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

描述（由申请人提供）：本研究的目的是使用功能性近红外光谱（fNIRS）来研究正在接受早发性精神病理学临床治疗的学龄前儿童（3-5岁）样本中易怒的神经基础。易怒在人口的每个成员中都存在，然而，它也是一个重要的心理健康问题，几乎存在于所有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是第一个研究沮丧和抑制控制的大脑机制，这意味着年轻，高度易怒的儿童的关键行为缺陷。获得这些功能异常的神经系统的措施，支持挫折和抑制控制的学龄前儿童表现出不同程度的易怒，将首先帮助我们确定哪些儿童表现出更高水平的焦虑。 这些神经系统的功能紊乱。这也是迈向长期目标的第一步，即检查这些神经系统异常的程度，这些神经系统异常在易怒首次出现的年龄被确定，可能代表可以帮助区分精神病理学相关发展轨迹的生物标志物，以便在精神病理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，fNIRS是一种无痛、非限制性、可移动的光学成像技术，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测与挫折和抑制控制相关的特定区域内的神经活动，以确定与该症状相关的脑缺陷。探索性分析将通过将这些神经系统中的活动与诊断报告相关联来检查这些神经系统异常可预测症状严重程度和临床诊断的程度。最后，本研究的长期计划包括未来建议完成纵向R 01研究，结合fNIRS和功能磁共振成像（fMRI）。学龄前儿童的大型社区样本，在易怒水平的范围内，将参加年度fNIRS测量的神经系统的挫折和抑制控制使用年龄适当的任务。在该项目的后期，当儿童进入童年中期时，他们将被扫描，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理解。 我们的跨学科研究团队联合了发展心理学家，神经科学家和儿童精神病学家，他们是各自领域的专家，但在理解易怒的神经机制作为儿童心理健康结果的预测因素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.