Brain-Gut biomarkers of anxiety and depressive symptoms in youth with inflammatory bowel disease

炎症性肠病青少年焦虑和抑郁症状的脑肠生物标志物

• 批准号: 10582645
• 负责人: Bonney Reed
• 金额: $ 17.19万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10582645
• 关键词: Adult; Age; Anxiety; Autonomic nervous system; Award; Behavioral; Biofeedback; Biofeedback Training; Biological Markers; Brain; Brain Diseases; C-reactive protein; Central Nervous System; Child; Childhood; Clinic; Clinical; Clinical Management; Clinical Research; Communication; Control Groups; Coping Skills; Cross-Sectional Studies; Data; Data Analyses; Development Plans; Diagnosis; Disease; Disease Outcome; Eligibility Determination; Emotional; Enrollment; Foundations; Future; Galvanic Skin Response; Gastrointestinal Diseases; Gastrointestinal tract structure; Goals; Grant; Health; Immune; Individual; Individual Differences; Inflammation; Inflammatory Bowel Diseases; Intervention; K-Series Research Career Programs; Laboratories; Leukocyte L1 Antigen Complex; Longitudinal cohort; Longitudinal, observational study; Measures; Mediating; Medical; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Modeling; Neurosecretory Systems; Newly Diagnosed; Outcome; Outcome Measure; Patients; Personal Satisfaction; Process; Productivity; Psychophysiology; Randomized; Relapse; Research; Research Personnel; Risk; Role; Scientist; Sedimentation process; Serum; Severity of illness; Standardization; Stress; Stress and Coping; Study models; Surveys; Symptoms; Time; Training; Training Programs; Translational Research; Treatment Protocols; Treatment outcome; Waiting Lists; Writing; Youth; acceptability and feasibility; anxiety symptoms; career; career development; cohort; comparison control; depressive symptoms; design; evidence base; experience; family burden; follow-up; gut-brain axis; heart rate variability; illness length; immune function; indexing; innovation; novel; participant enrollment; pediatric patients; perceived stress; personalized medicine; physical conditioning; pilot test; psychologic; psychological symptom; psychosocial; randomized, clinical trials; recruit; research and development; response; risk stratification; satisfaction; sex; stress reactivity; stressor; systemic inflammatory response; therapy development; treatment effect; treatment group

Project Summary/Abstract This K23 Career Development Award application is designed to prepare the PI for her long-term career goal of becoming an independent clinical scientist with lines of research focused on the brain-gut axis as it relates to disease, emotional, and behavioral functioning in pediatric patients diagnosed with inflammatory bowel disease (IBD). Consistent with this goal, the proposed research and career development plan will build upon pilot data collected during the applicant's KL2 Award demonstrating a positive and significant relationship between high stress reactivity in response to a standardized laboratory stressor and greater mental health symptoms in youth newly diagnosed with IBD. These preliminary data suggest that stress reactivity (as measured via skin conductance, a reliable indicator of autonomic nervous system (ANS) activity) in response to a stress challenge, may serve as a biomarker of psychosocial functioning that could then be used to risk stratify youth who would benefit from coping skills interventions. Thus, the goals of the current study are to conduct a longitudinal observational study to (1) compare relationships between stress reactivity and mental health symptoms in patients with IBD and healthy controls and (2) examine indices of stress reactivity as novel predictors of mental and physical health outcomes in youth with IBD. To this end, we propose to recruit an observational, longitudinal cohort of youth newly diagnosed with IBD (N=60) to be compared to age and sex-matched healthy controls (N=60) at baseline and then followed at six assessment points across 24-months. Indices of stress processing to be assessed include skin conductance and heart rate variability, both validated psychophysiological measures of stress processing. Further, this project will develop a biofeedback enhanced coping skills training program using a treatment group (n=20) and wait-list control group (n=20) to which patients with IBD who screen positive for symptoms of anxiety and/or depression will be randomized. We will evaluate the treatment's feasibility, acceptability, and preliminary outcomes on psychological symptoms, autonomic reactivity, and IBD symptoms. Career development activities will take place under the mentorship of an interdisciplinary mentoring team to provide advanced training in 1) clinical and translational research, 2) longitudinal data analysis and RCT methodology to support intervention development, 3) brain-gut processes and clinical management relevant to pediatric IBD, and 4) scholarly productivity and grant writing. Findings from this K23 proposal will be instrumental in demonstrating longitudinal trajectories of disease and psychosocial functioning in newly diagnosed youth with IBD and determining whether indices of stress processing can serve as objective biomarkers of risk. Findings will be used to inform refined iterations of our biofeedback enhanced coping skills treatment protocol with focus on determining mechanisms of treatment effect, implementation to minimize burden on families, and a future randomized clinical trial.

项目概要/摘要 此 K23 职业发展奖申请旨在帮助 PI 为她的长期职业目标做好准备： 成为一名独立的临床科学家，其研究重点是脑肠轴，因为它与 诊断为炎症性肠病的儿科患者的疾病、情绪和行为功能 （IBD）。与这一目标一致，拟议的研究和职业发展计划将建立在试点数据的基础上 在申请人的 KL2 奖期间收集，证明高水平之间存在积极且重要的关系 对标准化实验室压力源的应激反应和青少年更严重的心理健康症状 新诊断患有 IBD。这些初步数据表明，应激反应性（通过皮肤测量） 电导，自主神经系统（ANS）活动的可靠指标）响应压力挑战， 可以作为心理社会功能的生物标志物，然后可以用来对年轻人进行风险分层 从应对技能干预中受益。因此，当前研究的目标是进行纵向研究 观察性研究（1）比较应激反应与心理健康症状之间的关系 IBD 患者和健康对照者（2）检查应激反应指数作为精神状态的新预测因子 以及患有 IBD 的青少年的身体健康结果。为此，我们建议招募一个观察性的、纵向的 新诊断患有 IBD 的青少年队列 (N=60) 将与年龄和性别匹配的健康对照进行比较 (N=60) 在基线，然后在 24 个月内的六个评估点进行跟踪。应力处理指标 待评估的内容包括皮肤电导和心率变异性，这两项都是经过验证的心理生理指标 的应力处理。此外，该项目将开发生物反馈增强应对技能培训计划 使用治疗组 (n=20) 和等待名单对照组 (n=20)，筛查结果呈阳性的 IBD 患者 对于焦虑和/或抑郁的症状将是随机的。我们将评估治疗的可行性， 可接受性，以及心理症状、自主反应性和 IBD 症状的初步结果。 职业发展活动将在跨学科指导团队的指导下进行 提供 1) 临床和转化研究、2) 纵向数据分析和 RCT 方面的高级培训 支持干预开发的方法，3）与相关的脑肠过程和临床管理 儿科 IBD，以及 4) 学术生产力和资助写作。 K23 提案的调查结果将很有帮助 展示新诊断的青少年疾病和心理社会功能的纵向轨迹 IBD 并确定压力处理指数是否可以作为风险的客观生物标志物。发现 将用于通知我们的生物反馈增强应对技能治疗方案的改进迭代 确定治疗效果的机制、实施以尽量减轻家庭负担以及未来 随机临床试验。

项目成果

Parent and Family Functioning in Pediatric Inflammatory Bowel Disease.

• DOI: 10.3390/children7100188
• 发表时间: 2020-10-17
• 期刊: Children (Basel, Switzerland)
• 作者: Cushman G;Shih S;Reed B
• 通讯作者: Reed B

Implementing psychological therapies for gastrointestinal disorders in pediatrics.

• DOI: 10.1080/17474124.2020.1806055
• 发表时间: 2020-11
• 期刊: Expert review of gastroenterology & hepatology
• 影响因子: 3.9
• 作者: Reed B;Buzenski J;van Tilburg MAL
• 通讯作者: van Tilburg MAL

Assessing the Prevalence of and Risk Factors for Disordered Eating Attitudes and Behaviors in Adolescents With Inflammatory Bowel Disease.

评估患有炎症性肠病的青少年饮食态度和行为紊乱的患病率和危险因素。

• DOI: 10.1093/ibd/izab154
• 发表时间: 2022
• 期刊: Inflammatory bowel diseases
• 影响因子: 4.9
• 作者: David,JennieG;Chute,Douglas;Reed,Bonney;Saeed,Shehzad;DeMatteo,David;Atay,Orhan;Maddux,Michele;Daly,Brian
• 通讯作者: Daly,Brian

Passive Coping Associations With Self-Esteem and Health-Related Quality of Life in Youth With Inflammatory Bowel Disease.

• DOI: 10.3389/fpsyg.2021.670902
• 发表时间: 2021
• 期刊: Frontiers in psychology
• 影响因子: 3.8
• 作者: Reed B;Rea KE;Claar RL;van Tilburg MAL;Levy RL
• 通讯作者: Levy RL