Frontal Lobe Injury and Executive Control of Cognition and Emotion

额叶损伤与认知和情绪的执行控制

• 批准号: 9239266
• 负责人: DIANE SWICK
• 金额: --
• 依托单位: VA NORTHERN CALIFORNIA HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-10-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9239266
• 关键词: Address; Affect; Afghanistan; Anger; Attention; Attention Concentration; Attentional deficit; Behavioral; Brain; Chronic Post Traumatic Stress Disorder; Cognition; Cognitive; Cognitive deficits; Common Data Element; Cues; Diagnosis; Disease; Dissociation; Effectiveness; Elements; Emotional; Emotions; Event; Face; Family; Functional Magnetic Resonance Imaging; Future; Healthcare; Hybrids; Impairment; Incentives; Injury; Iraq; Knowledge; Lead; Maintenance; Marshal; Measures; Memory; Methods; Military Personnel; Mind; Monitor; Moods; Motivation; Motor; Nature; Occupational; Patient Self-Report; Patients; Pattern; Performance; Phenotype; Population; Post-Traumatic Stress Disorders; Preparation; Process; Protocols documentation; Psychotherapy; Questionnaires; Rehabilitation therapy; Reporting; Research; Resistance; Resolution; Rest; Retrieval; Rewards; Sampling; Series; Severities; Short-Term Memory; Site; Stimulus; Stream; Symptoms; Task Performances; Therapeutic; Thinking; Trauma; Veterans; attentional control; brain electrical activity; clinical predictors; cognitive performance; cognitive process; cognitive reappraisal; combat; conflict resolution; design; distraction; emotional distress; executive function; experience; experimental study; frontal lobe; frontal lobe function; improved; indexing; information processing; innovation; neural correlate; neuromechanism; neurophysiology; novel; novel strategies; predictive of treatment response; response; social; sustained attention; symptom cluster; temporal measurement; treatment response

Post-traumatic stress disorder (PTSD) is a serious psychiatric condition that affects a substantial number of military personnel who served in Afghanistan and Iraq. Over 30% of all OEF/OIF/OND Veterans who receive health care from the VA have been diagnosed with PTSD. The disorder is characterized by symptom clusters of re-experiencing or intrusion, hyperarousal, avoidance, and negative alterations in cognition. In addition to these distressing emotional and mood problems, impairments in attention and executive control can be observed. Impairments in these frontal lobe functions could, in turn, have a negative impact on social and occupational activities. Recent studies show that PTSD is associated with deficits in highly specific frontal lobe functions, such as response inhibition and sustained attention. These cognitive deficits are strongly correlated with symptom severity. Conversely, other executive control processes, including interference resolution and error monitoring, are intact. Little is known about why these dissociations occur, and what their underlying neural mechanisms might be. The current project will extend previous findings in the OEF/OIF Veteran population by asking why this specific pattern of spared and impaired frontal lobe functions is observed, and how targeted task manipulations such as cues and rewards might improve performance. The proposed studies will investigate the cognitive and neural mechanisms of three cognitive domains that are difficult for Veterans with PTSD: (1) staying “on task”, the ability to focus on the task at hand without mind wandering; (2) response inhibition, the ability to withhold inappropriate motor responses; (3) distractor resistance, the ability to filter out extraneous stimuli to maintain items in working memory. The project will use a direct measure of the brain's electrical activity to determine when in the information processing stream potential weaknesses occur. This is a critical element, because knowing if a particular deficit is associated with early suppression of distractors, sustained attention, and/or response inhibition may inform future therapeutic approaches. The project will also record electroencephalographic (EEG) activity at rest to examine possible changes in connectivity associated with PTSD. The relationship between off-task cognition (“mind wandering”), fluctuations of attention, and trauma-related thoughts and memories will be explored. The proposed studies will contribute to larger efforts to characterize this Veteran population by including PhenX common data elements and easily replicated methods that can be implemented at other research sites. An innovative aspect of the current proposal is its novel approach to resting state EEG, which is easier and less expensive to collect than resting state fMRI. The observed patterns of EEG network activity will be related to specific “phenotypes” of resting state cognition as determined by the validated Amsterdam Resting-State Questionnaire (Diaz et al., 2013, 2014). We hope the project will lead to broader efforts to characterize the brain states correlated with maladaptive thoughts in a naturalistic setting, with possible use of this knowledge in the future to predict clinical response to treatment.

创伤后应激障碍(PTSD)是一种严重的精神疾病，影响着相当多的人 曾在阿富汗和伊拉克服役的军事人员。超过30%的OEF/OIF/OND退伍军人 接受退伍军人管理局医疗保健的人都被诊断出患有创伤后应激障碍。这种障碍的特点是 重新体验或侵扰、过度觉醒、回避和消极改变的症状群 认知力。除了这些令人痛苦的情绪和情绪问题外，注意力和精神障碍 可以观察到执行控制。这些额叶功能的损害反过来可能会有 对社会活动和职业活动的负面影响。最近的研究表明，创伤后应激障碍与 高度特异的额叶功能缺陷，如反应抑制和持续注意力。 这些认知缺陷与症状严重程度密切相关。相反，其他高管 控制流程，包括干扰解决和错误监控，完好无损。人们对此知之甚少 为什么会发生这些解离，以及它们潜在的神经机制可能是什么。海流 该项目将在OEF/OIF退伍军人群体中扩展先前的发现，询问为什么这个特定的 观察额叶功能受损和受损的模式，以及如何有针对性地进行任务操作 例如，暗示和奖励可能会提高绩效。拟议的研究将调查 退伍军人创伤后应激障碍患者三个认知领域的认知神经机制：(1) 保持“专注于任务”，能够专注于手头的任务而不走神；(2)反应 抑制，抑制不适当的运动反应的能力；(3)分心阻力，抑制的能力 过滤掉无关的刺激以保持工作记忆中的项目。该项目将使用直接测量 大脑的电活动来确定何时处于信息处理流的电位 弱点是会出现的。这是一个关键因素，因为知道特定的赤字是否与 早期抑制干扰、持续注意力和/或反应抑制可能会提示未来 治疗方法。该项目还将记录休息时的脑电活动，以 检查与创伤后应激障碍相关的连接性可能发生的变化。非工作时间与工作时间的关系 认知(“走神”)，注意力的波动，以及与创伤相关的想法和记忆 探索过了。拟议的研究将有助于更大的努力来描述这一退伍军人群体的特征。 通过包括PhenX通用数据元素和易于复制的方法，可在 其他研究网站。当前提案的一个创新方面是它对休息状态的新颖方法 脑电，这是更容易和更便宜的收集比静息状态的功能磁共振。观察到的模式 脑电网络活动将与特定的静息状态认知表型有关，由 经过验证的阿姆斯特丹休眠状态调查问卷(Diaz等人，2013年、2014年)。我们希望这个项目能 导致更广泛的努力来表征与不适应思想相关的大脑状态 自然环境，未来可能使用这一知识来预测临床反应 治疗。