Dynamic Inflammatory and Mood Predictors of Cognitive Aging in Bipolar Disorder

双相情感障碍认知老化的动态炎症和情绪预测因子

• 批准号: 9425179
• 负责人: LISA T EYLER
• 金额: $ 11.03万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-25 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9425179
• 关键词: Accounting; Address; Adult; Affect; Age; Aging; Anti-Inflammatory Agents; Anti-inflammatory; Behavior Therapy; Behavioral; Behavioral Mechanisms; Biological; Biological Response Modifier Therapy; Bipolar Disorder; Bipolar I; Characteristics; Cognition; Cognitive; Cognitive aging; Complex; Development; Diagnosis; Emotional; Future; Goals; Health; Home visitation; Immune; Immune response; Immune system; Impaired cognition; Individual; Inflammation; Inflammatory; Inflammatory Response; Intervention; Investigation; Lead; Longitudinal cohort; Measurement; Measures; Mediating; Mental disorders; Methods; Monitor; Moods; National Institute of Mental Health; Participant; Patients; Pharmacology; Play; Population; Process; Psyche structure; Role; Sampling; Severities; Societies; Technology; Variant; age related; aged; burden of illness; clinically relevant; cognitive change; cognitive function; cognitive performance; cohort; comparison group; cytokine; design; follow-up; functional decline; immune function; inflammatory marker; innovation; longitudinal design; middle age; mood symptom; novel; phase change; physical conditioning; portability; premature; severe mental illness

As the population ages, the burden on individuals and society due to the cognitive and health effects of serious mental illnesses, such as bipolar disorder (BD), will increase. Premature and accelerated aging trajectories in BD are beginning to be recognized in many health and cognitive domains, but specific mechanisms have not yet been identified, particularly for the course of cognitive aging. Markers of inflammatory function, such as cytokine levels, are known to affect cognition, change with age, and predict declines in mentally healthy individuals. Cytokine levels also appear to be abnormal in those with BD, but mood instability in BD makes measurement of short- and long-term changes in both inflammatory and cognitive measures challenging. Nonetheless, studies within this population afford a unique opportunity to better understand how variations in the degree of emotional and behavioral dysregulation may moderate or mediate immune-cognitive associations. We propose to use an innovative multi-cohort burst longitudinal design (MBLD) to characterize trajectories of cognitive and inflammatory response and identify: 1) relationships between cognition and inflammation in the short term while accounting for effects of mood variability, 2) baseline measures and levels of short-term variability in inflammatory markers that might predict long-term trajectories of cognitive change, and 3) relationships between inflammatory, cognitive, and mood variables in the long-term (i.e., mechanisms of change). We will assess 144 adults (35-60 years old) with clinically-relevant symptoms of mood dysregulation, as indicated by Bipolar I diagnosis, and 115 similarly aged non-BD comparison (NC) participants without mental illnesses. Cognition, cytokine levels, and mood (along with other potential contributing variables) will be measured weekly or daily over a two week period using intensive remote monitoring and home visits (burst assessment). Burst assessments will be repeated annually (longitudinal assessment) for three years in the BD group, and at one year in the NC group. This project addresses NIMH Strategic Objective # 2: charting mental illness trajectories to determine when, where, and how to intervene. Specifically, using an innovative design that allows us to account for, and measure the impact of, variability in mood symptoms, we can discover inflammatory markers (both static and dynamic) that predict the course of cognitive change among individuals with mood instability. By understanding the complex and dynamic interplay between inflammation, cognition, and mood, pharmacologic and behavioral interventions can be designed to slow or reverse the trajectory of declining function in bipolar disorder.

随着人口老龄化，对个人和社会造成的负担对认知和健康造成严重影响 精神疾病，如双相情感障碍(BD)，将会增加。中国的早衰和加速老化轨迹 BD开始在许多健康和认知领域得到承认，但具体的机制还没有 尤其是在认知老化的过程中。炎症功能的标志物，如 细胞因子水平，已知会影响认知，随年龄变化，并预测心理健康的下降 个人。细胞因子水平在BD患者中也出现异常，但BD患者的情绪不稳定使 衡量炎症和认知指标的短期和长期变化具有挑战性。 尽管如此，对这一人群的研究提供了一个独特的机会，可以更好地理解 情绪和行为失调的程度可能会调节或调节免疫认知 联想。我们建议使用一种创新的多队列突发纵向设计(MBLD)来表征 认知和炎症反应的轨迹和识别：1)认知和炎症反应之间的关系 短期炎症，同时考虑情绪变异性的影响，2)基线测量和水平 炎症标志物的短期可变性可能预测认知变化的长期轨迹， 3)炎症、认知和情绪变量之间的长期关系(即 更改)。我们将评估144名成年人(35-60岁)，他们有与临床相关的情绪失调症状， 如双相I诊断所示，115名年龄相近的非BD对照(NC)参与者没有 精神疾病。认知、细胞因子水平和情绪(以及其他潜在的影响变量)将是 使用密集的远程监控和家访(猝发)在两周内每周或每天测量 评估)。屋宇署每年进行一次爆破评估(纵向评估)，为期三年。 组，NC组治疗一年。本项目针对NIMH战略目标2：心智图表 疾病轨迹以确定何时、何地以及如何干预。具体地说，使用创新的设计 这使我们能够解释和衡量情绪症状的可变性的影响，我们可以发现 预测个体认知变化过程的炎性标志物(静态和动态) 情绪不稳定。通过了解炎症、认知和疾病之间复杂而动态的相互作用 情绪、药物和行为干预可以被设计来减缓或逆转 双相情感障碍的功能衰退。