A Study of Preschool Irritability: Brain Imaging in the Clinic Setting

描述(申请人提供)：这项研究的目标是使用功能性近红外光谱(FNIRS)来研究3-5岁的学龄前儿童(3-5岁)的易怒的神经基础，这些儿童正在接受临床上的早发性精神病理学治疗。易怒存在于每个人的一个维度上，然而，它也是一个重要的心理健康问题，几乎存在于每一种形式的精神病理学中。DSM-V修订版中甚至增加了一个新的诊断类别，以确保这种症状所需的研究和临床服务。这项拟议中的研究将首次检验挫折感和抑制控制的大脑机制，这标志着幼儿高度易怒的关键行为缺陷。在表现出不同程度易怒的学龄前儿童中，获得支持挫折和抑制控制的神经系统功能异常的这些测量将首先帮助我们确定哪些儿童表现出更高水平的 这些神经系统内的功能障碍。这也是朝着更长期目标迈出的第一步，即检查这些神经系统异常的程度，这些异常是在易怒首次出现的年龄发现的，可能代表着有助于区分相关精神病理学发展轨迹的生物标记物，以便在症状学的早期阶段应用不同的治疗方法。儿童将在临床环境中使用fNIRS进行测试，这是一种无痛、非限制性、可运输的光学成像技术，允许受试者/实验者互动。将采用经过充分验证的实验范式。初步分析将使用最先进的分析技术，探索与挫折和抑制控制相关的特定区域的神经活动，以确定与这一症状相关的大脑缺陷。探索性分析将通过将这些神经系统的活动与诊断报告相关联来检查这些神经系统异常预测症状严重程度和临床诊断的程度。最后，这项研究的长期计划包括未来完成纵向R01研究的建议，将功能近红外光谱和功能磁共振成像(FMRI)结合起来。一个大的社区样本的学龄前儿童，跨越易怒水平的范围，将参加每年的fNIRS测量神经系统的挫折和抑制控制使用适合年龄的任务。在该项目的后期，当儿童进入童年中期时，将对他们进行扫描，同时使用fNIRS和fMRI来增加我们对这种症状的神经和临床轨迹的了解。我们的跨学科研究团队联合了发展心理学家、神经学家和儿童精神病学家，他们都是各自领域的专家，但在理解易怒作为儿童心理健康结果预测因子的神经机制方面有着共同的兴趣。

DESCRIPTION (provided by applicant): The goal of this research is to use functional Near Infrared Spectroscopy (fNIRS) to study the neural basis of irritability in a sample of preschool children (ages 3-5) who are being clinically treated for early onset psychopathology. Irritability exists on a dimension in every member of the population, however, it is also a significant mental health concern that is present in nearly every form of psychopathology. A new diagnostic category in the DSM-V revision has even been added in order to secure the research and clinical services that this symptom requires. The proposed study will be the first to examine brain mechanisms for frustration and inhibitory control, which signify key behavioral deficits, in young, highly irritable children. Obtaining these measures of functional abnormalities in the neural systems supporting frustration and inhibitory control in preschool children presenting with varying levels of irritability will first help us to identify which children show greater levels of dysfunction within these neural systems. It is also a first step toward the longer term goal of examining the extent to which these neural system abnormalities, identified at the age at which irritability first presents, may represent biological markers that can help distinguish relevant developmental trajectories of psychopathology, so that different treatments can be applied at this early stage of symptomatology. Children will be tested in the clinic setting using fNIRS, an optical imaging technique that is painless, non-restrictive, transportable, and allows for subject/experimenter interaction. Well-validated experimental paradigms will be employed. Primary analyses will probe the neural activity within specific regions related to frustration and inhibitory control, using state-of-the-art analysis techniques, in order to define brain deficits tat correlate with this symptom. Exploratory analyses will examine the extent to which these neural system abnormalities may predict symptom severity and clinical diagnosis by correlating activity in these neural systems with diagnostic report. Finally, long term plans for this research include a future proposal to complete a longitudinal R01 study, combining fNIRS and functional magnetic resonance imaging (fMRI). A large community sample of preschool children, across the range of irritability levels, will participate in yearly fNIRS measurement of neural systems fo frustration and inhibitory control using age appropriate tasks. In the later years of the project, when children have entered middle childhood, they will be scanned, using simultaneous fNIRS and fMRI to increase our understanding of the neural and clinical trajectories of this symptom. Our transdisciplinary research team unites developmental psychologists, neuroscientists, and child psychiatrists who are experts in their respective fields, but share a common interest in understanding the neural mechanisms for irritability as a predictor of child mental health outcomes.