Primary Research Project: Functional MRI

主要研究项目：功能性核磁共振成像

• 批准号: 7645104
• 负责人: Helen S Mayberg
• 金额: $ 23.28万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7645104
• 关键词: Acute myocardial infarction; Algorithms; American; Anterior; Antidepressive Agents; Base of the Brain; Behavioral; Biochemical Genetics; Brain; Brain Stem; Brodmann' s area; Caliber; Cardiac; Cardiology; Classification; Clinical; Clinical Management; Cognitive Therapy; Complex; Condition; Coronary artery; Corpus striatum structure; Data; Depressed mood; Development; Diabetes Mellitus; Diagnosis; Diagnostic tests; Disease; Disease remission; Escitalopram; Evaluation; Family Physicians; Functional Magnetic Resonance Imaging; Genetic; Goals; Health Professional; Hippocampus (Brain); Hyperlipidemia; Hypertension; Hypothalamic structure; Image; Individual; Intervention; Lateral; Life Style; Magnetic Resonance Imaging; Major Depressive Disorder; Measurement; Measures; Medial; Medical; Mental Depression; Mental Health; Methods; Modeling; Multivariate Analysis; Myocardial Ischemia; Organ; Outcome; Patients; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Psychiatrist; Psychologist; Psychosocial Factor; Psychotherapy; Randomized; Recording of previous events; Research Project Grants; Rest; Risk Factors; Role; Scanning; Selection Bias; Selective Serotonin Reuptake Inhibitor; Smoking; Standards of Weights and Measures; Testing; Time; Training; Treatment outcome; Week; base; cohort; college; diet and exercise; duloxetine; interest; research study; response; single episode major depressive disorder; tool

Although there are several effective treatments for a major depressive episode, there are no reliable predictors of the likelihood of remission, response or non-response with an initial trial of either an antidepressant medication or psychotherapy. In prioritizing a role for direct measures of brain functioning in the development of new algorithms for clinical management of depressed patients, a systematic characterization of pretreatment patterns predictive of unambiguous remission to standard treatments is a necessary first step. This project will characterize imagingbased brain subtypes that distinguish groups of never-treated depressed patients who subsequently respond to pharmacotherapy or cognitive behavior therapy (CBT), respectively. A prospectively-treated cohort of 400 never-treated depressed patients randomized to receive either escitalopram, duloxetine or CBT for 1.2 weeks will define these subtypes. Resting-state BOLD functional magnetic resonance imaging (fMRI) scans will be acquired prior to initiating antidepressant therapy and at a fixed, early time point specific for each treatment. Pre-treatment scan patterns derived using multivariate analyses and associated with the six possible response outcomes (3 types of response; 3 types of nonresponse) will be used to determine whether pretreatment brain patterns can distinguish among outcome groups. A second fMRI scan, acquired early in the treatment course, will be used to assess the likelihood of response to the specific treatment assigned. The proposed studies are a first step towards defining brain-based subtypes predictive of differential treatment outcome in major depression. The data from these studies will also be entered into more complex algorithms integrating imaging findings with behavioral, environmental, biochemical and genetic information for individual patients.

虽然有几种有效的治疗重度抑郁发作的方法，但没有