Neuroimaging of Children at Risk for Biopolar Disorder

描述(由申请人提供)：这项计划的长期目标 以患者为导向的导师研究职业发展奖(K23)是 培养应聘者以病人为中心的临床研究技能，以便他可以 成为儿童心理健康领域的独立研究员。Dr。 张的具体目标是熟练掌握儿科情绪障碍 研究，特别是在利用大脑成像技术方面的研究 阐明与儿童临床表现相关的神经生物学数据 以及患有躁郁症(BD)的青少年。为了实现这一目标， 应聘者将接受儿童时期神经成像领域专家的指导 和成人BD，以及统计和研究设计。此外，候选人还 将参加他所在部门的教育活动以及正式的 认知神经科学、脑成像和 统计数据。最后，候选人将密切开展一项研究项目。 与他的研究训练计划保持一致。拟议研究的目标是 该项目是收集纵向现象学和脑成像数据 患有BD的父母的儿童和青少年后代，他们患BD的风险很高 发展成双相情感障碍。这些高危儿童，其中一些已经患有BD，以及 大脑将在三年内对健康对照进行纵向评估 功能磁共振成像(FMRI)和质子磁共振 波谱(MRS)。功能磁共振成像任务将与情绪和注意力相关，以及 质子磁共振波谱具有双侧背外侧前额叶皮质(DLPFC)， 具体评估N-乙酰天冬氨酸/肌酐(NAA/Cr)的比率。 现象学将通过结构化的诊断性访谈进行评估， 临床医生评定的量表和患者评定的问卷。我们假设 (1)已经患有BD的高危子女将有不同的领域 与健康对照组相比，主要是DLPFC和DLPFC 前扣带回皮质(ACC)，(2)患有BD的高危后代将有较低的 双侧DLPFC的NAA/Cr比值与健康对照组相比，以及(3)高危人群 在这项研究过程中患上BD的后代将表现出更大的 DLPFC、NAA/Cr较正常对照组和脑组织模式降低 激活与那些已经患有BD的受试者相似，无论是在基线还是在 三年随访。通过开展这项研究项目和 实施科研培训计划，张博士计划成为一名 儿科BD领域的独立调查员，从而为 目前对BD的神经生物学和发展的认识。

DESCRIPTION (provided by the applicant): The long-term objective of this Mentored Patient-Oriented Research Career Development (K23) Award is to develop the candidate's skills in patient-oriented clinical research so that he may become an independent researcher in the field of child mental health. Dr. Chang's specific goal is to gain proficiency in pediatric mood disorders research, specifically in the area of utilizing brain imaging techniques to elucidate neurobiological data correlated to clinical presentations of children and adolescents with bipolar disorder (BD). To accomplish this goal, the candidate will be mentored by experts in the field of neuroimaging, childhood and adult BD, and statistics and research design. The candidate furthermore will participate in educational activities in his department as well as formal coursework in the areas of cognitive neuroscience, brain imaging, and statistics. Finally, the candidate will carry out a research project closely aligned with his research training plan. The goal of the proposed research project is to gather longitudinal phenomenological and brain imaging data on child and adolescent offspring of parents with BD, who are at high risk for developing bipolar disorder. These at-risk children, some already with BD, and healthy controls will be assessed longitudinally over three years by brain functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy (MRS). fMRI tasks will be related to emotion and attention, and proton MRS will be of bilateral dorsolateral prefrontal cortices (DLPFC), specifically assessing n-acetyl aspartate/creatinine (NAA/Cr) ratios. Phenomenology will be assessed through structured diagnostic interviews, clinician-rated scales, and patient-rated questionnaires. We hypothesize that (1) at-risk offspring already with BD at baseline will have differing areas of activation and deactivation than healthy controls, primarily in DLPFC and anterior cingulate cortex (ACC), (2) at-risk offspring with BD will have lower NAA/Cr ratios in bilateral DLPFC compared to healthy controls, and (3) at-risk offspring who develop BD in the course of this study will demonstrate a greater decrease in DLPFC NAA/Cr from baseline than controls and patterns of brain activation similar to those subjects already with BD, either at baseline or at three-year follow-up. Through conducting this research project and implementation of the research training plan, Dr. Chang plans to become an independent investigator in the field of pediatric BD and thus contributing to the current knowledge of the neurobiology and development of BD.