Treatments for Psychogenic Nonepileptic Seizures (NES)

心因性非癫痫性癫痫发作 (NES) 的治疗

• 批准号: 7255455
• 负责人: W CURT LAFRANCE
• 金额: $ 16.3万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7255455
• 关键词: Accident and Emergency department; Antiepileptic Agents; Anxiety; Applications Grants; Award; Behavior; Behavioral; Classification; Clinical; Clinical Trials; Comorbidity; Condition; Conscious; Convulsions; DSM-IV; Diagnosis; Diagnostic; Diagnostic tests; Disabled Persons; Disease; Dissociative disorder; Electroencephalography; Epilepsy; Evaluation; Exposure to; Fellowship; Frequencies; Functional disorder; Goals; Impulsivity; Individual; Intervention; Intervention Studies; Intubation; Invasive; Laboratories; Major Depressive Disorder; Measures; Mental Depression; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentorship; Minority; Modality; Monitor; Neurologic; Neurology; Numbers; Pathology; Patients; Personal Satisfaction; Pharmaceutical Preparations; Post-Traumatic Stress Disorders; Protocols documentation; Psychiatric Diagnosis; Psychiatry; Psychosocial Factor; Psychotherapy; Randomized; Randomized Controlled Trials; Research; Research Design; Research Project Grants; Resources; Risk Factors; Seizures; Serotonin; Sertraline; Severities; Societies; Sum; Symptoms; System; Techniques; Training; base; cost; depressive symptoms; design; experience; medical schools; neuropsychiatry; prognostic; programs; psychologic; psychopharmacologic; psychosocial; response; skills; treatment trial

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) that will enable Dr. LaFrance to continue to develop his programmatic line of research in the treatment of psychogenic nonepileptic seizures (NES). NES resemble epileptic seizures, but have no associated epileptiform activity with the behaviors. NES have no single cause and are associated with underlying psychological problems and co-morbid psychiatric diagnoses. Patients with NES are often difficult to manage, severely disabled and frequently encountered in neurology, psychiatry, and emergency departments. The disorder is not responsive to antiepileptic drugs (AEDs), and a number of patients with NES are inappropriately treated with aggressive and invasive measures. Dr. LaFrance's training goals are to: 1) Develop expertise in designing and executing clinical trials studying treatments for patients with NES. 2) Gain expertise in biostatistical analysis, for designing and evaluating clinical and interventional studies. 3) Develop skills with specific psychotherapies for integrating psychosocial treatments in NES research. 4) Gain additional expertise in the field of epilepsy, focusing on epilepsy monitoring techniques. These training goals will be achieved through a 5 year research program that utilizes 1) the resources available at the Brown Medical School, 2) the experienced mentorship provided by Drs. Ivan Miller, Gabor Keitner and Andrew Blum and the expertise of the assembled consultant team, 3) focused coursework and clinical experiences, and 4) the proposed clinical intervention research project. The proposed research extends the natural progression of Dr. LaFrance's current research in NES under his NIH/Brown Institutional T32 fellowship. The application builds on Dr. LaFrance's clinical training in neurology and psychiatry by providing research experience in grantsmanship, research design, and exposure to combined modality interventions. The Specific Aims of this application are 1) to investigate the efficacy of sertraline in treatment of psychogenic NES and its co-morbid psychiatric disorders and 2) to identify predictors of response to treatment and to identify potential mechanisms of NES.

描述（由申请人提供）：此申请是为了获得指导的注重患者的研究职业发展奖（K23）的要求，该奖项将使Lafrance博士能够继续开发他的程序化研究线，以治疗心理学无毒性癫痫发作（NES）。 NES类似于癫痫发作，但与行为没有相关的癫痫样活性。 NES没有单一原因，并且与潜在的心理问题和合并的精神病诊断有关。 NES患者通常难以管理，严重残疾并经常在神经病学，精神病学和急诊科中遇到。该疾病对抗癫痫药（AEDS）没有反应，许多NES患者接受了侵略性和侵入性措施的不当治疗。 Lafrance博士的培训目标是：1）在设计和执行NES患者的治疗方法设计和执行临床试验方面发展专业知识。 2）在生物统计分析，设计和评估临床和介入研究方面获得专业知识。 3）开发具有特定心理治疗的技能，以整合NES研究中的心理疗法。 4）在癫痫领域获得更多专业知识，重点是癫痫监测技术。这些培训目标将通过一项使用5年的研究计划来实现1）Brown医学院可用的资源，2）DRS提供的经验丰富的指导。伊万·米勒（Ivan Miller），加博尔·基特纳（Gabor Keitner）和安德鲁·布鲁姆（Andrew Blum）以及组装顾问团队的专业知识，3）专注的课程和临床经验，以及4）提议的临床干预研究项目。拟议的研究扩展了Lafrance博士在NIH/Brown机构T32奖学金下在NES的当前研究的自然发展。该申请是基于Lafrance博士在神经病学和精神病学方面的临床培训，它通过提供助学士，研究设计的研究经验，并接触合并的方式干预措施。本应用的具体目的是1）研究舍曲林在治疗心理NES及其联合性精神疾病方面的功效，以及2）确定对治疗反应的预测指标并确定NES的潜在机制。

项目成果

You've made the diagnosis of functional neurological disorder: now what?

• DOI: 10.1136/practneurol-2017-001835
• 发表时间: 2018-08-01
• 期刊: Practical neurology
• 影响因子: 2.8
• 作者: Adams, Caitlin;Anderson, Jordan;Perez, David L
• 通讯作者: Perez, David L

Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda.

• DOI: 10.1016/j.nicl.2021.102623
• 发表时间: 2021
• 期刊: NeuroImage. Clinical
• 作者: Perez DL;Nicholson TR;Asadi-Pooya AA;Bègue I;Butler M;Carson AJ;David AS;Deeley Q;Diez I;Edwards MJ;Espay AJ;Gelauff JM;Hallett M;Horovitz SG;Jungilligens J;Kanaan RAA;Tijssen MAJ;Kozlowska K;LaFaver K;LaFrance WC Jr;Lidstone SC;Marapin RS;Maurer CW;Modirrousta M;Reinders AATS;Sojka P;Staab JP;Stone J;Szaflarski JP;Aybek S
• 通讯作者: Aybek S

Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders.

• DOI: 10.1001/jamaneurol.2018.1264
• 发表时间: 2018-09-01
• 期刊: JAMA neurology
• 影响因子: 29
• 作者: Espay AJ;Aybek S;Carson A;Edwards MJ;Goldstein LH;Hallett M;LaFaver K;LaFrance WC Jr;Lang AE;Nicholson T;Nielsen G;Reuber M;Voon V;Stone J;Morgante F
• 通讯作者: Morgante F

Methodological issues in conducting treatment trials for psychological nonepileptic seizures.

进行心理非癫痫发作治疗试验的方法学问题。

• DOI: 10.1176/jnp.2007.19.4.391
• 发表时间: 2007
• 期刊: The Journal of neuropsychiatry and clinical neurosciences
• 作者: LaFranceJr,WCurt;Blum,AndrewS;Miller,IvanW;Ryan,ChristineE;Keitner,GaborI
• 通讯作者: Keitner,GaborI

Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders.

• DOI: 10.1016/j.jpsychires.2018.04.006
• 发表时间: 2018-07
• 期刊: Journal of psychiatric research
• 影响因子: 4.8
• 作者: Williams B;Jalilianhasanpour R;Matin N;Fricchione GL;Sepulcre J;Keshavan MS;LaFrance WC Jr;Dickerson BC;Perez DL
• 通讯作者: Perez DL