MRI Markers of Feedback Timing during Learning in Individuals with TBI with and without Clinical Depression

患有或不患有临床抑郁症的 TBI 个体学习期间反馈时间的 MRI 标记

• 批准号: 10183077
• 负责人: Ekaterina Dobryakova
• 金额: $ 38.32万
• 依托单位: KESSLER FOUNDATION, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10183077
• 关键词: Address; Area; Brain; Brain Injuries; Caregiver Burden; Clinical; Cognition; Cognitive; Collaborations; Corpus striatum structure; Data; Depressed mood; Development; Diagnostic; Disadvantaged; Dissociation; Effectiveness; Environment; Exhibits; Feedback; Fostering; Functional Magnetic Resonance Imaging; Funding; Goals; Health Care Costs; Heart; Impairment; Individual; Inpatients; Intervention; Interview; Investigation; Knowledge; Lead; Learning; Lentiform nucleus structure; Link; Magnetic Resonance Imaging; Major Depressive Disorder; Measures; Memory; Mental Depression; Mission; National Institute of Neurological Disorders and Stroke; Neuropsychology; Outpatients; Parkinson Disease; Participant; Pathway interactions; Patients; Performance; Phase; Population; Prevalence; Probability; Process; Protocols documentation; Publishing; Recording of previous events; Rehabilitation Outcome; Rehabilitation therapy; Research; Standardization; Structure; Testing; Translating; Traumatic Brain Injury; Verbal Learning; base; brain circuitry; clinical practice; clinically significant; cognitive process; comorbidity; depressive symptoms; design; executive function; experience; experimental study; functional independence; imaging biomarker; improved; innovation; knowledge base; neural circuit; neuromechanism; novel; recruit; rehabilitation strategy; standardize measure

Project Summary/Abstract The overall objective of the proposed project is to investigate brain mechanisms during learning in individuals with traumatic brain injury (TBI) with and without clinical depression. Such knowledge can help guide rehabilita- tion strategies and reduce the burden of TBI. Feedback about the accuracy of one’s actions can improve learn- ing by informing individuals whether their action is correct or not. Individuals with depression have been shown to have learning deficits and altered brain activity during learning compared to healthy individuals when feed- back is presented immediately. Impaired learning through immediate feedback has also been observed in Par- kinson’s disease (PD) patients. However, PD patients are able to learn from feedback when it is presented af- ter a delay through engagement of separate neural mechanisms. We show that individuals with TBI exhibit def- icits in learning through immediate feedback that are likely exacerbated by depressive symptoms. Deficits in learning through immediate feedback can lead to perseveration of incorrect actions and decreased strategy use during rehabilitation. However, there is no evidence directly examining the neural mechanisms of learning in individuals with TBI with and without depression. The proposed research fills this gap. The identification of the neural mechanisms associated with learning in individuals with TBI with and without clinical depression will inform 1) scientific knowledge about the effect of depression on the injured brain, 2) TBI interventions about the effectiveness of feedback and its timing, and 3) the development of generalized interventions for other clinical populations that require rehabilitation and have high occurrence of depression. These objectives lie at the heart of the mission of the NINDS as they will broaden “fundamental knowledge about the brain and nervous system” associated with learning in TBI. The knowledge gained from fulfilling the above objectives will “reduce the burden” of learning deficits after TBI. To test our hypotheses, TBI participants will be recruited based on structured clinical interview. Qualified participants will perform an experiment where they study word pairs out- side of the functional magnetic resonance imaging (MRI) scanner. Then, in the MRI, participants will see word pairs in multiple-choice format, along with novel distractors, and select the correct paired-associate. After each choice, feedback will be experimentally manipulated to be presented either immediately or after a 25-minute delay. During the final phase outside of the MRI, participants complete a second diagnostic paired-associate multiple-choice assessment to evaluate the influence of immediate vs. delayed feedback on learning. We hy- pothesize that depressed individuals with TBI will show improvements in learning from delayed compared to immediate feedback. This learning dissociation will occur because learning through delayed feedback relies on neurocircuitry that is not negatively affected by TBI and depression. Non-depressed individuals without TBI and clinically depressed individuals without TBI will also be recruited to differentiate the influences of depres- sion from the impact of TBI on the brain.

项目摘要/摘要 该项目的总体目标是研究个体学习过程中的大脑机制。 伴有和不伴有临床抑郁的创伤性脑损伤(TBI)。这样的知识可以帮助指导康复者- 控制策略，减轻颅脑损伤负担。对一个人行为的准确性的反馈可以改善学习- ING通过告知个人他们的行为是否正确来实现。患有抑郁症的人已经被证明 与健康的人相比，在学习过程中有学习缺陷和大脑活动改变的人 BACK被立即呈现。通过即时反馈而导致的学习障碍也被观察到了 金森氏病(PD)患者。然而，帕金森病患者能够从反馈中学习。 通过连接不同的神经机制来延时。我们表明，患有脑外伤的个体表现出明显的 通过即时反馈进行学习的机会，抑郁症状可能会加剧这种情况。中国的赤字 通过即时反馈学习可能会导致坚持错误的行动和减少策略 在康复过程中使用。然而，没有证据直接检验学习的神经机制。 在患有和不伴有抑郁的脑损伤患者中。这项拟议的研究填补了这一空白。身份的鉴定 伴和不伴临床抑郁的脑外伤患者与学习相关的神经机制将 告知1)有关抑郁对受损大脑的影响的科学知识，2)关于脑损伤的脑损伤干预 反馈的有效性及其时机，以及3)其他临床综合干预措施的发展 需要康复和抑郁症发生率较高的人群。这些目标在于 NINDS的使命的核心，因为他们将拓宽关于大脑和神经的基本知识 系统“与在TBI中学习有关。实现上述目标所获得的知识将“减少” 脑外伤后学习障碍的负担。为了验证我们的假设，我们将根据以下条件招募TBI参与者 有组织的临床访谈。合格的参与者将进行一项实验，他们学习单词对-- 功能磁共振成像(MRI)扫描仪的一侧。然后，在核磁共振中，参与者将看到Word 用多项选择题和新奇的干扰词，选择正确的配对连词。在每个 选择，反馈将被实验性地处理为立即或25分钟后呈现 延迟。在MRI之外的最后阶段，参与者完成第二次配对诊断 多项选择评估评估即时反馈与延迟反馈对学习的影响。我们- 研究表明，与其他患者相比，患有脑损伤的抑郁患者在学习延迟方面会有改善。 即时反馈。这种学习分离将会发生，因为通过延迟反馈进行学习依赖于 不会受到脑外伤和抑郁症的负面影响的神经回路。无脑损伤的非抑郁症患者 而临床上没有脑外伤的抑郁症患者也将被招募来区分抑郁症的影响。 Sion来自于脑外伤对大脑的影响。