reward Exposure Therapy for Late-Life Depression - Administrative Supplement

晚年抑郁症的正价系统功能和奖赏暴露疗法 - 行政补充

• 批准号: 10724357
• 负责人: Jennifer N Bress
• 金额: $ 5.8万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10724357
• 关键词: Administrative Supplement; Adult; Affective; Age; Aging; Anhedonia; Area; Back; Behavior; Behavior Therapy; Behavioral; Biological Markers; Brain; COVID-19 impact; COVID-19 pandemic; Clinical; Clinical Trials Design; Collaborations; Communities; Complement; Consultations; Data; Depressed mood; Disease remission; Economic Burden; Elderly; Emotional; Event-Related Potentials; Feedback; Functional disorder; Generations; Geriatric Psychiatry; Goals; Impairment; Individual; Intervention; Knowledge; Longevity; Major Depressive Disorder; Manuals; Manuscripts; Matched Group; Measures; Mediating; Mediator; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Neurobiology; Outcome; Parents; Participant; Patient Self-Report; Physiology; Positive Valence; Preparation; Psychophysiology; Psychotherapy; Quality of life; Reporting; Research; Research Domain Criteria; Research Personnel; Research Project Grants; Research Training; Rewards; Sample Size; Series; Severities; Stimulus; Supportive care; System; Techniques; Time; Training; Ventral Striatum; age group; age related; biosignature; career; career development; comparison group; depressive symptoms; design; effective therapy; experience; geriatric depression; high risk; improved; indexing; learning community; machine learning method; neural; novel; opioid user; parental role; patient engagement; peer; predicting response; recruit; research study; response; reward processing; skills; suicidal risk; sustained attention; trait

Project Summary/Abstract The goal of the proposed K23 Mentored Patient-Oriented Research Career Development Award is to provide the PI with the mentorship, theoretical knowledge, and research skills to develop into a fully independent psychophysiological researcher studying biomarkers of depression that can be used as targets for novel interventions. In consultation with her mentors, the PI has recruited a team of expert consultants to guide her in executing a research project and training plan that will provide experience essential to her goals. The proposed study will be conducted in the Weill Cornell Institute of Geriatric Psychiatry. The study focuses on late-life depression because it is prevalent and has negative outcomes. Existing treatments have low response rates and are rarely used correctly in the community due to their complexity. The project is based on the premise that focused treatments targeting biosignatures of specific neural abnormalities will have the greatest impact on clinical outcomes in late-life depression. It concentrates on positive valence systems, which are vulnerable to aging and often impaired in depression. The project will investigate positive valence systems in older adults with major depression receiving Engage, a psychotherapy designed to reactivate reward system functions. Engage has been found efficacious in late-life depression and easy to learn by community-based therapists. Consistent with RDoC methods, the proposed study will examine target engagement of Engage in 35 depressed older adults (age ≥ 60) during a 9-week course of Engage therapy, using three units of analysis to assess positive valence system function: physiology (event-related potentials), self-reports, and behavior. It will compare Engage-treated participants with 35 depressed participants, group-matched on age, receiving manualized supportive therapy. Additional analyses will assess whether low baseline positive valence function, or increases in positive valence function during treatment, predict improvement of anhedonia with Engage, and whether reward function mediates change in anhedonia. The proposed training plan complements the research study with individualized tutorials, formal coursework, research collaborations, and manuscript preparation that will provide the PI with knowledge and skills in several areas: 1) Age-related neurobiological changes in the positive valence system and related networks; 2) Advanced statistical techniques to identify distinct neural abnormalities in depressed individuals based on their ERP profiles; and 3) Clinical trial design for psychotherapeutic interventions. The proposed project may provide important information about target engagement and mechanisms of a biologically informed, easily implemented treatment for late-life depression that has potential for dissemination. It will also provide pilot data for an R-series study using machine learning methods to predict response to Engage and will serve as an important stepping-stone for the PI as she prepares for an independent research career.

项目概要/摘要 拟议的 K23 指导的以患者为导向的研究职业发展奖的目标是 为 PI 提供指导、理论知识和研究技能，使其发展成为一名全面的 独立心理生理学研究员研究抑郁症的生物标志物，可作为治疗目标 与她的导师协商后，P​​I 招募了一个专家顾问团队来指导。 她执行一个研究项目和培训计划，这将为她的目标提供必要的经验。 拟议的研究将在威尔康奈尔老年精神病学研究所进行。 重点关注晚年抑郁症，因为它很普遍并且现有的治疗方法具有负面效果。 响应率低，并且由于其复杂性而很少在社区中正确使用。 前提是针对特定神经异常生物特征的集中治疗将具有 它对晚年抑郁症的临床结果影响最大，主要集中在正价系统上。 容易受到衰老的影响，并且经常因抑郁症而受损。该项目将研究正价系统。 患有重度抑郁症的老年人接受 Engage 治疗，这是一种旨在重新激活奖励系统的心理疗法 已发现参与对晚年抑郁症有效，并且易于通过社区学习。 与 RDoC 方法一致，拟议的研究将检查参与的目标参与度。 35 名抑郁老年人（年龄 ≥ 60 岁）接受为期 9 周的 Engage 疗法，使用三个分析单元 评估正价系统功能：生理学（事件相关电位）、自我报告和行为。 将比较接受 Engage 治疗的参与者与 35 名抑郁症参与者，按年龄、接受治疗进行分组匹配 手动支持治疗将评估是否低基线正价功能， 或治疗期间正价函数的增加，通过 Engage 预测快感缺失的改善，以及 奖赏函数是否介导快感缺失的变化。 拟议的培训计划通过个性化的教程、正式的培训来补充研究性学习 课程作业、研究合作和手稿准备将为 PI 提供知识和 几个领域的技能：1）正价系统中与年龄相关的神经生物学变化以及相关 2) 先进的统计技术可识别抑郁症患者的明显神经异常 基于他们的 ERP 概况；3) 心理治疗干预的临床试验设计。 项目可能提供有关生物靶标参与和机制的重要信息 知情且易于实施的晚年抑郁症治疗方法也将具有传播潜力。 使用机器学习方法为 R 系列研究提供试点数据，以预测对 Engage 和 will 的反应 在 PI 为独立研究生涯做准备时，她是她的重要垫脚石。