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Anti-depressant response in neurobiologically defined psychiatric veteran groups

神经生物学定义的精神病退伍军人群体的抗抑郁反应

基本信息

批准号：
10038794
负责人：
ALAN N SIMMONS
金额：
--
依托单位：
VA SAN DIEGO HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-10-01 至 2021-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10038794
关键词：
Affect Amygdaloid structure Anterior Antidepressive Agents Arousal Award Behavior Behavioral Behavioral Symptoms Biological Biological Assay Brain Brain imaging Cellular biology Classification Clinic Clinical Clinical Research Clinical Treatment Cognitive Complex Data Diagnosis Diagnostic Disease Distress Drug Prescriptions Economics Emotional FDA approved Face Family Fostering Fright Future Generalized Anxiety Disorder Genes Genetic Goals Grant Grouping Health Care Costs Hippocampus (Brain)Individual Insula of Reil Interleukin-6 Lead Learning Link Literature Machine Learning Major Depressive Disorder Measures Medical Mental Depression Mental Health Mental disorders Mission Modeling Molecular Molecular Biology Neurobiology Neurotransmitters Outcome Patients Pattern Peripheral Pharmaceutical Preparations Pharmacology Pharmacotherapy Physiological Physiology Population Post-Traumatic Stress Disorders Prediction of Response to Therapy Predictive Value Psychiatric Diagnosis Psychiatric therapeutic procedure Quality of life Research Risk Running Selective Serotonin Reuptake Inhibitor Serotonin Sertraline Signal Transduction Soldier Startle Reaction Statistical Methods Stress Subgroup Symptoms System Testing Treatment outcome Veterans Work base behavioral phenotyping clinical practice combat comorbidity disease classification feasibility testing heart rate variability high risk imaging study improved inflammatory marker interest mild traumatic brain injury military veteran multidisciplinary novel strategies optimal treatments predict clinical outcome predictive modeling psychopharmacologic random forest response success supervised learning treatment response white matter

项目摘要

The soldiers that face combat are at high risk for the potentially significant repercussions of combat stress. Combat stress can lead to a number of impactful emotional and cognitive conditions, most notably Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and mild Traumatic Brain Injury (mTBI). While there have been attempts to match a specific neurobiological pattern to a specific DSM identified disorder, the pursuit has met limited success. Clinically, different DSM diagnoses are often approached with similar treatments with similar response rates (~33-50%). Clinically groups are identified my sets behaviors (DSM disorders) and research has aimed to find the neurobiological underpinnings of these behavior defined groups. Our aim is to instead identify neurobiological groups in the context of underlying neurobiological and with the long term goal of improving response rates to medical trials be clustering of relevant features. However, due to the complex relationship between the neurobiological variables a simple linear relationship or risk score is not appropriate. Here we present a novel approach in which we define neurobiologically distinct subgroups — based on the most feasible, most robust, and most likely to relate to treatment outcomes — in these Veterans with combat related psychiatric distress. We have selected a set of brain imaging, molecular biology, and physiological markers such that measures will not be influenced by current clinical models. We will then seek to determine robust subgroups from this model-based hierarchical clustering approach. Next, we contrast our neurobiologically defined groups with traditional groups or general response. Finally, to help best understand the available data and feed forward for future studies, we will run a supervised machine learning (random forest) to determine the optimal variables and groups to predict treatment response. We have opted to solely test sertraline, as this is the most commonly prescribed medication in this population at the San Diego VA mental health clinics (FDA approved for MDD and PTSD). The model-based clustering approach allows us to look at the non-linear relationship between variables of interest and foster an attempt to better link clinical research and clinical practice to best benefit our Veteran population.

面对战斗的士兵面临着潜在的重大影响的高风险

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Higher affective congruency in the approach-avoidance task is associated with insular deactivation to dynamic facial expressions.

在避免进近任务中，更高的情感一致性与与动态面部表情的岛屿失活有关。

DOI：
10.1016/j.neuropsychologia.2020.107734
发表时间：
2021-01-22
期刊：
Neuropsychologia
影响因子：
2.6
作者：
Harlé KM;Simmons AN;Bomyea J;Spadoni AD;Taylor CT
通讯作者：
Taylor CT

Proactive engagement of cognitive control modulates implicit approach-avoidance bias.

DOI：
10.3758/s13415-020-00815-3
发表时间：
2020-10
期刊：
Cognitive, affective & behavioral neuroscience
影响因子：
0
作者：
Harlé KM;Bomyea J;Spadoni AD;Simmons AN;Taylor CT
通讯作者：
Taylor CT

The effect of obstructed action efficacy on reward-based decision-making in healthy adolescents: a novel functional MRI task to assay frustration.

DOI：
10.3758/s13415-021-00975-w
发表时间：
2022-06
期刊：
COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE
影响因子：
2.9
作者：
Harle, Katia M.;Ho, Tiffany C.;Connolly, Colm G.;Simmons, Alan N.;Yang, Tony T.
通讯作者：
Yang, Tony T.

Neural affective mechanisms associated with treatment responsiveness in veterans with PTSD and comorbid alcohol use disorder.