Neuroimaging Biomarkers of Symptom Severity, Adverse Life Events and Prognosis in Motor Functional Neurological Disorders

运动功能性神经疾病症状严重程度、不良生活事件和预后的神经影像生物标志物

• 批准号: 10218015
• 负责人: David Lewis Perez
• 金额: $ 19.74万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-14 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10218015
• 关键词: Amygdaloid structure; Anterior; Applications Grants; Atrophic; Awareness; Behavior; Behavioral; Biologic Development; Biological; Biological Markers; Brain; Caring; Characteristics; Child Abuse; Clinic; Clinical; Clinical Research; Complement; Conversion disorder; Data; Diagnosis; Diagnostic; Diffusion Magnetic Resonance Imaging; Disease; Dorsal; Electroencephalography; Emotions; Evaluation; Event; Exhibits; Foundations; Functional Magnetic Resonance Imaging; Future; Goals; Growth; Healthcare Systems; Imaging Techniques; Individual; Insula of Reil; Laboratories; Laboratory Study; Life; Limb structure; Link; Magnetic Resonance Imaging; Measures; Mediating; Medical; Modeling; Moods; Morbidity - disease rate; Motor; Movement Disorders; Network-based; Neurobiology; Neurology; Neurosciences; Outpatients; Patient Self-Report; Patients; Population; Population Research; Prevalence; Prognosis; Psychiatry; Psychometrics; Publishing; Quality of life; Regulation; Research; Research Training; Rest; Risk Factors; Scientist; Seizures; Sensory; Severities; Somatoform Disorders; Structure; Symptoms; Techniques; Testing; Thick; Training; Traumatic Brain Injury; Vision; Work; base; cingulate cortex; clinical phenotype; cohort; cost; disorder risk; disorder subtype; experience; gray matter; health related quality of life; imaging modality; imaging study; improved; interest; magnetic resonance imaging biomarker; midbrain central gray substance; morphometry; multimodality; nervous system disorder; neuroimaging; neuroimaging marker; neuropsychiatric disorder; neuropsychiatry; neuroregulation; novel; preservation; prognostic; relating to nervous system; research study; response biomarker; tool development; tractography; treatment research; treatment response; white matter

PROJECT SUMMARY/ABSTRACT Functional Neurological Disorder (FND/ Conversion Disorder) is a highly prevalent and disabling neuropsychiatric condition. Motor FND symptoms include Nonepileptic Seizures, Functional Movement Disorders and Functional Weakness. Clinical research across these motor FND subtypes, including research studies from the candidate's laboratory, suggest that these populations share many clinical and phenotypic similarities that warrant increased research integration (Perez et al. Cogn Behav Neurol 2016; Matin & Perez et al. J Neuropsychiatry Clin Neurosci 2017). Furthermore, despite the prevalence of motor FND, little is known about the underlying neuropathophysiology of this condition, which is a prerequisite for the development of biologically informed prognostic and treatment response biomarkers. Across 3 published neurobiologically focused articles, the candidate proposed a framework through which to conceptualize motor FND (Perez et al. J Neuropsychiatry Clin Neurosci 2012, 2015, Clin EEG Neurosci 2015). It is suggested that motor FND develops in the context of structural and functional alterations in neurocircuits mediating emotion awareness/expression, bodily awareness, viscerosomatic processing and behavioral regulation. A particular focus of this grant application is the specific hypothesis that FND symptoms relate to structural and functional alterations within the salience network, which includes the anterior insula, anterior cingulate cortex, dorsal amygdala and periaqueductal gray. The overall goal of this proposal is to comprehensively investigate structural and functional MRI biomarkers of symptom severity, adverse life event burden (a FND risk factor) and prognosis across motor FND. Across aims 1-3 of this proposal, multimodal structural and functional magnetic resonance imaging (MRI) techniques (including voxel-based morphometry, cortical thickness, resting-state functional connectivity and diffusion tensor imaging tractography) are used to systemically probe brain-symptom severity, brain-trauma burden and brain-prognosis relationships. Novel aspects of this proposal include the study of the full spectrum of motor FND, consistent with a trans-diagnostic approach and Dr. Perez's training in the full complement of structural and resting state functional MRI techniques. This project leverages the candidate's past fMRI experience probing brain-symptom relationships in other neuropsychiatric disorders (Perez et al. Psychiatry Res 2015; Psychiatry Clin Neurosci 2016), as well as Dr. Perez's recently published MRI study probing gray matter volume associations with self-report measures of symptom severity and childhood abuse burden in patients with motor FND (Perez et al. J Neurol Neurosurg Psychiatry 2017). Pilot data for all 3 aims is presented in this proposal. These studies in motor FND will identify trans-diagnostic neural biomarkers linked to symptom severity, adverse life events and prognosis. The results of this project will catalyze future comprehensive prognostic and treatment research including the potential future study of targeted neuromodulation and treatment response biomarkers based on baseline neuroimaging profiles.

项目总结/文摘

项目成果

Individual differences in social network size linked to nucleus accumbens and hippocampal volumes in functional neurological disorder: A pilot study.

功能性神经系统疾病中与伏隔核和海马体积相关的社交网络大小的个体差异：一项试点研究。

• DOI: 10.1016/j.jad.2019.07.061
• 发表时间: 2019
• 期刊: Journal of affective disorders
• 影响因子: 6.6
• 作者: Ospina,JuanPablo;Larson,AnnaG;Jalilianhasanpour,Rozita;Williams,Benjamin;Diez,Ibai;Dhand,Amar;Dickerson,BradfordC;Perez,DavidL
• 通讯作者: Perez,DavidL

Individual differences in interoceptive accuracy and prediction error in motor functional neurological disorders: A DTI study.

• DOI: 10.1002/hbm.25304
• 发表时间: 2021-04-01
• 期刊: Human brain mapping
• 影响因子: 4.8
• 作者: Sojka P;Diez I;Bareš M;Perez DL
• 通讯作者: Perez DL

Autonomic, Endocrine, and Inflammation Profiles in Functional Neurological Disorder: A Systematic Review and Meta-Analysis.

• DOI: 10.1176/appi.neuropsych.21010025
• 发表时间: 2022
• 期刊: The Journal of neuropsychiatry and clinical neurosciences
• 作者: Paredes-Echeverri S;Maggio J;Bègue I;Pick S;Nicholson TR;Perez DL
• 通讯作者: Perez DL

Additional occupational therapy considerations for functional neurological disorders: a potential role for sensory processing.

功能性神经系统疾病的其他职业治疗注意事项：感觉处理的潜在作用。

• DOI: 10.1017/s1092852918000950
• 发表时间: 2018
• 期刊: CNS spectrums
• 影响因子: 3.3
• 作者: Ranford,Jessica;Perez,DavidL;MacLean,Julie
• 通讯作者: MacLean,Julie

The role of the anterior and midcingulate cortex in the neurobiology of functional neurologic disorder.

前扣带皮层和中扣带皮层在功能性神经系统疾病的神经生物学中的作用。

• DOI: 10.1016/b978-0-444-64196-0.00014-5
• 发表时间: 2019
• 期刊: Handbook of clinical neurology
• 作者: Ospina,JuanPablo;Jalilianhasanpour,Rozita;Perez,DavidL
• 通讯作者: Perez,DavidL