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Effect of TMS on PTSD Neuroimaging and Psychophysiological Biomarkers

TMS 对 PTSD 神经影像和心理生理生物标志物的影响

基本信息

批准号：
10630128
负责人：
Sanne JH van Rooij
金额：
$ 17.88万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10630128
关键词：
Acceleration African American Aftercare Amygdaloid structure Biological Biological Markers Brain Clinical Cognitive Cues Data Data Analyses Development Disease Distal Dose Down-Regulation Dropout Emotional FDA approved Financial Hardship Foundations Fright Funding Future Galvanic Skin Response Goals Hippocampus Hospitals Impairment Individual Differences Infrastructure Intervention Low income MRI Scans Major Depressive Disorder Measurable Measures Mental disorders Mentors Neurobiology Neuronavigation Neurosciences Outcome Outcome Measure Patient Recruitments Patients Persons Pharmaceutical Preparations Pharmacological Treatment Phenotype Physiologic pulse Physiology Placebos Population Post-Traumatic Stress Disorders Prefrontal Cortex Primary Care Protocols documentation Psychiatric therapeutic procedure Psychophysiology Randomized Recovery Regulation Research Research Personnel Safety Site Startle Reaction Stimulus Structure Symptoms Testing Therapeutic Effect Time Training Transcranial magnetic stimulation Trauma Treatment Efficacy Treatment outcome United States United States National Institutes of Health Universities Work career career development clinical investigation comorbidity conditioned fear experience experimental study functional disability healthy volunteer high risk improved interest neural circuit neurobiological mechanism neuroimaging neuroimaging marker neuromechanism neuroregulation novel personalized medicine predicting response predictive marker primary care clinic programs recruit research study response study population suicidal risk trauma exposure treatment duration treatment response

项目摘要

Project Summary/Abstract The purpose of this K01 proposal is to enable the PI to become an independent research investigator with expertise in focal neuromodulation, clinical investigations, and neuroimaging and psychophysiological biomarker research in traumatized populations and post-traumatic stress disorder (PTSD). The candidate's long-term goal is to build a NIH-funded research program to advance treatment for trauma-related disorders by understanding the neurobiological mechanisms of treatment and identifying predictive biomarkers for treatment outcome. The proposed study leverages the PI's experience with pre- and post-treatment studies in traumatized populations, PTSD biomarker research, and her strong foundation in neuroimaging and longitudinal data analyses. The training plan includes structured mentoring, hands-on training in Transcranial Magnetic Stimulation (TMS) and brain functional connectivity (FC) analyses, didactic coursework and a rigorous proposed research study in order to provide new training in 1) focal neuromodulation (TMS), 2) clinical investigations, 3) FC analyses, and additional training in 4) PTSD biomarkers, and 5) career development. With 30-50% of PTSD patients not responding to first line therapies, novel treatments are warranted; however, development is hampered by a lack of understanding of neural mechanisms underlying recovery from PTSD. TMS studies in PTSD have applied 1Hz stimulation over the rDLPFC and demonstrated a potential therapeutic effect, but the mechanism of TMS remains unclear. This K01 proposal aims to advance TMS treatment for PTSD by better understanding the mechanism of action of TMS and examining the effect of 1Hz rDLPFC stimulation on PTSD neuroimaging and psychophysiological biomarkers, particularly related to the fear neurocircuitry often implicated in PTSD and hypothesized to be improved by DLPFC stimulation. The proposed experiments leverage the infrastructure of the Grady Trauma Project (GTP), the largest civilian PTSD research study, for patient recruitment and clinical and biological assessment foundation. PTSD patients will be recruited and randomized to a TMS (N=30) or sham treatment (N=30) group. Neuroimaging and psychophysiological data will be collected in the week before and after the two-week treatment period (week 4). This K01 project will significantly contribute to the advancement of treatment for PTSD by: 1) determining if 1Hz TMS to the right DLPFC improves PTSD intermediate phenotypes; 2) suggesting novel brain modulation targets for future studies; 3) providing preliminary data for future studies examining individual differences for treatment response; and 4) advancing our understanding of neurobiology of PTSD treatment response using TMS as a probe.

项目总结/摘要本K 01提案的目的是使PI成为独立的研究者，在局灶性神经调节、临床研究、神经影像学和心理生理学生物标志物方面的专业知识对受创伤人群和创伤后应激障碍（PTSD）的研究。候选人的长期目标是建立一个NIH资助的研究项目，通过了解创伤相关疾病的治疗方法，治疗的神经生物学机制和识别治疗结果的预测生物标志物。的拟议的研究利用了PI在创伤人群中进行治疗前和治疗后研究的经验， PTSD生物标志物研究，以及她在神经成像和纵向数据分析方面的坚实基础。的培训计划包括结构化指导、经颅磁刺激（TMS）实践培训，大脑功能连接（FC）分析，教学课程和严格的研究建议，以提供以下方面的新培训：1）局灶性神经调节（TMS），2）临床研究，3）FC分析，以及 4）PTSD生物标志物和5）职业发展的额外培训。由于30-50%的PTSD患者对一线治疗没有反应，因此需要新的治疗方法;然而，由于缺乏对PTSD恢复的神经机制的理解，发展受到阻碍。经颅磁刺激（TMS）在创伤后应激障碍（PTSD）中的研究已经在rDLPFC上应用了1Hz刺激，并证明了一种潜在的治疗方法但TMS的作用机制尚不清楚。K 01提案旨在推进TMS治疗PTSD 通过更好地理解TMS的作用机制和检查1Hz rDLPFC刺激的效果，创伤后应激障碍神经影像学和心理生理学生物标志物，特别是与恐惧神经回路有关的，与创伤后应激障碍有关，并假设通过DLPFC刺激得到改善。拟议的实验利用格雷迪创伤项目（GTP）的基础设施，最大的民间创伤后应激障碍研究，为病人招募和临床和生物评估基金会。PTSD患者将被招募并随机分配 TMS组（N=30）和假手术组（N=30）。将收集神经影像学和心理生理学数据在两周治疗期（第4周）之前和之后的一周。K 01项目将大大有助于通过以下方式促进PTSD治疗：1）确定右侧DLPFC的1Hz TMS是否改善PTSD 中间表型; 2）为未来的研究提出新的脑调节靶点; 3）提供初步的未来研究的数据，检查治疗反应的个体差异;以及4）推进我们的使用TMS作为探针来理解PTSD治疗反应的神经生物学。

项目成果

期刊论文数量（12）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Dynamic Functional Connectivity Predicts Treatment Response to Electroconvulsive Therapy in Major Depressive Disorder.

DOI：
10.3389/fnhum.2021.689488
发表时间：
2021
期刊：
Frontiers in human neuroscience
影响因子：
2.9
作者：
Dini H;Sendi MSE;Sui J;Fu Z;Espinoza R;Narr KL;Qi S;Abbott CC;van Rooij SJH;Riva-Posse P;Bruni LE;Mayberg HS;Calhoun VD
通讯作者：
Calhoun VD

Community Violence Exposure is Associated with Hippocampus-Insula Resting State Functional Connectivity in Urban Youth.

DOI：
10.1016/j.neuroscience.2021.06.010
发表时间：
2021-08-01
期刊：
Neuroscience
影响因子：
3.3
作者：
Reda MH;Marusak HA;Ely TD;van Rooij SJH;Stenson AF;Stevens JS;France JM;Tottenham N;Jovanovic T
通讯作者：
Jovanovic T

Decreased Utilization of Environmental Information-A Key Deficit in Posttraumatic Stress Disorder?

环境信息利用的减少——创伤后应激障碍的一个关键缺陷？