Functional Magnetic Resonance Imaging Markers of Early-Onset Suicide Attempt

描述(由申请人提供)：建议的申请将为候选人提供所需的专业知识，以建立一个独立的研究生涯，专注于调查儿童和青少年的神经生物学自杀企图。申请者是一名儿童和青少年精神病学家，他建议从自杀学和功能神经成像方面的导师那里获得多学科培训，以及儿童神经生物学、儿童发育、神经成像和数据分析方面的专家小组。我们建议使用功能神经成像和神经科学中的既定方法来表征早发性自杀企图背后的神经生物学。我们将评估这些青少年，以及年龄匹配的精神控制组和具有良好神经认知任务的健康控制组。我们假设，青少年自杀未遂的历史将与神经活动模式的差异有关，与精神疾病和健康对照组相比。这个研究项目的主要目标是检查潜在的训练依赖的神经回路。 在有和没有自杀未遂史的抑郁症青少年中，研究认知和情绪处理的异常，集中在以下领域：情绪处理、认知控制和危险决策，已被证明分别招募腹侧和背内侧前额叶皮质、杏仁核和腹侧纹状体、背侧前额叶皮质区、腹内侧额前皮质和背内侧前额叶皮质。我们对青少年自杀企图的神经回路的研究很重要，因为它将有助于更准确地定义：1)与自杀行为相关的认知和情感处理异常；2)与这些神经认知异常相关的功能神经回路；以及3)这些异常与自杀行为的发生和病史之间的关系。增加对这些神经标志物的了解将对未来针对治疗和预防努力的目标产生重大影响，以改善有自杀行为的个人的长期结果。这是第一次在儿科人群中进行此类研究。功能神经成像指导、教学、课程作业和临床研究培训由功能神经成像计划主任Mary Phillips，M.D.(Canab)和自杀研究捐赠主席David Brent，M.D.赞助，将为候选人在青少年自杀预防方面进行多学科认知神经科学研究做好准备。公共卫生相关性： 确定自杀风险的标记物并增加对认知神经科学的理解 自杀未遂可能会对未来治疗和监测的设计和监测产生重大影响 预防工作，防止有自杀行为的人死亡并改善其长期结局。这是第一次在青少年中进行此类研究。

DESCRIPTION (provided by applicant): The proposed application will provide the candidate with the needed expertise to establish an independent research career focusing on the investigation of the neurobiology suicide attempt in children and adolescents. The applicant is a child and adolescent psychiatrist who proposes to obtain multidisciplinary training from mentors in suicidology and functional neuroimaging, with a panel of experts in childhood neurobiology, child development, neuroimaging, and data analysis. We propose to use established methods in functional neuroimaging and neuroscience to characterize the neurobiology underlying early onset suicide attempt. We will assess these adolescents, and age-matched psychiatric controls and healthy controls with well-established neurocognitive tasks. We hypothesize that history of suicide attempt in adolescents will be associated with differences in patterns of neural activity compared with both psychiatric and healthy controls. The primary objective of this research project is to examine the neural circuitry underlying traitdependent abnormalities in cognitive and emotion processing in adolescents with depression with and without history of suicide attempt, by focusing on the following areas: emotional processing, cognitive control, and risky decision-making, that have been demonstrated to recruit ventral and dorsomedial prefrontal cortices and amygdala and ventral striatum, dorsal prefrontal cortical regions, and ventromedial and dorsomedial prefrontal cortices, respectively. Our study of the neural circuitry of adolescent suicide attempt is important in that it will help to more precisely define: 1) cognitive and affective processing abnormalities associated with suicidal behavior; 2) functional neurocircuitry related to these neurocognitive abnormalities; and, in turn, 3) the relationship between these abnormalities and onset and history of suicidal behavior. Increased understanding of these neural markers will have a significant impact upon the future targeting of treatment and prevention efforts to improve the long-term outcome of individuals with suicidal behavior. This is the first study of its kind in a pediatric population. The functional neuroimaging instruction, didactics, coursework, and clinical research training, sponsored by Mary Phillips, M.D., M.D. (Cantab), Director of the Functional Neuroimaging Program, and David Brent, M.D., Endowed Chair in Suicide Studies, will prepare the candidate to perform multidisciplinary cognitive neuroscience research in adolescent suicide prevention. PUBLIC HEALTH RELEVANCE: Identification of markers for suicide risk and increased understanding of the cognitive neuroscience of suicide attempt may have a significant impact upon the future design and monitoring of treatment and prevention efforts to prevent death and improve the long-term outcome of individuals with suicidal behavior. This is the first study of its kind in adolescents.