fMRI Studies Of Pediatric Mood And Anxiety Disorders

儿科情绪和焦虑症的功能磁共振成像研究

• 批准号: 8158094
• 负责人: Daniel Pine
• 金额: $ 90.72万
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8158094
• 关键词: Address; Adolescent; Adult; Anxiety Disorders; Behavioral; Brain region; Childhood; Clinical; Data; Data Analyses; Data Set; Diagnosis; Disease; Exhibits; Functional Magnetic Resonance Imaging; Goals; Image; Major Depressive Disorder; Medial; Moods; Parahippocampal Gyrus; Phase; Prefrontal Cortex; Procedures; Process; Series; base; cingulate gyrus; improved

Through a series of three protocols, we are using functional magnetic resonance imaging (fMRI) to examine neurocognitive correlates of pediatric mood and anxiety disorders. Through ongoing collaborative studies, we also have increasingly compared findings in these syndromes with findings in adult anxiety disorders as well as findings in other pediatric mental disorders. Such work holds the potential to dramatically impact public health, for various reasons. Mood and anxiety disorder dramatically alter the well-being of children and adolescents. fMRI research is vital for generating new treatments. As such, this protocol holds the hope of generating such new treatments. Moreover, most adult mood and anxiety disorders also emerge from earlier disorders, manifest in childhood. Therefore, not only might this protocol dramatically alter the well-being of youth, but it also holds the hope of improving the lives of adults. Finally, we have increasingly incoroporated novel treatment approaches into the body of work implemented under this protocol. For example, based on our work demonstrated attention perturbations in anxious youth, we have developed novel computer-based methods for retraining attention in pediatric anxiety disorders. This provides a novel means to achieve clinical benefits. The central focus of the protocol is on individual differences in neural circuitry function, as they relate to individual differences in behavior. Thus, in the most important aspect of the protocols, we are attempting to document deficits in brain systems mediating reward-related processes, attention bias, and emotional memory in pediatric mood and anxiety disorders. Initial findings from this project actually document the occurence of many such deficits, providing some of the first evidence establishing neuroscientific correlates of pediatric mood and anxiety disorders. In subsequent work, we also replicated these findings, already demonstrating these individual differences in broad groups of disorders more than five times. In the past year, this pattern of generating consistent between-group differences has continued. One major question to emerge from these initial sets of findings concerns the degree to which these correlates represent distinct markers in specific forms of pediatric mental illnesses. Only after addressing these remaining questions on specificity will neuroscience work be able to inform attempts to improve methods for diagnosis and treatment in pediatric mental illnesses. Thus, a particularly important goal in coming years will be to contrast neurocognitive profiles among individual groups of pediatric mood and anxiety disorders. Prior neuropsychological studies in children as well as in adults note that mood and anxiety disorders are associated with deficits in attention modulation and emotional memory. We have found consistent evidence of such deficits in the current protocol. Moreover, prior imaging studies in healthy adults note that tasks requiring attention modulation or emotional memory engage cortico-limbic brain regions previously implicated in adult mood and anxiety disorders. These regions include the amygdala, ventro-medial prefrontal cortex, cingulate gyrus, and hippocampus. Once again, we also find such evidence in the current set of projects. As a result, we hypothesize that fMRI attention modulation and emotional memory paradigms will engage these cortico-limbic brain regions in both psychiatrically healthy and impaired subjects. We actually already have confirmed this hypothesis in broad groups of children. Each received neurocognitive examinations, and a subset received fMRI examinations. Each received standardized assessments of response to treatment. As part of our studies in healthy subjects, we also successfully developed each of the fMRI protocols that will be used in the current project. As noted above, many of our initial hypotheses have been confirmed, and our studies are now moving forward to examine issues of specificity and to consider how our findings might be used to inform advances in treatment. During the coming year, we will be continue the process of analyzing the extensive data emerging from the fMRI studies performed as part of this protocol; we also will continue to analyze data from behavioral studies in patient groups. Moreover, we also are in the early phases of implementing new treatments, based on our initial findings. As described above, these involve novel computer-based procedures, such as attention retraining. Finally, we are in the midst of acquiring data with new protocols. Based on the results of these analyses, we also plan to prepare a number of manuscripts. Beyond these ongoing behavioral and fMRI studies, our group is also involved in various collaborations that have led to analyses of other data sets and reporting of research findings. We have also developed a new treatment, based on our initial findings, that we have begun piloting as part of these projects.

通过一系列三个方案，我们使用功能磁共振成像（fMRI）来检查小儿情绪和焦虑症的神经认知相关性。 通过正在进行的协作研究，我们还越来越多地将这些综合征的发现与成人焦虑症的发现以及其他儿科障碍的发现。 由于各种原因，此类工作有可能极大地影响公共卫生。 情绪和焦虑症极大地改变了儿童和青少年的幸福感。 fMRI研究对于产生新治疗至关重要。 因此，该协议希望产生这种新的治疗方法。 此外，大多数成人情绪和焦虑症也从早期的疾病中出现，在童年时期也表现出来。 因此，该协议不仅可以极大地改变青年的福祉，而且还希望改善成年人的生活。 最后，我们越来越涉及到根据该协议实施的工作体系的新型治疗方法。 例如，基于我们的工作表明了焦虑青年的注意力扰动，我们开发了基于计算机的新方法来培训小儿焦虑症中的注意力。 这为获得临床益处提供了一种新颖的手段。 该方案的主要重点是与行为的个体差异相关的神经回路功能的个体差异。 因此，在协议的最重要方面，我们试图记录大脑系统中的缺陷，以调解与奖励相关的过程，注意力偏见和小儿情绪和焦虑症中的情绪记忆。 该项目的初步发现实际上记录了许多此类缺陷的情况，提供了一些第一个证据，以建立小儿情绪和焦虑症的神经科学相关性。 在随后的工作中，我们还复制了这些发现，已经证明了在广泛的疾病中的这些个体差异超过五次。 在过去的一年中，这种产生一致的组间差异的模式仍在继续。 从这些最初的发现中出现的一个主要问题涉及这些相关性的程度代表特定形式的小儿精神疾病的不同标记。 只有在解决了有关特异性的剩余问题之后，神经科学工作才能为改善小儿精神疾病的诊断和治疗方法的尝试提供信息。 因此，未来几年的一个特别重要的目标是对比儿科情绪和焦虑症组之间的神经认知概况。 先前在儿童以及成年人中的神经心理学研究指出，情绪和焦虑症与注意调节和情绪记忆的缺陷有关。 我们发现了当前协议中此类缺陷的一致证据。 此外，健康成年人的先前成像研究指出，需要注意调节或情绪记忆的任务与以前涉及成人情绪和焦虑症有关的皮质膜大脑区域。 这些区域包括杏仁核，腹膜前额叶皮层，扣带回和海马。 再次，我们还在当前项目集中找到了此类证据。 结果，我们假设fMRI注意力调节和情绪记忆范例将使这些皮质膜膜大脑区域与精神上健康和受损的受试者相关。 实际上，我们已经在一群儿童中证实了这一假设。 每个人都接受了神经认知检查，并接受了fMRI检查。 每个人都接受了对治疗反应的标准化评估。 作为在健康受试者研究的一部分，我们还成功地开发了当前项目中将使用的每种fMRI方案。 如上所述，我们的许多最初假设已得到证实，我们的研究现在正在进行研究以检查特异性问题，并考虑如何使用我们的发现来告知治疗的进展。 在来年，我们将继续分析从该协议的一部分进行的功能磁共振成像研究中出现的广泛数据；我们还将继续分析患者群体中行为研究的数据。 此外，根据我们的初步发现，我们也处于实施新疗法的早期阶段。 如上所述，这些涉及新颖的基于计算机的程序，例如注意力再培训。 最后，我们正处于使用新协议的数据中。 根据这些分析的结果，我们还计划准备许多手稿。 除了这些正在进行的行为和功能磁共振成像研究之外，我们的小组还参与了各种合作，这些合作导致了对其他数据集的分析和研究结果的报告。 根据我们的初步发现，我们还开发了一种新的处理方法，即我们已经开始驾驶这些项目的一部分。