The AURORA Study: a longitudinal, multimodal library of brain biology and function after traumatic stress exposure
The AURORA Study: a longitudinal, multimodal library of brain biology and function after traumatic stress exposure
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DOI：
10.1038/s41380-019-0581-3
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发表时间：
2020-02-01
影响因子：
11
通讯作者：
Kessler, Ronald
中科院分区：
文献类型：
--
作者：
McLean, Samuel A.;Ressler, Kerry;Kessler, Ronald
不利的创伤后神经精神后遗症(APN)在平民创伤幸存者和退伍军人中很常见。按照传统分类，这些APN包括创伤后应激、脑震荡后综合征、抑郁症和局部或广泛性疼痛。传统的分类已经阻碍了科学进步，因为它们人为地将APN分割成孤立的、与大脑功能的离散组成部分无关的综合征诊断，并进行孤立的研究。分类和本体论上的这些限制减缓了对病理生理机制、生物行为标记物、风险预测工具和预防/治疗干预措施的发现。克服这些限制的进展一直具有挑战性，因为这种进展将需要进行研究，既要评估广泛的创伤后后遗症(以克服碎片化)，又要进行深入的生物行为评估(以索引后遗症的大脑功能领域)。本文综述了提高对创伤后恢复(Aurora)研究的认识方法。Aurora使用最先进的自我报告、神经认知、生理、数字表型、心理物理、神经成像和基因组评估，从创伤早期开始，持续一年，对APNS的发展进行大规模(n=5000个目标样本)深入评估。Aurora的目标是实现改进的表型、预测工具和对分子机制的理解，以便为预防和治疗干预措施的未来开发和测试提供信息。
Adverse posttraumatic neuropsychiatric sequelae (APNS) are common among civilian trauma survivors and military veterans. These APNS, as traditionally classified, include posttraumatic stress, postconcussion syndrome, depression, and regional or widespread pain. Traditional classifications have come to hamper scientific progress because they artificially fragment APNS into siloed, syndromic diagnoses unmoored to discrete components of brain functioning and studied in isolation. These limitations in classification and ontology slow the discovery of pathophysiologic mechanisms, biobehavioral markers, risk prediction tools, and preventive/treatment interventions. Progress in overcoming these limitations has been challenging because such progress would require studies that both evaluate a broad spectrum of posttraumatic sequelae (to overcome fragmentation) and also perform in-depth biobehavioral evaluation (to index sequelae to domains of brain function). This article summarizes the methods of the Advancing Understanding of RecOvery afteR traumA (AURORA) Study. AURORA conducts a large-scale (n = 5000 target sample) in-depth assessment of APNS development using a state-of-the-art battery of self-report, neurocognitive, physiologic, digital phenotyping, psychophysical, neuroimaging, and genomic assessments, beginning in the early aftermath of trauma and continuing for 1 year. The goals of AURORA are to achieve improved phenotypes, prediction tools, and understanding of molecular mechanisms to inform the future development and testing of preventive and treatment interventions.