Neuromodulation for Enhancement of Emotion Regulation in Bipolar Mood Disorders

神经调节增强双相情感障碍的情绪调节

基本信息

批准号：
10617725
负责人：
Kristen K Ellard
金额：
$ 19.93万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10617725
关键词：
Address Anatomy Anterior Aversive Stimulus Behavioral Bipolar Disorder Brain Chronic Clinical Cognitive Therapy Computer Assisted Computer Systems Data Development Distress Dorsal Dose Electromagnetics Emotional Emotions Ensure Feeling suicidal Functional Magnetic Resonance Imaging Functional disorder Future Goals Health Care Costs Individual Inferior Insula of Reil Intervention Investigation Literature Magnetic Resonance Maintenance Mentors Mood Disorders Network-based Neuronavigation Neurosciences Outcome Parietal Lobe Participant Pathology Pathway Analysis Patients Pattern Performance Physiologic pulse Prefrontal Cortex Productivity Psychopathology Public Health Randomized Reaction Time Research Research Proposals Site Statistical Methods Synapses Techniques Technology Testing Training Transcranial magnetic stimulation Work behavioral response bipolar patients clinical translation cognitive reappraisal cohort efficacy testing emotion dysregulation emotion regulation executive function experience functional MRI scan improved individual patient innovation neural neural circuit neuroimaging neuroregulation pharmacologic precision medicine programs psychopharmacologic psychosocial recruit response specific biomarkers success suicidal behavior tool treatment strategy

项目摘要

PROJECT SUMMARY/ABSTRACT Individuals with bipolar mood disorders (BD) experience severe and episodic emotion dysregulation. Our existing pharmacological and psychosocial treatments fail to normalize emotion dysregulation for many bipolar patients. We need new and innovative approaches to help improve emotion dysregulation for these patients. The long-term goal of this proposal is to understand the pathophysiology of emotion dysregulation in BD, and to develop strategies to directly target and improve emotion regulation capacity. To this end, the candidate proposes: (1) training objectives to acquire expertise in advanced network-based analysis of neuroimaging data and training in the use of transcranial magnetic stimulation (TMS) as a translational clinical and research tool; (2) a research objective to identify patient-specific biomarkers of emotion dysregulation in BD and to experimentally engage these targets using TMS; (3) a team of mentors and advisors to ensure the candidate’s success, with expertise in bipolar disorder pathology and treatment (Dr. Andrew Nierenberg), advanced network analysis of neuroimaging data (Dr. Randy Buckner), clinical and research applications of TMS (Dr. Mark George and Dr. Joan Camprodon), neuromodulation of mood disorders (Dr. Darin Dougherty), emotion regulation (Dr. James Gross), task-based neuroimaging in BD (Dr. Thilo Deckersbach), and advanced statistical methods (Dr. Mark Vangel). The central hypothesis of the research proposal is that neuromodulation of patient-specific targets of emotion regulation-related neurocircuitry using TMS will enhance the capacity for emotion regulation in BD. The rationale for this proposal is that existing treatments don’t adequately address severe emotion dysregulation in BD, thus new innovative approaches are needed. This project has the potential to provide preliminary evidence for the future development of TMS as an innovative treatment strategy that can be used adjunctive to existing treatments to improve emotion regulation in BD. Specific aims proposed are: 1) to identify patient-specific pathophysiological markers of implicit and explicit emotion dysregulation in BD; 2) to determine the effect of TMS on emotion regulation circuit dynamics in BD; and 3) to determine the effect of TMS on emotion regulation behavioral responses in BD. The approach is innovative in that it uses a patient- specific, precision medicine approach with combined TMS-fMRI to target and probe emotion dysregulation at the level of neurocircuitry. The proposed research is significant, because it is has the potential to advance our understanding of the pathophysiology of emotion dysregulation in BD and will provide crucial pilot data towards testing the efficacy of TMS for improving emotion dysregulation in BD patients. Overall, the candidate will use this project and its associated training to transition and expand this work into an independent program of research developing neuroscience-informed interventions for bipolar mood disorders.

项目摘要/摘要患有双极情绪障碍（BD）的个体患有严重的情绪失调。我们的现有的药物和社会心理治疗无法使许多双极的情绪失调正常患者。我们需要新的创新方法来帮助改善这些患者的情绪失调。该建议的长期目标是了解BD中情绪失调的病理生理学，以及制定直接针对和改善情绪调节能力的策略。为此，候选人建议：（1）培训目标，以获得基于高级网络的神经影像数据分析的专业知识以及使用经颅磁刺激（TMS）作为翻译的临床和研究工具的培训；（2）一个研究目标，旨在识别BD中情绪失调的患者特异性生物标志物使用TMS实验参与这些目标；（3）一组导师和顾问，以确保候选人的成功，具有双相情感障碍病理学和治疗方面的专业知识（Andrew Nierenberg博士），高级神经影像数据的网络分析（Randy Buckner博士），TMS的临床和研究应用（博士 Mark George和Joan Camprodon博士），《情绪障碍的神经调节》（Darin Dougherty博士），情感监管（James Gross博士），BD中基于任务的神经影像学（Thilo Deckersbach博士）和高级统计方法（Mark Vangel博士）。研究建议的中心假设是神经调节使用TMS的患者特定于情绪调节的神经通路的目标将增强能力 BD中的情绪调节。该提议的理由是现有治疗方法无法充分解决 BD中严重的情绪失调，因此需要新的创新方法。这个项目有潜力为TM的未来发展提供初步证据，作为一种创新的治疗策略可用于现有治疗的辅助手段，以改善BD中的情绪调节。提出的具体目的是： 1）确定BD中隐式和明确情绪失调的患者特异性病理生理标记； 2）确定TMS对BD中情绪调节电路动力学的影响； 3）确定效果 TMS在情绪调节BD中的行为反应。这种方法是创新的，因为它使用患者 - 具有TMS-FMRI的具体精密医学方法，以靶向和探测情绪失调神经循环的水平。拟议的研究很重要，因为它有可能促进我们的了解BD中情绪失调的病理生理学，并将提供关键的飞行员数据旨在测试TMS改善BD患者情绪失调的效率。总体而言，候选人将使用该项目及其相关的培训将这项工作转变为独立计划开发针对双相情绪障碍的神经科学知识干预措施的研究。