Modulation of the OCD neural network by conventional treatment

通过常规治疗调节强迫症神经网络

基本信息

批准号：
10594013
负责人：
JUSTIN T BAKER
金额：
$ 34.09万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-06-01 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10594013
关键词：
Affect Aftercare Anisotropy Anterior Behavior Behavioral Brain Clinical Clinical assessments Complement Corpus Callosum Corpus striatum structure Cues Data Data Collection Devices Diffusion Magnetic Resonance Imaging Dimensions Early treatment Fiber Functional Magnetic Resonance Imaging Funding Goals Hospitals Individual Insula of Reil Internal Capsule Intervention Limb structure Link Magnetic Resonance Imaging Measures Medication Management National Institute of Mental Health Neurites Outcome Participant Pattern Performance Phase Phenotype Prediction of Response to Therapy Prevention therapy Probability Radial Reporting Residential Treatment Rewards Sampling Serial Magnetic Resonance Imaging Severities Signal Transduction Structure Symptoms Testing Therapeutic Time Uncertainty Variant Visit behavioral impairment burden of illness clinical heterogeneity conventional therapy density digital efficacious treatment experience flexibility imaging biomarker indexing member neural circuit neural network psychopharmacologic response standard of care trait

项目摘要

PROJECT SUMMARY/ABSTRACT McLean Hospital Project 4 The main goal of the proposed project, entitled “Modulation of the OCD neural network by conventional treatment,” is to study how conventional interventions for severe OCD – intensive exposure and response prevention (ERP) therapy and standard of care medication management – affect the putative OCDnet to further our understanding of how commonly available, efficacious treatments for OCD impact neural circuits involved in avoidance and aversive uncertainty. To achieve this goal, P4 will identify abnormalities in the vlPFC, rACC, insula, dACC, OFC and rostral striatum that track with performance on the PAAT and clinical symptom reports in individuals with OCD as they receive intensive treatment and undergo changes in illness burden over time. The project will follow 95 individuals with OCD using intensive longitudinal assessment of brain and behavior over the typical ~8wk treatment course. P4 will build on our group’s operational experience performing serial MRI (functional and structural) and detailed serial clinical assessments in OCD, and our toolkit for intensive longitudinal assessment, currently deployed in other NIMH-funded data collection efforts and developed with members of Core C, to identify changes in the OCDnet, persistent avoidance (as measured on PAAT and with exploratory device-based measures), and clinical changes in OCD. Three sets of comprehensive study visits (before, during, and after treatment) with MRI and clinical assessments will provide illness trajectory information for probing relationships between changing constructs at a coarse timescale, complemented by low-burden, digital phenotyping to capture variation at intermediate and finer time scales. Elucidating the ways in which the putative OCDnet changes in relation to changes in clinical and therapeutic parameters will provide targets for new interventions for OCD and help understand how and in which individuals currently available treatments achieve their optimal therapeutic benefit.

项目摘要/摘要麦克莱恩医院项目4 拟议项目的主要目标，名为“传统的OCD神经网络调节治疗方法是研究如何进行严重强迫症的常规干预措施 - 密集暴露和反应预防（ERP）疗法和护理药物管理标准 - 影响推定的OCDNET进一步我们对OCD的常见，有效的治疗方式的理解回避和厌恶不确定性。为了实现这一目标，P4将确定VLPFC，RACC的异常 Insula，DACC，OFC和Rostral Striatum在PAAT和临床符号报告上进行性能跟踪在强迫症患者接受强化治疗并随着时间的推移而发生疾病的变化。该项目将使用大脑和行为的密集纵向评估进行95个强迫症患者在典型的〜8WK治疗课程上。 P4将基于我们小组的运营经验表演串行 MRI（功能性和结构性）和OCD中的详细串行临床评估，以及我们的工具包纵向评估，目前部署在其他NIMH资助的数据收集工作中，并与 Core C的成员，确定OCDNET的变化，持续避免（如Paat和With 基于探索性设备的措施）和强迫症的临床变化。三组全面的学习访问（在治疗之前，期间和治疗后）进行MRI和临床评估将提供疾病轨迹信息为了探测在粗糙的时间尺度上的变化构造之间的关系，由Low-Burden完成，数字表型以捕获中间和更细的时间尺度上的变化。阐明推定的OCDNET与临床和治疗参数变化有关的变化将为目标提供目标针对强迫症的新干预措施，并帮助了解个人当前如何以及在哪些人中可用的治疗方法获得最佳的治疗益处。