Longitudinal study of sleep duration, reward and cognitive control circuits, and vulnerability for depression and suicidal ideation during adolescence

项目摘要 青春期开始了一段易患抑郁症和自杀倾向以及睡眠不足的时期。短睡眠 持续时间在年轻人中极为常见（即，44%的高中生报告睡眠时间为6小时或更少。 是抑郁、自杀和其他负面结果的危险因素。睡眠损失 假设通过干扰奖励和认知控制神经元来影响内化症状 途径。这些大脑网络在青春期继续发育，与发育和 维持抑郁症，并已被证明是敏感的急性睡眠限制，在我们以前的 实验工作。我们的发现是，在以下情况下，奖励和认知控制回路中的激活变钝， 睡眠限制（与睡眠延长相比）提供了涉及睡眠丧失合理机制 在发展内在精神病理学的道路上。扩展这一工作线的下一个关键步骤是 研究睡眠不足的累积效应，自然地研究睡眠过程中睡眠与大脑的关系， 在一个学年中，并检查这些预测抑郁症纵向变化的程度， 自杀倾向这就是我们提出的研究目标。我们计划招募210名11.5岁的年轻人- 14.5（66%的女性），目前在7年级，8年级或9年级，代表了习惯性睡眠的连续性 持续时间，但确保50%的睡眠时间为7小时或更少。参与者将在接下来的4年里接受随访 在青春期抑郁发作的高峰期，通过活动记录仪对睡眠进行年度评估 和行为测量（奖励学习，认知控制），沿着fMRI扫描基线（7 - 9年级） 2年后（9 - 11年级）重复。将每季度收集网上自我报告评估 （每3个月一次;共14-16次），以检查睡眠变化之间更细微的时间关联。 持续时间、抑郁症状和自杀意念。在这个纵向4年设计中，我们将研究如何 睡眠时间的减少会影响奖赏和认知控制， 联合预测随后的抑郁症状和自杀意念。睡眠不足可能是一个重要的- 但可以改变的精神病理学脆弱性因素了解睡眠的时间关联 和心理健康-以及神经机制的作用-将有助于更好地针对以睡眠为重点的干预措施 决定什么时候，什么人，最适合做。研究结果将提供杠杆作用， 开发新的干预措施，增强现有的（睡眠或心理健康）治疗，和/或改变公众 策略（即，晚些时候开学），以改善青少年的睡眠，并最终防止内化障碍。

Project Summary Adolescence begins a period of vulnerability for depression and suicidality, as well as for sleep loss. Short sleep duration is extremely common in youth (i.e., 44% of high school students report 6 or less hours of sleep on school nights), and is a risk factor for depression, suicidality, and other negative outcomes. Sleep loss is hypothesized to exert an influence on internalizing symptoms by disrupting reward and cognitive control neural pathways. These brain networks continue to develop during adolescence, are implicated in the development and maintenance of depression, and have been shown to be sensitive to acute sleep restriction in our prior experimental work. Our findings of blunted activation within both reward and cognitive control circuitry following sleep restriction (as compared to sleep extension) provide plausible mechanisms by which sleep loss is involved in the pathway to developing internalizing psychopathology. The next critical step to extend this line of work is to examine the cumulative effects of insufficient sleep, to examine sleep-brain relationships naturalistically during the school year, and to examine the extent to which these predict longitudinal changes in depression and suicidality. These are the goals of our proposed study. We propose to enroll a sample of 210 youth ages 11.5– 14.5 (66% female), who are currently in the 7th, 8th, or 9th grades, representing a continuum of habitual sleep duration, but ensuring 50% with 7 or fewer hours of sleep. Participants will then be followed for the next 4 years during the peak risk for depression onset during adolescence, with annual assessments of sleep via actigraphy and behavioral measures (reward learning, cognitive control), along with fMRI scans at baseline (7th–9th grade) and repeated 2 years later (in 9th–11th grade). Self-report internet-based assessments will be collected quarterly (every 3 months; 14–16 in total) to examine more nuanced temporal associations between changes in sleep duration, depression symptoms, and suicidal ideation. In this longitudinal 4-year design, we will examine how declining sleep duration influences reward and cognitive control, and whether sleep and these mechanisms jointly predict subsequent depression symptoms and suicidal ideation. Insufficient sleep may be an important— yet modifiable—vulnerability factor for psychopathology. Understanding the temporal associations linking sleep and mental health—as well as the role of neural mechanisms—will help better target sleep-focused interventions by determining when, and in whom, they would best be directed. Study findings will provide leverage for developing novel interventions, augmenting existing (sleep or mental health) treatments, and/or changing public policy (i.e., later school start times) to improve adolescent sleep, and ultimately, prevent internalizing disorders.