Cranial electrotherapy stimulation: Piloting a road to PTSD prevention in first responders

颅脑电疗刺激：在急救人员中试行预防 PTSD 的道路

• 批准号: 10853457
• 负责人: BENJAMIN D GREENBERG
• 金额: $ 66.08万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10853457
• 关键词: Address; Administrative Supplement; Affect; Arousal; Automobile Driving; Award; Biometry; Brain; Centers of Research Excellence; Cephalic; Chronic; Clinic; Clinical Psychology; Cognitive; Collaborations; Development; Distress; Early Intervention; Ecological momentary assessment; Economics; Effectiveness; Electric Stimulation Therapy; Emotions; Environmental Monitoring; Exposure to; FDA approved; Fatigue; Frequencies; Future; Goals; Grant; Homeostasis; Hormones; Hospitals; Hydrocortisone; Individual; Infrastructure; Intervention; Knowledge; Limbic System; Literature; Measures; Medical; Memory; Mental Depression; Mental disorders; Methodology; Nature; Occupations; Opioid; Outcome; Overdose; Parents; Pathogenesis; Persons; Pharmacotherapy; Physiologic pulse; Physiological; Physiology; Pilot Projects; Post-Traumatic Stress Disorders; Prevention; Prevention strategy; Principal Investigator; Process; Protocols documentation; Psychiatry; Psychotherapy; Recurrence; Research Personnel; Resources; Rhode Island; Risk; Sampling; Schedule; Scientist; Signal Transduction; Sleep; Sleeplessness; Source; Stress; Structure; System; Techniques; Testing; Thalamic structure; Time; Training; Trauma; Work; acceptability and feasibility; allostatic load; anxiety symptoms; anxiety treatment; biological adaptation to stress; brain research; career; clinical translation; comorbidity; disorder prevention; effective intervention; effective therapy; experience; feasibility testing; fighting; fire fighter; first responder; heart rate variability; high risk; hormonal signals; indexing; innovation; insight; neural; neural circuit; neuropsychiatric disorder; neuropsychiatry; neuroregulation; noninvasive brain stimulation; novel strategies; positive emotional state; prevent; preventive intervention; resilience; side effect; skills; sleep quality; stem; stress reduction; success; symptomatic improvement; traumatic event; traumatic stress

PROJECT SUMMARY The goal of the Butler Hospital COBRE Center for Neuromodulation parent award is to support interdisciplinary clinical-translational brain research by creating the key infrastructure to support the careers of interdisciplinary investigators with as overall objective to advance the use of noninvasive neuromodulation in circuit-based therapies for neuropsychiatric disorders, including posttraumatic stress disorder. In doing so, the COBRE Center for Neuromodulation addresses the pressing need for innovative and effective treatments for people struggling with psychiatric disorders. The current proposal builds upon this overarching objective. Specifically, the proposed administrative supplement aims to test the feasibility and acceptability of a four-week course of noninvasive cranial electrotherapy stimulation (CES) as well as establish an early signal of CES effects on homeostatic functioning in a sample of firefighter first responders. Firefighters are at ultra-high risk for developing posttraumatic stress disorder due to the nature of their occupation which has both dire personal as well as economic, workforce- related consequences. Therefore, there is an urgent need for an effective preventative intervention for posttraumatic stress disorder. This is scientifically challenging, and current intervention strategies that aim to prevent the development of posttraumatic stress disorder have either had little to modest success (e.g., pharmacotherapy) or are unrealistic to implement when the source of trauma is one's occupation and thus unavoidable (e.g., psychotherapy). The repeated exposure to traumatic events regularly faced by firefighters puts them at risk for homeostatic dysregulation, contributing to the pathogenesis of posttraumatic stress disorder. CES is thought to reestablish physiological homeostasis, thus reducing the negative consequences of (repeated) traumatic stress. However, despite literature on CES effectiveness to improve symptoms of anxiety, insomnia, and depression, the mechanism of CES effects on homeostatic functioning remains rather hypothetical with little direct evidence to date. In addition, the application of CES should be carefully integrated with firefighter work schedules. Even though CES carries little to no side effects and can be done safely outside the clinic, its usage would be restricted to off-duty days which raises important questions about CES feasibility and acceptability in firefighters. Ultimately, the long-term goal of this line of work is to develop an effective, easily deployable, proactive intervention to prevent the development of posttraumatic stress disorder in first responders. To test feasibility, acceptability, and early signal of CES homeostasis, we have assembled a collaborative partnership between investigators of the Butler Hospital COBRE for Neuromodulation and the Rhode Island Hospital COBRE on Opioids and Overdose. Both the COBRE for Neuromodulation and the COBRE on Opioids and Overdose are in Rhode Island within a 10-minute driving distance. This proximity permits a close partnership between investigators. The proposed complimentary and interdisciplinary team will leverage expertise on the pathogenesis of posttraumatic stress disorder and methodological strengths from the fields of psychiatry (Dr. Fukuda), cognitive neuropsychiatry (Dr. van ’t Wout-Frank), and clinical psychology (Dr. Weiss) to propose the use of CES as a novel approach to posttraumatic stress disorder prevention. Dr. Fukuda, Principal Investigator on a pilot project supported through the COBRE Center for Neuromodulation, and Dr. van ’t Wout-Frank, Project Leader within the COBRE Center for Neuromodulation, provide the expertise in posttraumatic stress disorder, infrastructure to support the administration of CES as a noninvasive brain stimulation technique, and in assessing its effects via measuring brain activity and (psycho)physiology, including the stress hormone cortisol and heart rate variability. However, the COBRE Center for Neuromodulation at Butler Hospital does not currently include investigators with the combined expertise in posttraumatic stress disorder and advanced skills to assess the effects of noninvasive brain stimulation techniques in a naturalistic and near real-time manner. This additional critical expertise comes from Dr. Weiss, a Project Leader affiliated with the COBRE on Opioids and Overdose through Rhode Island Hospital, who will lead the implementation of ecological momentary assessments to naturalistically and in near real-time assess the effects of CES. This team is uniquely poised to preliminarily, yet comprehensively, assess whether and how CES would be beneficial for prevention of posttraumatic stress disorder based on ecological monitoring of subjective (i.e., negative and positive affect, fatigue) and objective biometric indices of stress responses (i.e., heart rate variability, cortisol, quality of sleep) and neural circuit changes (i.e., thalamic functioning and default mode network structural and functional connectivity). The proposed project allows the building and strengthening of new collaborations between investigators from two distinct Centers of Biomedical Research Excellence to expand and strengthen scientific resources and expertise for future grant submissions to address the critical need to prevent posttraumatic stress disorder in those in high-risk occupations such as firefighter first responders.

项目摘要 巴特勒医院COBRE神经调节中心家长奖的目标是支持跨学科 通过创建关键基础设施来支持跨学科的职业生涯， 研究者的总体目标是推进无创神经调节在基于回路的 治疗神经精神障碍，包括创伤后应激障碍。在此过程中，COBRE 神经调节中心解决了人们对创新和有效治疗的迫切需求 与精神疾病作斗争 目前的建议是以这一总体目标为基础的。具体而言，拟议的行政 补充旨在测试为期四周的非侵入性颅骨检查的可行性和可接受性 电疗刺激（CES）以及建立CES对稳态功能影响的早期信号 在消防员第一反应者的样本中。消防员患创伤后应激障碍的风险极高 由于他们的职业性质造成的混乱，这种职业既有可怕的个人问题，也有经济问题，劳动力- 相关后果。因此，迫切需要采取有效的预防性干预措施， 创伤后应激障碍这在科学上具有挑战性，目前的干预战略旨在 预防创伤后应激障碍的发展要么几乎没有成功（例如， 药物治疗）或不切实际的实施时，创伤的来源是一个人的职业， 不可避免的（例如，心理治疗）。消防员经常面临的反复暴露于创伤事件 使他们处于自我平衡失调的风险中，从而导致创伤后应激的发病机制 disorder. CES被认为可以重建生理稳态，从而减少 （反复）创伤性压力。然而，尽管有关于CES有效改善焦虑症状的文献， 失眠和抑郁症，CES对稳态功能的作用机制仍然相当 迄今为止几乎没有直接证据的假设。此外，CES的应用还应谨慎整合 消防员的工作时间表即使CES几乎没有副作用，也可以安全地进行 在诊所之外，它的使用将仅限于下班时间，这引发了关于CES的重要问题 在消防员中的可行性和可接受性。最终，这一工作的长期目标是开发一个 有效的、易于部署的、积极的干预措施，以防止创伤后应激障碍的发展 在第一反应。 为了测试CES稳态的可行性，可接受性和早期信号，我们已经组装了一个合作的 巴特勒医院COBRE神经调节和罗得岛的研究人员之间的伙伴关系 医院眼镜蛇对阿片类药物和过量。神经调节的COBRE和阿片类药物的COBRE 和Overdose位于罗得岛，距离酒店不到10分钟车程。这种接近允许一个紧密的 调查人员之间的合作。拟议的免费跨学科小组将利用 创伤后应激障碍发病机制的专门知识和方法优势， 精神病学（福田博士）、认知神经精神病学（货车't Wout-Frank博士）和临床心理学（韦斯博士） 提出使用CES作为预防创伤后应激障碍的新方法。福田博士， 首席研究员在一个试点项目的支持下，通过COBRE中心神经调节，博士。 货车't Wout-Frank是COBRE神经调节中心的项目负责人， 创伤后应激障碍，支持CES作为非侵入性大脑管理的基础设施 刺激技术，并通过测量大脑活动和（心理）生理学来评估其效果， 包括应激激素皮质醇和心率变异性。然而，COBRE中心 巴特勒医院的神经调节目前不包括具有以下综合专业知识的研究者： 创伤后应激障碍和先进的技能，以评估非侵入性脑刺激的影响 以自然和接近实时的方式。这一额外的关键专业知识来自韦斯博士， 隶属于COBRE的项目负责人，通过罗得岛医院负责阿片类药物和过量，他将 引导生态瞬时评估的实施，以自然和近实时的方式评估 CES的影响。这个小组是唯一准备初步，但全面，评估是否和 如何CES将有利于预防创伤后应激障碍的基础上生态监测 主观的（即，消极和积极的影响，疲劳）和压力反应的客观生物测定指数（即， 心率变异性、皮质醇、睡眠质量）和神经回路变化（即，丘脑功能和默认 模式网络结构和功能连接性）。该项目允许建筑和 加强来自两个不同生物医学研究中心的研究人员之间的新合作 卓越，以扩大和加强科学资源和专业知识，为未来的赠款提交，以解决 迫切需要预防那些从事高风险职业的人（如消防员）的创伤后应激障碍 第一反应。

项目成果

Limitations of performance validity tests in dementia evaluations: The role of base rates.

• DOI: 10.1037/pas0001166
• 发表时间: 2022-11
• 期刊: PSYCHOLOGICAL ASSESSMENT
• 影响因子: 3.6
• 作者: Gaudet, Charles E;Castelluccio, Brian;Gold, Dov;McLaughlin, Nicole C R;Correia, Stephen
• 通讯作者: Correia, Stephen

Exploring response inhibition and error monitoring in obsessive-compulsive disorder.

• DOI: 10.1016/j.jpsychires.2020.04.002
• 发表时间: 2020-04
• 期刊: Journal of psychiatric research
• 影响因子: 4.8
• 作者: Vitor Portella Silveira;I. Frydman;Leonardo Franklin Fontenelle;P. Mattos;R. de Oliveira-Souza;J. Moll;M. Hoexter;E. Miguel;N. McLaughlin;E. Shephard;M. Batistuzzo

Mechanical Affective Touch Therapy for Anxiety Disorders: Feasibility, Clinical Outcomes, and Electroencephalography Biomarkers From an Open-Label Trial.

• DOI: 10.3389/fpsyt.2022.877574
• 发表时间: 2022
• 期刊: FRONTIERS IN PSYCHIATRY
• 影响因子: 4.7
• 作者: Carpenter, Linda L.;Kronenberg, Eugenia F.;Tirrell, Eric;Kokdere, Fatih;Beck, Quincy M.;Temereanca, Simona;Fukuda, Andrew M.;Garikapati, Sahithi;Hagberg, Sean
• 通讯作者: Hagberg, Sean

Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response.

• DOI: 10.1038/s41398-023-02425-2
• 发表时间: 2023-04-26
• 期刊: TRANSLATIONAL PSYCHIATRY
• 影响因子: 6.8
• 作者: McLaughlin, N. C. R.;Magnotti, J. F.;Banks, G. P.;Nanda, P.;Hoexter, M. Q.;Lopes, A. C.;Batistuzzo, M. C.;Asaad, W. F.;Stewart, C.;Paulo, D.;Noren, G.;Greenberg, B. D.;Malloy, P.;Salloway, S.;Correia, S.;Pathak, Y.;Sheehan, J.;Marsland, R.;Gorgulho, A.;De Salles, A.;Miguel, E. C.;Rasmussen, S. A.;Sheth, S. A.
• 通讯作者: Sheth, S. A.

Practice makes plasticity: 10-Hz rTMS enhances LTP-like plasticity in musicians and athletes.

• DOI: 10.3389/fncir.2023.1124221
• 发表时间: 2023
• 期刊: FRONTIERS IN NEURAL CIRCUITS
• 影响因子: 3.5
• 作者: Kweon, Jamie;Vigne, Megan M.;Jones, Richard N.;Carpenter, Linda L.;Brown, Joshua C.
• 通讯作者: Brown, Joshua C.