PREDICTING PRESCHOOL PSYCHOPATHOLOGY WITH BRAIN CONNECTIVITY IN PRETERM NEONATES

 描述(申请人提供)：每年，在美国出生的婴儿中，约有12%会受到早产的影响。早产儿有较高的精神障碍发生率，包括ADHD和自闭症，以及相关的注意力和社交缺陷。为了解决影响早产儿结局的因素，医学研究所建议采用多学科方法，研究重点是确定新生儿发育的预测因素，包括社会、情感和行为结果。这项以患者为导向的辅导式职业发展奖(K23)的目的是使候选人能够开发一个资助的研究计划，旨在了解新生儿结构和功能脑连接与早产儿精神结局之间的关系。候选人的长期目标是成为一名独立的临床调查员，研究高危婴儿精神结局的神经成像表现。为了实现这一目标，建议在三个关键领域进行培训和指导：1)应用先进的脑MRI分析技术，特别是扩散张量成像和静息状态功能连接；2)提高设计、解释和分析发展精神病理学纵向研究的技能；3)对累积心理社会风险暴露和脑-行为关系的关键协变量进行建模。该奖项的研究计划将在培训计划和由专家导师和顾问组成的跨学科团队的支持下实施。这个K23提案中的项目将通过1)全面评估学龄前阶段的精神症状，特别关注ADHD和自闭症症状，2)将新生儿微结构和功能连接的变化与儿童早期ADHD和ASD症状联系起来，以及3)探索关键的心理社会风险因素是否也影响不良的社会情绪和精神结果，来解决早产儿精神障碍发病率上升的原因。这项拟议的研究在学龄前阶段对自出生以来纵向跟踪的早产儿样本进行了全面的精神和社会情绪评估，这些样本可以获得新生儿结构和静息状态功能连接性的MRI数据。该项目为解决这一关键科学问题提供了前所未有的机会，也为处于神经科学研究前沿的机构提供了独特的培训机会。该候选人致力于在早产人群中进一步发展新生儿神经成像和学龄前精神病理学领域的专业知识。来自这些研究活动的数据将支持R01应用程序的开发，该应用程序跟踪这一研究人群在学龄期的发展精神病理学轨迹和随后的大脑发育。该项目可以在大脑可塑性显著的时期为早期识别和有针对性的干预策略提供信息，改善早产儿的精神结局。

 DESCRIPTION (provided by applicant): Each year, preterm birth affects roughly 12% of babies born in the United States. Children born preterm have higher rates of psychiatric disorders, including ADHD and autism, and related attentional and social deficits. To address the factors contributing to outcomes in very preterm infants, the Institute of Medicine recommended a multidisciplinary approach with research focused on identifying neonatal predictors of development including social, emotional and behavioral outcomes. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a funded research program aimed at understanding the relationship between neonatal structural and functional brain connectivity and psychiatric outcomes in preterm infants. The candidate's long-term goal is to become an independent clinical investigator studying the neuroimaging manifestations of psychiatric outcomes in high-risk infants. To achieve this goal, training and mentorship are proposed in three key areas: 1) applying advanced brain MRI analysis techniques, specifically diffusion tensor imaging and resting state functional connectivity, 2) enhancement of skills in the design, interpretation and analysis of longitudinal studies of developmental psychopathology and 3) modeling cumulative psychosocial risk exposure and key covariates of brain-behavior relationships. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and advisors. The project in this K23 proposal will address the unexplained etiology of increased rates of psychiatric disorders in preterm children by 1) comprehensively evaluating psychiatric symptoms during the preschool period with a particular focus on ADHD and autism symptoms, 2) relating alterations in neonatal microstructural and functional connectivity to ADHD and ASD symptoms during early childhood as well as 3) exploring whether key psychosocial risk factors also impact poor social-emotional and psychiatric outcomes. The proposed study adds a comprehensive psychiatric and social-emotional assessment during the preschool period in a captured sample of premature children longitudinally followed since birth for whom neonatal structural and resting state functional connectivity MRI data are available. This project provides an unprecedented opportunity to address this key scientific question and a unique training opportunity at an institution at the forefront of neuroscience research. The candidate is committed to further developing expertise in the area of neonatal neuroimaging and preschool psychopathology in preterm populations. Data from these research activities will support the development of an R01 application tracking developmental psychopathology trajectories and subsequent brain development of this study population into school-age. This project could inform early identification and targeted intervention strategies during a period of significant brain plasticity improving psychiatric outcomes for preterm children.