Motivational Negative Symptoms in Schizophrenia: Intervention and Biomarkers

 产品说明： 阴性症状显著干扰日常功能，并导致退伍军人精神分裂症患者社区结果不佳。阴性症状主要有两种类型：表达型（情感平淡、失语）和动机型（无意志和不合群）。动机性消极症状会干扰获得和维持就业[1]，形成社会关系[2]和独立生活[3]。精神分裂症的阴性症状被认为是一种未满足的治疗需求。他们还为我们提供了一个治疗目标，将大大改善许多退伍军人与SCZ的日常生活。治疗开发是当前提案的主要目标，因为是动机的潜在神经生理学生物标志物的检查。动机性阴性症状的生物标志物可以作为临床试验中的敏感终点，并可以帮助我们了解动机性阴性症状的原因和治疗方法。目前的CDA提案将在一项随机对照试验中评估从已建立的动机增强（MI）技术中改编并采用认知行为方法增强的动机阴性症状治疗的可行性。我将通过多个结局领域的指标评估MI的疗效：1）临床评定的动机阴性症状; 2）功能结局（社交、工具和独立生活的真实改善）; 3）神经生理学生物标志物（瞳孔测量和脑电图（EEG））。退伍军人将被随机分配到MI治疗或对照治疗，每周1小时，持续12周。将在基线、治疗完成和3个月随访时进行评估组合。我们将在4年的研究中招募100名患有精神分裂症和高动机阴性症状的退伍军人。该建议旨在研究基于群体的MI，以减少动机阴性症状，并利用瞳孔测量和EEG调查动机的生物标志物。预计这种针对具有致残性动机阴性症状的退伍军人的以恢复为导向的群体MI治疗将产生结果，以告知更大的治疗试验，并增强精神分裂症退伍军人的动机阴性症状的神经生理学测量。

 DESCRIPTION: Negative symptoms significantly interfere with daily functioning and contribute to the poor community outcomes of Veterans with schizophrenia. There are two main types of negative symptoms: expressive (flat affect, alogia) and motivational (avolition and asociality). It is the motivational negative symptoms that interfere with obtaining and maintaining employment [1], forming social relationships [2] and living independently [3]. Negative symptoms in schizophrenia are considered an unmet treatment need. They also offer us a treatment target that would vastly improve the daily lives of many Veterans with SCZ. Treatment development is a primary goal of the current proposal, as is the examination of potential neurophysiological biomarkers of motivation. Biomarkers for motivational negative symptoms can be used as sensitive endpoints in clinical trials and can help us understand the causes and treatments of motivational negative symptoms. The current CDA proposal will assess the feasibility of a treatment for motivational negative symptoms adapted from established motivational enhancement (MI) techniques and augmented with cognitive-behavioral approaches, in a randomized controlled trial. I will assess the efficacy of MI with measures from multiple outcome domains: 1) clinically-rated motivational negative symptoms; 2) functional outcomes (real-world improvements in social, instrumental, and independent living); and 3) neurophysiological biomarkers (pupillometry and electroencephalography (EEG)). Veterans will be randomly assigned to the MI treatment or a control treatment for weekly 1-hour sessions for 12 weeks. The assessment battery will be administered at baseline, at completion of treatment, and at 3-month follow-up. We will enroll 100 Veterans with schizophrenia and high motivational negative symptoms across the 4 years of the study. This proposal is designed to examine group-based MI for reducing motivational negative symptoms and investigating biomarkers of motivation with pupillometry and EEG. It is expected that this recovery-oriented group MI treatment for Veterans with disabling motivational negative symptoms will yield results to inform larger treatment trials and enhance neurophysiological measurement of motivational negative symptoms in Veterans with schizophrenia.