Central and Peripheral Nervous System Correlates of Difficulty Discarding in Hoarding Disorder

中枢和周围神经系统与囤积症中丢弃困难的相关性

• 批准号: 9917103
• 负责人: James Charles McPartland
• 金额: $ 21.21万
• 依托单位: HARTFORD HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-25 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9917103
• 关键词: Anterior; Anxiety Disorders; Arousal; Awareness; Behavior; Behavioral; Biological Markers; Brain; Carbon Dioxide; Cardiac; Cardiovascular system; Clinical; Clinical Trials; Cognitive Therapy; Complex; Compulsive Hoarding; Control Groups; Decision Making; Diagnosis; Disease; Electroencephalography; Emotional; Exhibits; Fire - disasters; Functional Magnetic Resonance Imaging; Goals; Heart Rate; Home environment; Individual; Injury; Insula of Reil; Intervention; Left; Measurement; Measures; Mediating; Mental disorders; National Institute of Mental Health; Neuraxis; Participant; Patients; Peripheral; Peripheral Nervous System; Psychopathology; Psychophysiology; Public Health; Recovery; Research; Research Personnel; Risk; Sampling; Savings; Series; Shapes; Specificity; Stimulus; Sympathetic Nervous System; Symptoms; Techniques; Time; Treatment Efficacy; Work; anxious; base; blood oxygenation level dependent response; brain abnormalities; disorder control; effective therapy; functional disability; hemodynamics; imaging study; improved; innovation; mortality; multilevel analysis; neurobiological mechanism; novel; recruit; relating to nervous system; response; therapy development

There is a critical gap in our understanding of the underlying neurobiological mechanisms of difficulty discarding, the core behavioral feature of hoarding disorder (HD). This gap represents an important problem because, until it is filled, the field will not be able to precisely identify mechanistic targets for new treatment development in HD. The long-term goal of the proposed research is to identify biomarkers of difficulty discarding in HD and to develop treatments that engage those biomarkers. This is important because current treatments for HD are only modestly effective, with only a 35% response rate across studies. The short-term goal here is to determine the peripheral (PNS) and central nervous system (CNS) correlates of difficulty discarding behavior in HD and to distinguish these correlates from related psychopathology. The rationale for this goal is that by assessing PNS and CNS responses and the degree to which they are unique to HD and specifically to difficulty discarding, we will identify meaningful biomarker-based intervention targets. We will recruit 40 patients with primary HD, 40 clinical controls with anxiety disorders but not HD, and 40 healthy controls without psychiatric disorders. We will assess electrodermal, cardiac, and neural (EEG) activity during a series of discarding-relevant and emotionally neutral (discarding-irrelevant) tasks. Our central hypothesis is that patients with HD will demonstrate greater psychophysiological arousal and error related negativity during the discarding-relevant task than will anxious and healthy control participants. The proposed study will pursue the following specific aims: 1) determine the PNS and CNS correlates of difficulty discarding by comparing PNS and CNS activity during the discarding and neutral tasks; 2) determine the causal relationship between PNS and CNS activity and discarding behavior; and 3) determine whether PNS and CNS correlates of difficulty discarding are present to a greater degree in HD relative to other psychopathology. Our approach is innovative because it uses multilevel analysis and will examine, for the first time, the immediate CNS effects of discarding decisions in clinical HD participants. Our focus on the neurobiological mechanisms of HD is significant, as HD is a common and poorly treated condition and the proposed study will have direct implications for biomarker- informed novel treatment development.

在我们对困难的潜在神经生物学机制的理解上存在着一个关键的差距 丢弃，囤积症（HD）的核心行为特征。这一差距代表了一个重要问题 因为，在填满之前，该领域将无法精确识别新治疗的机制目标 HD的发展。拟议研究的长期目标是确定困难的生物标志物 在HD中丢弃并开发利用这些生物标志物的治疗方法。这一点很重要，因为目前 HD的治疗仅适度有效，在所有研究中仅有35%的应答率。短期 这里的目标是确定外周（PNS）和中枢神经系统（CNS）相关的困难 丢弃HD中的行为，并将这些相关性与相关的精神病理学区分开来。的理由 这一目标是通过评估PNS和CNS反应及其在HD中的独特程度， 具体到难以丢弃，我们将确定有意义的基于生物标志物的干预目标。我们将 招募40例原发性HD患者，40例焦虑症但非HD的临床对照，以及40例健康 对照组无精神疾病。我们将评估皮肤电、心脏和神经（EEG）活动， 一系列与情绪无关的任务。我们的核心假设是 HD患者在治疗期间将表现出更大的心理生理唤醒和错误相关的消极性， 与焦虑和健康的对照组相比，拟议的研究将继续 具体目的如下：1）通过比较，确定PNS和CNS与难弃性的相关性 在丢弃和中性任务期间PNS和CNS活动; 2）确定 PNS和CNS活性和丢弃行为;以及3）确定PNS和CNS是否与困难相关 相对于其他精神病理学，丢弃在HD中存在更大程度。我们的方法是创新的 因为它使用多层次分析，并将首次检查丢弃的直接CNS影响， 临床HD参与者的决策。我们对HD的神经生物学机制的关注是重要的，因为HD 是一种常见且治疗不良的疾病，拟议的研究将对生物标志物产生直接影响- 告知新的治疗开发。