Neurostimulation Enhanced Cognitive Restructuring for Transdiagnostic Emotional Dysregulation: A Component Analysis

神经刺激增强跨诊断情绪失调的认知重构：成分分析

基本信息

批准号：
10583921
负责人：
Andrada Delia Neacsiu
金额：
$ 79.4万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-01 至 2027-10-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10583921
关键词：
Address Adult Affective Alcohol consumption Amygdaloid structure Anorexia Anxiety Disorders Area Arousal Autobiography Behavior Therapy Behavioral Biological Markers Bipolar I Brain Brain imaging Clinical Cognitive Cognitive Therapy Combined Modality Therapy Communities Control Groups DSM-V Depressed mood Development Diagnostic Disease Distress Down-Regulation Emotional Emotions Equilibrium Exclusion Exhibits Frequencies Functional Magnetic Resonance Imaging Functional disorder Goals Grant Instruction Insula of Reil Integrative Therapy Intervention Interview Knowledge Learning Left Literature Maintenance Major Depressive Disorder Measurement Measures Medial Mediating Memory Modeling Monitor Mood Disorders Neurobiology Neuronavigation Neurophysiology - biologic function Outcome Participant Pathway interactions Patient Self-Report Patients Physiological Prefrontal Cortex Process Psychiatric therapeutic procedure Psychopathology Psychophysiology Psychotherapy Psychotic Disorders Public Health Randomized Recovery Regulation Reporting Research Sampling Scanning Stress Structure Testing Time Training Translating Visit Work affective neuroscience anxious biobehavior burden of illness clinical diagnostics clinical practice clinically significant cognitive enhancement cognitive neuroscience electric field emotion dysregulation emotion regulation emotional functioning expectation flexibility follow-up functional gain heart rate variability imaging study improved indexing individual variation insight neural neural network neurobehavioral neurophysiology neuroregulation noninvasive brain stimulation novel novel strategies novel therapeutic intervention placebo controlled trial psychoeducation psychoeducational remediation repetitive transcranial magnetic stimulation response biomarker sex skills stress disorder stressor substance use success therapy duration tool

项目摘要

Emotional dysregulation constitutes a serious public health problem and novel approaches are needed to effectively address it transdiagnostically. Despite rapid advancements in affective and cognitive neuroscience, there have been few attempts to translate basic findings into novel interventions. In addition, the relevance of different nodes in the emotion regulation network to psychopathology and to successful reduction of emotional arousal is not yet fully understood. Noninvasive neurostimulation, such as repetitive transcranial magnetic stimulation (rTMS), is a powerful tool with which dysfunction can be alleviated temporarily, by modulating neural activation. Therefore, the objective of the current study is to examine immediate neural and behavioral changes following neuromodulation enhanced emotion regulation training for transdiagnostic adults who report difficulties calming down when upset. The central hypothesis is that neurostimulation enhances the acquisition of emotion regulation skills and leads to remediated neural function in the emotion regulation network. Our long-term goal is to develop novel interventions that harness neuroscientific findings to advance behavioral treatments. The primary aim of this project is to evaluate the unique neural and behavioral effects of a one-session training combining cognitive restructuring (CR), an emotion regulation skill, with excitatory rTMS over the dorsolateral prefrontal cortex (dlPFC). The secondary aim is to identify key changes in the emotion regulation neural network following the combined intervention versus each of the components alone. The third aim is to explore personalized biomarkers for response to emotion regulation training. To achieve these aims, 240 rTMS naïve, community adults who meet criteria for affective or stress DSM-5 disorders (excluding if co-occurring anorexia, alcohol and substance use, bipolar I, or psychotic disorders) and who self-report high emotional dysregulation and low use of CR will participate in brain imaging while undergoing an emotional regulation task. Participants will be randomly assigned to CR training (groups 1 & 2) or to psychoeducation about emotions (group 3; aimed to control for nonspecific factors). Participants will be reminded of recent stressors and will undergo real (groups 1 & 3) or sham (group 2) high frequency rTMS, targeted using fMRI results. Participants who learned CR will practice this skill during rTMS in a one-time session, and physiological arousal will be monitored throughout the emotion induction and regulation practice. Following this training, participants will undergo another functional scan and an exit interview to assess for immediate neural and behavioral changes. Bio- behavioral measures of emotion regulation will be assessed at a one week and a one month follow up visit. If successful, our line of research will provide key mechanistic information to develop a novel transdiagnostic treatment for affective and stress disorders.

情绪失调构成了一个严重的公共卫生问题，需要新的方法来解决尽管情感和认知神经科学取得了快速进展，此外，几乎没有尝试将基本发现转化为新的干预措施。情绪调节网络中的不同节点对精神病理学和成功减少情绪的影响唤醒尚未完全了解，例如重复经颅磁刺激。刺激（rTMS）是一种强大的工具，可以通过调节来暂时缓解功能障碍因此，当前研究的目的是检查即时神经和行为。对报告的跨诊断成人进行神经调节增强情绪调节训练后的变化心烦意乱时很难平静下来。核心假设是神经刺激可以增强情绪。获得情绪调节技能并导致情绪调节中的神经功能得到修复我们的长期目标是开发利用神经科学研究结果来推进的新颖干预措施。行为治疗。该项目的主要目的是评估单次训练的独特神经和行为效果将认知重建 (CR)（一种情绪调节技能）与背外侧的兴奋性 rTMS 相结合前额皮质（dlPFC）的第二个目的是识别情绪调节神经的关键变化。联合干预与单独干预后的网络的第三个目标是探索。用于响应情绪调节训练的个性化生物标志物为了实现这些目标，240 rTMS naïve，符合 DSM-5 情感或压力障碍标准的社区成年人（不包括同时发生的厌食症、酒精和药物滥用、躁郁症 I 或精神障碍）以及自我报告高度情绪失调的人 CR使用率较低的参与者将在进行情绪调节任务时参与大脑成像。将被随机分配到 CR 培训（第 1 组和第 2 组）或关于情绪的心理教育（第 3 组；旨在来控制非特定因素）。参与者将被提醒最近的压力源，并将经历真实的压力。（第 1 组和第 3 组）或假手术（第 2 组）高频 rTMS，使用功能磁共振成像结果进行定位。 CR 将在 rTMS 期间一次性练习这项技能，并且将监测生理唤醒培训结束后，学员将接受整个情绪诱导和调节练习。另一项功能扫描和离职面谈，以评估即时的神经和行为变化。情绪调节的行为测量将在一周和一个月的随访中进行评估。如果成功的话，我们的研究方向将为开发一种新型的跨诊断方法提供关键的机制信息情感和压力障碍的治疗。