Mid-Career Mentorship and Research in Imaging-Related Patient-Oriented Research

影像相关的以患者为导向的研究中的职业中期指导和研究

• 批准号: 10219796
• 负责人: DANIEL P DICKSTEIN
• 金额: $ 18.67万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10219796
• 关键词: 16 year old; Address; Adolescent; Adult; Affective; Age; Aggressive behavior; Amygdaloid structure; Area; Attention deficit hyperactivity disorder; Award; Behavior; Behavioral; Behavioral Mechanisms; Bipolar Disorder; Brain; Brain imaging; Categories; Child; Childhood; Chronic; Clinical; Cognitive; Congresses; Corpus striatum structure; Data; Data Analyses; Development; Diagnosis; Diagnostic; Diagnostic and Statistical Manual of Mental Disorders; Diffusion; Diffusion Magnetic Resonance Imaging; Dimensions; Disease; Doctor of Medicine; Doctor of Philosophy; Education; Educational Curriculum; Educational workshop; Enrollment; Euphoria; Evaluation; Event; Frequencies; Frustration; Functional Magnetic Resonance Imaging; Functional disorder; Gaussian model; Generalized Anxiety Disorder; Glean; Goals; Image; Imaging Techniques; Impaired cognition; Impairment; Knowledge; Learning; Link; Manic; Mediating; Medical Psychology; Mental Health; Mental disorders; Mentors; Mentorship; Methods; Mid-Career Clinical Scientist Award (K24); Midcareer Investigator Award in Patient-Oriented Research; Modeling; National Institute of Mental Health; Neurosciences; Oppositional Defiant Disorder; Outpatients; Parents; Participant; Patient imaging; Patients; Phenotype; Physicians; Prefrontal Cortex; Psychiatric therapeutic procedure; Psychiatrist; Psychiatry; Psychologist; Psychopathology; Punishment; Research; Research Domain Criteria; Research Methodology; Research Personnel; Rest; Reversal Learning; Rewards; Sampling; Scanning; Scientist; Severities; Stimulus; Strategic Planning; Suicide; Symptoms; Techniques; Teenagers; Testing; Time; Training; Veins; Visit; Work; affective neuroscience; associated symptom; base; brain behavior; career; career development; clinical care; common symptom; early-career faculty; flexibility; functional MRI scan; gray matter; hypomania; imaging modality; imaging program; innovation; meetings; neuropsychiatry; next generation; novel; novel diagnostics; novel strategies; patient oriented research; peer; precision medicine; programs; response; severe mood dysregulation; single episode major depressive disorder; skills; social; spectrograph; symptom cluster; temporal measurement; white matter

PROJECT SUMMARY/ABSTRACT: BACKGROUND: NIMH-sponsored meetings (2014) and the 1st and 2nd Congresses on Pediatric Irritability (Sept 2015 and 2017) highlighted the critical need for greater understanding of the brain/behavior mechanisms underlying irritability in children— particularly in trans-diagnostic samples of children drawn across the range of irritability, rather than a single DSM disorder. The reason is that irritability and resultant aggression are the most common symptoms for which parents seek psychiatric care for their children (>40% of ED cases, >20% of psychiatric outpatient visits). Childhood irritability is a significant predictor of impairment in adulthood, including psychopathology, suicide, and decreased financial attainment. The career development objectives of this K24 Midcareer Investigator Award in Patient-Oriented Research (POR) are to gain expertise in (1) computational psychiatry techniques including modeling of functional magnetic resonance imaging (fMRI) data; (2) white matter connectivity via diffusion tensor imaging (DTI) and diffusion spectral imaging (DSI), and (3) mentorship in education. The research objectives of this K24 Award are: (1) identify PFC-amygdala-striatal circuit-based clusters of irritability using computational psychiatry modeling of event-related reversal learning fMRI, resting-state fMRI, and diffusion white matter connectivity data, and (2) to develop, pilot, and test a novel tiered mentorship program for imaging-related POR for medical and psychology trainees and early career faculty. My central hypothesis is that all irritability does not result from a single mechanism; rather unique symptom clusters of irritability result from specific PFC-amygdala-striatal circuit alterations mediating cognitive flexibility. The rationale for this K24 proposal is that, at this critical juncture in my career, it will allow me to acquire new imaging and mentorship skills, passing them on to the next generation of clinician/scientists. Research Method: I will test this hypothesis by enrolling a trans-diagnostic sample of n=72 adolescents ages 13-16 years drawn across the range of irritability, while using extant data from children with bipolar disorder and typically-developing controls to initially learn computational psychiatry modeling and DTI analysis methods from my mentors. This K24 is innovative because it will tackle the NIMH-high priority area with cutting-edge imaging techniques, including multi-band fMRI scanning for better temporal resolution of fMRI data, computational psychiatry modeling for better inference/interpretation of these data, and multi-band DTI/DSI scanning that can address prior concerns of difficulty resolving crossing white matter tracts and long scan times. This K24 is significant because it will address the NIMH high-priority area of research on pediatric irritability (NIMH Strategic Plan 1.1 and 1.3), while my plan for mentorship and innovative curricular sharing will help fuel the next generation of clinician/scientists using imaging-related POR to help their patients suffering from neuropsychiatric illness—at Brown and beyond—and for some, engaging themselves in imaging POR.

项目摘要/摘要： 背景：NIMH主办的会议(2014)和关于儿科易怒问题的第一和第二届大会 (2015年9月和2017年9月)强调了更好地了解大脑/行为机制的迫切需要 儿童潜在的易怒-特别是在跨诊断的儿童样本中 易怒，而不是单一的DSM障碍。原因是易怒和随之而来的攻击性是 父母为子女寻求精神治疗的最常见症状(40%的ED病例，20%的ED病例 精神科门诊就诊次数)。童年易怒是成年后受损的一个重要预测因素， 包括精神病、自杀和经济成就下降。职业发展目标 K24以患者为中心的研究(POR)职业中期研究人员奖的目的是获得(1)方面的专业知识 计算精神病学技术，包括功能磁共振成像(FMRI)数据的建模； (2)通过扩散张量成像(DTI)和扩散光谱成像(DSI)实现的白质连通性；以及(3) 教育方面的导师制。本次K24奖的研究目标是：(1)识别PFC-杏仁核-纹状体 使用事件相关反转学习的计算精神病学模型的易怒的基于电路的集群 FMRI、静息状态fMRI和扩散白质连接数据，以及(2)开发、试验和测试一种新的 为医学和心理学实习生和早期职业生涯提供与成像相关的POR的分级指导计划 教职员工。我的中心假设是，所有的易怒都不是由一种单一的机制产生的；而是独一无二的 应激性症状群源于特定的PFC-杏仁核-纹状体环路改变，介导认知 灵活性。这项K24提案的理由是，在我职业生涯的这个关键时刻，它将使我能够 获得新的成像和指导技能，并将其传递给下一代临床医生/科学家。 研究方法：我将通过登记72名青少年的跨诊断样本来检验这一假设 13-16岁的易怒范围，同时使用双相情感障碍儿童的现有数据 通常-开发控件以初步学习计算精神病学建模和DTI分析方法 从我的导师那里。这款K24是创新的，因为它将以尖端技术解决NIMH高优先级领域 成像技术，包括多波段fMRI扫描，以获得更好的fMRI数据的时间分辨率， 计算精神病学建模，以更好地推断/解释这些数据，以及多频段DTI/DSI 扫描可以解决先前担心的难以解决跨越白质束和长扫描的问题 泰晤士报。K24具有重要意义，因为它将解决NIMH高度优先的儿科研究领域 易怒(NIMH战略计划1.1和1.3)，而我的导师和创新课程分享计划将 帮助推动下一代临床医生/科学家使用与成像相关的POR来帮助他们的患者 从神经精神疾病-在布朗和其他地方-对一些人来说，投身于POR成像。