Multimodal Profiling of Response to Pediatric Comprehensive Behavioral Intervention for Tics

儿科抽动综合行为干预反应的多模式分析

• 批准号: 10743782
• 负责人: Christine A Conelea
• 金额: $ 79.23万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-12 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10743782
• 关键词: Affect; Age; Behavior; Behavior Therapy; Behavioral; Brain; Child; Childhood; Chronic; Clinical; Clinical Trials; Clinical assessments; Code; Data; Decision Making; Electroencephalography; Elements; Functional Magnetic Resonance Imaging; Future; Gilles de la Tourette syndrome; Goals; Impairment; Improve Access; Impulsivity; Intervention; Knowledge; Link; Literature; Logistic Regressions; Measurement; Measures; Mental disorders; Methods; Modeling; Motor; Movement; Multi-Institutional Clinical Trial; Obsessive-Compulsive Disorder; Outcome; Outcome Measure; Outpatients; Patient-Focused Outcomes; Patients; Procedures; Process; Provider; Research; Rest; Sampling; Seminal; Severities; Signal Transduction; Symptoms; Therapeutic; Tic disorder; Work; Youth; associated symptom; behavior measurement; behavior observation; bench-to-bedside translation; biobehavior; clinical practice; design; efficacy trial; experience; follow up assessment; functional magnetic resonance imaging/electroencephalography; improved; indexing; individualized medicine; magnetic resonance imaging/electroencephalography; member; motor control; multidisciplinary; multimodality; neural; neuropsychiatric disorder; neuropsychiatric symptom; neuroregulation; novel; patient engagement; predicting response; predictive marker; predictive modeling; primary care setting; profiles in patients; prognostic indicator; psychosocial; repetitive behavior; research and development; response; skills; standard care; support network; therapeutic target; therapy development; tic suppression; treatment adherence; treatment planning; vocalization

PROJECT SUMMARY The overall objective of this proposal is to conduct the first mechanistic clinical trial of pediatric Comprehensive Behavioral Intervention for Tics (CBIT) to identify bio-behavioral predictors and correlates of response and the most potent aspects of CBIT delivery. Chronic tics affect 1-3% of youth in the US and are a disabling neuropsychiatric symptom associated with multiple childhood-onset mental disorders. CBIT is the current first-line, gold-standard treatment for tics and focuses on skills to enhance voluntary tic suppression and reduce tic triggers. However, about 50% of youth do not benefit from CBIT. The current study aims to use multimodal measurements to identify predictors of response (for whom does CBIT work?), the therapeutic processes that activate change (what are the potent aspects of CBIT delivery?), and correlates of response (what changes occur in patients whose tics improve?). Study hypotheses, based on the literature and our preliminary data, predict that CBIT relies upon, engages, and strengthens connectivity within and between functional brain networks that support top-down control over motor functions. Youth ages 10-17 years with chronic tics (N = 100) will complete a course of 8 outpatient, weekly sessions of CBIT and pre-, post-, and 3-month follow up assessments. Multimodal assessments will include: 1) neural measures of functional connectivity among the brain's large-scale functional networks using fMRI and EEG during rest and tic expression and suppression, 2) direct-observation behavioral measurement of tics, and 3) psychosocial measures, including assessments of clinical symptoms and patient-centered outcome measures informed by preliminary data and our Patient Advisory Board. CBIT process will be assessed via a novel video-based behavioral coding of CBIT sessions. This project has the potential to directly benefit patients both immediately and in the long-term. Results will have a downstream impact on clinical practice by informing individualized treatment planning and efforts to streamline and improve CBIT quality. Results will also have an upstream impact on treatment development by identifying novel neural targets for intervention and strategies for improving CBIT outcomes via refinement or adjunctive procedures.

项目摘要 该提案的总体目的是进行小儿综合的首次机械临床试验 抽动（CBIT）的行为干预，以识别生物行为预测因素和反应的相关性 CBIT交付的最有效方面。慢性抽动影响美国1-3％的青年，并且是残疾人 与多种儿童发作的精神障碍相关的神经精神症状。 CBIT是电流 一线，金色标准的抽动和专注于增强自愿抑制和的技能 减少抽动触发器。但是，约有50％的年轻人没有受益于CBIT。当前的研究旨在使用 多模式测量以识别响应的预测指标（CBIT为谁工作？），治疗性 激活变化的过程（CBIT交付的有效方面是什么？）和响应的相关性 （在抽动改善的患者中发生了什么变化？）。基于文献和我们的研究假设 初步数据，预测CBIT依赖，参与并加强了内部和之间的连通性 支持自上而下控制电机功能的功能性大脑网络。年轻10-17岁的青年 慢性抽搐（n = 100）将完成8个门诊病人，每周的CBIT和PER-PER-tof-tof-tof-e和 3个月的随访评估。多模式评估将包括：1）功能的神经测量 在休息和抽动期间，使用fMRI和EEG使用fMRI和EEG之间的大脑大规模功能网络之间的连通性 表达和抑制，2）抽动的直接观察行为测量，3）心理社会心理 措施，包括评估临床症状和以患者为中心的结果指标 初步数据和我们的患者顾问委员会。 CBIT过程将通过新颖的基于视频的新颖 CBIT会话的行为编码。该项目有可能立即直接使患者受益 从长远来看。结果将通过告知个性化，对临床实践产生下游影响 治疗计划以及简化和提高CBIT质量的努力。结果也将有上游 通过确定干预的新神经目标和策略来影响治疗开发 通过细化或辅助程序改善CBIT结果。