Neuromodulation for Enhancement of Emotion Regulation in Bipolar Mood Disorders

神经调节增强双相情感障碍的情绪调节

• 批准号: 9977311
• 负责人: Kristen K Ellard
• 金额: $ 19.93万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9977311
• 关键词: Address; Anatomy; Anterior; Aversive Stimulus; Behavioral; Bipolar Disorder; Brain; Chronic; Clinical Research; Cognitive Therapy; Computer Assisted; Computer Systems; Data; Development; Distress; Dorsal; Dose; Electromagnetics; Emotional; Emotions; Ensure; Feeling suicidal; Functional disorder; Future; Goals; Health Care Costs; Individual; Inferior; Insula of Reil; Intervention; Investigation; Literature; Magnetic Resonance; Maintenance; Mentors; Mood Disorders; Network-based; Neuronavigation; Neurosciences; Outcome; Parietal Lobe; Participant; Pathology; Pathway Analysis; Patients; Pattern; Performance; Pharmacology; Physiologic pulse; Prefrontal Cortex; Productivity; Psychopathology; Public Health; Randomized; Reaction Time; Research; Research Proposals; Scanning; Site; Statistical Methods; Synapses; Techniques; Technology; Testing; Training; Transcranial magnetic stimulation; Work; base; behavioral response; bipolar patients; cognitive reappraisal; cohort; efficacy testing; emotion dysregulation; emotion regulation; executive function; experience; improved; individual patient; innovation; neural circuit; neuroimaging; neuroregulation; precision medicine; programs; psychopharmacologic; psychosocial; recruit; relating to nervous system; response; specific biomarkers; success; suicidal behavior; tool; treatment strategy

PROJECT SUMMARY/ABSTRACT Individuals with bipolar mood disorders (BD) experience severe and episodic emotion dysregulation. Our existing pharmacological and psychosocial treatments fail to normalize emotion dysregulation for many bipolar patients. We need new and innovative approaches to help improve emotion dysregulation for these patients. The long-term goal of this proposal is to understand the pathophysiology of emotion dysregulation in BD, and to develop strategies to directly target and improve emotion regulation capacity. To this end, the candidate proposes: (1) training objectives to acquire expertise in advanced network-based analysis of neuroimaging data and training in the use of transcranial magnetic stimulation (TMS) as a translational clinical and research tool; (2) a research objective to identify patient-specific biomarkers of emotion dysregulation in BD and to experimentally engage these targets using TMS; (3) a team of mentors and advisors to ensure the candidate’s success, with expertise in bipolar disorder pathology and treatment (Dr. Andrew Nierenberg), advanced network analysis of neuroimaging data (Dr. Randy Buckner), clinical and research applications of TMS (Dr. Mark George and Dr. Joan Camprodon), neuromodulation of mood disorders (Dr. Darin Dougherty), emotion regulation (Dr. James Gross), task-based neuroimaging in BD (Dr. Thilo Deckersbach), and advanced statistical methods (Dr. Mark Vangel). The central hypothesis of the research proposal is that neuromodulation of patient-specific targets of emotion regulation-related neurocircuitry using TMS will enhance the capacity for emotion regulation in BD. The rationale for this proposal is that existing treatments don’t adequately address severe emotion dysregulation in BD, thus new innovative approaches are needed. This project has the potential to provide preliminary evidence for the future development of TMS as an innovative treatment strategy that can be used adjunctive to existing treatments to improve emotion regulation in BD. Specific aims proposed are: 1) to identify patient-specific pathophysiological markers of implicit and explicit emotion dysregulation in BD; 2) to determine the effect of TMS on emotion regulation circuit dynamics in BD; and 3) to determine the effect of TMS on emotion regulation behavioral responses in BD. The approach is innovative in that it uses a patient- specific, precision medicine approach with combined TMS-fMRI to target and probe emotion dysregulation at the level of neurocircuitry. The proposed research is significant, because it is has the potential to advance our understanding of the pathophysiology of emotion dysregulation in BD and will provide crucial pilot data towards testing the efficacy of TMS for improving emotion dysregulation in BD patients. Overall, the candidate will use this project and its associated training to transition and expand this work into an independent program of research developing neuroscience-informed interventions for bipolar mood disorders.

项目总结/摘要 双相情感障碍（BD）患者会经历严重的偶发性情绪失调。我们 现有的药理学和心理社会学治疗不能使许多双相情感障碍正常化 患者我们需要新的和创新的方法来帮助改善这些患者的情绪失调。 这项提案的长期目标是了解BD患者情绪失调的病理生理学， 制定直接针对和提高情绪调节能力的策略。为此，候选人 建议：（1）培训目标，以获得先进的基于网络的神经影像数据分析的专业知识 以及培训使用经颅磁刺激（TMS）作为转化临床和研究工具; (2)研究目的是确定BD患者情绪失调的特异性生物标志物， 使用TMS实验性地吸引这些目标;（3）导师和顾问团队，以确保候选人的 成功，在双相情感障碍病理学和治疗的专业知识（安德鲁尼伦伯格博士），先进的 神经影像学数据的网络分析（Randy Buckner博士），TMS的临床和研究应用（Dr. Mark乔治和Joan Camprodon博士），情绪障碍的神经调节（Darin Doughnut博士），情绪 调节（James Gross博士），BD中基于任务的神经成像（Thilo Deckersbach博士），以及高级 统计方法（Mark Vangel博士）。研究建议的中心假设是神经调节 使用TMS的情绪调节相关神经回路的患者特异性目标将增强 BD的情绪调节这一建议的基本原理是，现有的治疗方法不能充分解决 BD患者存在严重的情绪失调，因此需要新的创新方法。这个项目有潜力 为TMS作为创新治疗策略的未来发展提供初步证据， 可以用于替代现有的治疗方法，以改善BD的情绪调节。建议的具体目标是： 1)确定BD患者内隐和外显情绪失调的特定病理生理学标志物; 2)确定TMS对BD患者情绪调节回路动力学的影响; 3）确定TMS对BD患者情绪调节回路动力学的影响。 TMS对BD患者情绪调节行为反应的影响。这种方法是创新的，因为它使用了一个病人- 结合TMS-fMRI的特定精确医学方法，以靶向和探测情绪失调， 神经回路的水平。这项研究具有重要意义，因为它有可能推动我们的研究。 了解BD情绪失调的病理生理学，并将提供关键的试点数据 旨在测试TMS改善BD患者情绪失调的疗效。总的来说，候选人 我将利用这个项目及其相关的培训，将这项工作转变和扩展为一个独立的项目 研究开发双相情感障碍的神经科学干预措施。