CSR&D Research Career Scientist Award Application

精神分裂症谱系障碍和自杀行为是主要的公共卫生问题， 老兵每年，退伍军人事务部为大约10万名精神分裂症患者提供护理， 占VA总医疗费用的近12%。与此同时，最近的研究表明，退伍军人表现出 与美国普通人群相比，自杀风险更高。PI正在进行的临床认知神经科学 VA的研究使用神经成像和心理生理学方法，主要集中在这些方面 两个领域：阐明精神分裂症和自杀行为的神经生物学。确定有前途的新 精神分裂症和自杀预防的干预目标是VA的关键重要目标。PI的 联邦资助和同行评审的出版物在这两个领域的跟踪记录有助于推动这一领域的发展。 PI的新VA CSR&D优异奖旨在确定正常的神经相关性和心理生理学 健康对照组情绪反应和调节退伍军人和情绪的病理严重性 低水平（非自杀性精神病对照）的重度抑郁症（MDD）退伍军人中的失调， 高风险（自杀意念者和自杀未遂者）自杀。受试者接受基线功能MRI检查 扫描和心理生理学范式，提供了一个可靠的，非语言的，低成本的情绪测量 处理（即情感惊吓调制）。在6个月随访时重复心理生理学会话; 在基线、6个月和12个月随访时进行临床症状评估。了解大脑回路 异常的潜在失调的情绪表达和心理介质，引起和 预测自杀行为和区分自杀者和自杀者具有明显的公共卫生重要性。 这项新资助的VA Merit研究有望帮助揭示生物和 心理因素引起自杀行为，可能有助于前瞻性地识别退伍军人， 自杀的风险。 PI目前精神分裂症谱研究的目标（由她以前的VA CSR&D Merit资助） 奖）是开始将精神分裂症的临床前科学研究转化为临床竞技场。为了 确定有希望的新目标，为精神分裂症的干预，更好地了解其病理 需要电路和潜在的遗传易感性。她的工作使用扩散张量成像（DTI）， 结构MRI表征额颞区的白色异常。DTI纤维束成像 允许量化大脑中白色物质连接的完整性。各种易感基因 涉及白色物质异常和精神分裂症（例如，NRG 1和ERBB 4）。和她一起 多学科的VA伊坎医学院在西奈山（ISMMS）的同事谁带来的专业知识， 遗传学，PI的工作调查精神分裂症的白色物质紊乱的模型。数据 目前正在分析和发表她最近的VA Merit研究60个人与异型 人格障碍（SPD）和60名健康对照者接受MRI和基因分型。这项工作 评估白色物质组织并检查白色物质连通性之间的关系 （各向异性分数和纤维束成像DTI测量），白色物质体积（结构MRI）， 两个潜在的易感基因（NRG 1和ERBB 4），以及整个研究中的认知障碍/缺陷症状。 江西篇章SPD参与者作为我们选择的表型进行研究，因为他们代表了一种精神分裂症 没有慢性抗精神病药物治疗、长期精神病和住院治疗的混杂因素。 影响：这项研究职业科学家奖将使PI能够增强她高度协作的VA 研究和指导有前途的VA MIRECC研究员和临床科学家。PI当前的VA Merit为 这是JJPVAMC进行研究3 T MRI扫描的第一项研究。私家侦探的目标是进一步扩大她的核磁共振成像 精神分裂症和自杀行为的研究项目。

Schizophrenia spectrum disorders and suicidal behavior are major public health problems affecting Veterans. Each year, the VA provides care to approximately 100,000 schizophrenia patients, accounting for nearly 12% of the VA’s total healthcare costs. At the same time, recent studies indicate that Veterans exhibit higher suicide risk compared with the general U.S. population. The PI’s ongoing clinical cognitive neuroscience research at the VA uses neuroimaging and psychophysiological approaches and primarily focuses on these two areas: elucidating the neurobiology of schizophrenia and suicidal behavior. Identification of promising new targets for intervention in schizophrenia and suicide prevention are critically important goals of the VA. The PI’s track record of federal funding and peer-reviewed publications in these two areas has helped advance the field. The PI’s new VA CSR&D Merit Award aims to identify the neural correlates and psychophysiology of normal emotional reactivity and regulation in healthy control Veterans and pathological severity of emotion dysregulation in Veterans with major depressive disorder (MDD) at low (non-suicidal psychiatric controls) and high-risk (suicidal ideators and suicide attempters) for suicide. Participants receive baseline functional MRI scans and a psychophysiological paradigm that provides a reliable, non-verbal, low-cost measure of emotion processing (i.e. affective startle modulation). The psychophysiology session is repeated at a 6-month follow-up; clinical symptom assessments are done at baseline, 6-, and 12-month follow-up. Understanding brain circuitry anomalies underlying dysregulated emotional expression and psychological mediators that give rise to and predict suicidal behavior and distinguish between ideators and attempters has clear public health importance. This newly-funded VA Merit study promises to help uncover the mechanisms by which biological and psychological factors give rise to suicidal behavior and may aid in prospectively identifying Veterans at greatest risk for suicide. The goal of the PI’s current schizophrenia-spectrum research (funded by her previous VA CSR&D Merit Award) is to begin to translate pre-clinical scientific research in schizophrenia into the clinical arena. In order to identify promising new targets for intervention in schizophrenia, a better understanding of its pathological circuitry and underlying genetic susceptibilities is required. Her work uses diffusion tensor imaging (DTI) and structural MRI to characterize white matter abnormalities in frontal-temporal regions. DTI fiber tractography allows quantification of the integrity of white matter connectivity in the brain. Various susceptibility genes are implicated in white matter abnormalities and schizophrenia (e.g., NRG1 and ERBB4). Together with her multidisciplinary VA-Icahn School of Medicine at Mount Sinai (ISMMS) colleagues who bring expertise in genetics, the PI’s work investigates a model of white matter disorganization in schizophrenia. Data are currently being analyzed and published from her recent VA Merit study of 60 individuals with schizotypal personality disorder (SPD) and 60 healthy controls who received MRI and were genotyped. This work evaluates white matter organization and examines the relationship between white matter connectivity (fractional anisotropy and tractography DTI measures), white matter volume (structural MRI), allelic variation in two underlying susceptibility genes (NRG1 and ERBB4), and cognitive impairment/deficit symptoms across the spectrum. SPD participants are studied as our choice of phenotype as they represent a form of schizophrenia without the confounding artifacts of chronic antipsychotic treatment, long-term psychosis, and hospitalization. Impact: This Research Career Scientist Award will allow the PI to augment her highly collaborative VA research and mentoring of promising VA MIRECC fellows and clinician-scientists. The PI’s current VA Merit is the first study at the JJPVAMC to conduct research 3T MRI scans. The PI’s goal is to further expand her MRI research program in schizophrenia and suicidal behavior at the JJPVAMC.