Neuroimaging in child clinical populations: considerations for a successful research program.
Neuroimaging in child clinical populations: considerations for a successful research program.
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儿童临床人群的神经影像学：成功研究计划的考虑因素。
DOI：
10.1016/j.jaac.2012.09.008
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发表时间：
2012
影响因子：
13.3
通讯作者：
Perlman,SusanB
中科院分区：
文献类型：
--
作者：
Perlman,SusanB
随着越来越多的转化研究继续跨越科学研究的所有领域的传统学科的界限，儿童精神病学领域在理解儿童精神病理学的病因学和制定治疗策略的目标方面变得越来越合作。一个值得注意的日益增加的合作领域是在神经科学领域，磁共振成像（MRI）用于探测心理缺陷背后的神经结构或功能。仅在2011年，该杂志发表的121篇文章中有13篇（11%）使用MRI检查特定神经回路的损伤，相当于每月约一篇文章。相比之下，2006年仅发表了一篇神经影像学文章（1%）。可以设想，这一数字在今后几年中还会增加。这种最先进的技术的进展显示出发现特异于症状表现的生物标志物的潜力，这些生物标志物可以为治疗或药理干预的发展提供信息，或者可能识别那些有未来疾病成熟风险的人。举一个自闭症研究领域的例子，功能性磁共振成像有助于识别与眼神接触缺陷相关的神经回路功能障碍。1在自闭症患者的兄弟姐妹中也发现了类似的发现，这些患者有患自闭症的遗传风险。[2]越来越多的文献使研究人员得出结论，针对这种损伤的治疗干预可能会通过改变神经功能来改善社会行为。3神经科学和精神病学学科之间的协同作用对该领域大有裨益。然而，在儿科人群中成功的神经成像并非没有挑战。MRI对儿童来说是一个狭窄、孤立且经常令人生畏的环境，需要长时间保持不动通常会导致数据丢失。有人可能会说，80%的成功率，在儿科患者群体中被认为是非常成功的，表明最受损的儿童没有提供有用的数据。因此，数据收集的低成功率不仅会带来高昂的经济成本，而且可能会削弱科学发现的效应大小，或者无法发现仅在最严重的情况下可能存在缺陷的神经回路。下面的段落提出了简要的考虑，目的是为那些希望开始一个程序的发育神经影像学或提高成功率在他们目前的工作在儿科临床人群中成功的神经影像学描绘的策略。
As a growing body of translational research continues to cut across the boundaries of traditional disciplines in all domains of scientific study, the field of child psychiatry has become increasingly collaborative in its goal of understanding the etiology of child psychopathology and developing treatment strategies. One notable area of increasing collaboration is in the field of neuroscience, where magnetic resonance imaging (MRI) is used to probe the neural structure or function underlying psychological deficits. In 2011 alone, 13 of the 121 articles (11%) published in the Journal used MRI to examine the impairment of a specific neural circuitry, representing approximately one article per monthly issue. In comparison, just one neuroimaging article (1%) was published in 2006. One can assume that that number will increase in the years ahead. Advances in this state-of-the-art technology show potential for the discovery of biomarkers specific to symptom presentation, which can inform the development of therapeutic or pharmacologic interventions or, possibly, identify those at risk for the maturation of future disorders. Taking a single example from the field of autism research, functional MRI has helped to identify dysfunction in neural circuitry related to deficits in eye contact. 1 Similar findings have been uncovered in siblings of patients with autism who are at genetic risk for the disorder. 2 The sum of this growing body of literature has led researchers to conclude that therapeutic interventions, aimed at this impairment, might improve social behavior through altered neural functioning. 3The synergy between the neuroscientific and psychiatric disciplines is of great benefit to the field. However, successful neuroimaging in pediatric populations is not without its challenges. MRI is a constricting, isolating, and often intimidating environment for children and the need to remain motionless for an extended period often leads to data loss. One could argue that an 80% success rate, considered highly successful in a pediatric patient group, indicates that the most impaired children are not providing useful data. Thus, low success rates in data collection come not only at a high financial cost, but also may dilute the effect sizes in scientific findings or fail to uncover the neural circuitry that may be deficient in only the most severe cases. The following paragraphs present brief considerations aimed at delineating strategies for successful neuroimaging in pediatric clinical populations for those who wish to begin a program of developmental neuroimaging or to improve success rates in their current work.