Anxiety in Parkinson's: Use of quantitative methods to guide rational treatment

帕金森病的焦虑：利用定量方法指导合理治疗

• 批准号: 9037568
• 负责人: Gregory Michael Pontone
• 金额: $ 20.41万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9037568
• 关键词: Accounting; Address; Affect; Aging; Anxiety; Anxiety Disorders; Basic Science; Classification; Clinical; Clinical Management; Clinical Research; Clinical Sciences; Clinical Treatment; Clinical Trials; Comorbidity; Complement; Cross-Sectional Studies; Data; Development; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Disabled Persons; Disease; Dopamine; Dopamine Agonists; Drug Controls; Elderly; Evidence based treatment; Expert Opinion; Faculty; Fellowship; Functional disorder; Funding; Goals; Health; Health Sciences; High Prevalence; Idiopathic Parkinson Disease; Individual; Institutes; Interruption; Intervention; Intervention Studies; Investigation; Knowledge; Learning; Medical; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Motor; Movement Disorders; Nerve Degeneration; Neurodegenerative Disorders; Observational Study; Parkinson Disease; Pathologic Processes; Patients; Pattern; Pharmaceutical Preparations; Physically Handicapped; Placebos; Population; Process; Psychiatrist; Public Health Schools; Quality of life; Randomized; Randomized Controlled Trials; Reaction; Research; Research Infrastructure; Research Personnel; Research Project Grants; Research Training; Resources; Services; Statistical Methods; Syndrome; System; Testing; Training; Training Programs; Translating; Translational Research; Work; anxiety reduction; anxiety symptoms; anxiety treatment; anxious; base; career; career development; clinical investigation; clinical practice; clinically significant; comorbid depression; design; disability; evidence base; fall risk; health related quality of life; improved; meetings; motor symptom; neuropsychiatry; neurotransmission; non-motor symptom; phenomenological models; pramipexol; programs; research and development; research clinical testing; skills; therapy design; treatment of anxiety disorders; treatment response

DESCRIPTION (provided by applicant): The candidate is a geriatric psychiatrist with fellowship training in the clinical evaluation and treatment of movement disorders. He plans to use this unique training to develop a career in clinical research investigating the neuropsychiatric aspects of Parkinson's disease (PD) and other diseases of aging. To accomplish this goal, he has developed a comprehensive research and training program in which he will learn to use quantitative statistical methods and clinical trial methodologies to better characterize and treat anxiety syndromes in PD. The career development and research plan will benefit from the infrastructure provided by: 1) The Johns Hopkins Institute for Clinical and Translational Research, which offers a variety of programs and services to facilitate the research projects of faculty investigators, 2) the Bloomberg School of Public Health at Johns Hopkins provides access to formal coursework and seminars relevant to the proposed project, and 3) the Morris K. Udall Parkinson's Disease Research Center (PDRC) at Johns Hopkins. The PDRC provides resources for recruitment, assessment, specialized testing, and other aspects of clinical and basic science research involving patients with PD. Anxiety disturbances are common in patients with PD. They affect up to 40% of patients and adversely affect physical disability and quality of life. Despite this, there is only limited information on the clinical characterization and pathophysiology and there have been no randomized controlled trials of pharmacologic treatment. The principal scientific objective for this K23 award is to gain an understanding of the clinical phenomenology of anxiety syndromes in PD and use that knowledge to better target and test pharmacologic treatments. The proposed work will provide further clinical characterization of anxiety syndromes in PD patients with respect to their association with the on- and off- motor state, comorbid psychiatric, and other non-motor features of PD, and treatment response. This proposal will attempt to identify empirically valid subtypes of anxiety associated with PD-specific features using latent class analysis. To translate findings from these investigations into clinical interventions, the second aim is to conduct an 8-week intervention study for anxiety in PD comparing pramipexole, an evidence-based treatment for motor symptoms and motor fluctuations to placebo. The pilot intervention will provide data and experiential training that, when combined with formal coursework and mentorship, will help develop the skills needed to design and conduct an R01 funded clinical trial and begin an independent career as an interventions researcher.

描述（由申请人提供）：候选人是一位老年精神科医生，接受过运动障碍临床评估和治疗方面的进修培训。他计划利用这种独特的培训来发展临床研究事业，研究帕金森病 (PD) 和其他衰老疾病的神经精神方面。为了实现这一目标，他制定了一项全面的研究和培训计划，其中他将学习使用定量统计方法和临床试验方法来更好地表征和治疗帕金森病焦虑综合征。职业发展和研究计划将受益于以下机构提供的基础设施：1) 约翰·霍普金斯大学临床和转化研究所，该研究所提供各种计划和服务以促进教师研究人员的研究项目，2) 布隆伯格公立学院约翰·霍普金斯大学健康中心提供与拟议项目相关的正式课程和研讨会，以及 3) 约翰·霍普金斯大学的 Morris K. Udall 帕金森病研究中心 (PDRC)。 PDRC 为涉及 PD 患者的招募、评估、专业测试以及临床和基础科学研究的其他方面提供资源。 焦虑障碍在帕金森病患者中很常见。它们影响高达 40% 的患者，并对身体残疾和生活质量产生不利影响。尽管如此，有关临床特征和病理生理学的信息有限，并且还没有药物治疗的随机对照试验。该 K23 奖项的主要科学目标是了解 PD 焦虑综合征的临床现象学，并利用这些知识更好地确定和测试药物治疗。拟议的工作将提供帕金森病患者焦虑综合征的进一步临床特征，包括其与运动状态和非运动状态、共病精神和帕金森病的其他非运动特征以及治疗反应的关系。 该提案将尝试使用潜在类别分析来识别与 PD 特定特征相关的经验有效的焦虑亚型。为了将这些调查结果转化为临床干预措施，第二个目标是进行一项为期 8 周的 PD 焦虑干预研究，比较普拉克索（一种治疗运动症状和运动波动的循证治疗药物）与安慰剂。试点干预将提供数据和体验式培训，与正式课程和指导相结合，将有助于培养设计和进行 R01 资助的临床试验所需的技能，并开始作为干预研究人员的独立职业生涯。