Effectiveness of a Synergistic, Neuroplasticity-Based intervention for Rapid and Durable Suicide Risk Reduction
基于神经可塑性的协同干预措施对快速、持久降低自杀风险的有效性
基本信息
- 批准号:10264902
- 负责人:
- 金额:$ 62.85万
- 依托单位:
- 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:2020-09-15 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AcuteAddressAdoptionAffectiveAgeAntidepressive AgentsAppointmentAreaBehaviorBlindedBrainCessation of lifeClinicalCognitionCognitiveCommunitiesComputersConsultConsultationsDataDepressed moodDiagnosticEducational InterventionEffectivenessEnrollmentFeeling suicidalFosteringFutureHealthcareHospitalsHourImpairmentIndividualInfusion proceduresInpatientsInterventionIntravenousKetamineLeadLearningLifeLiteratureMeasuresMedicalMedical RecordsMental DepressionMental HealthMolecular ProfilingMoodsNeurocognitiveNeuronal PlasticityOnline SystemsOutcomeOutpatientsParticipantPatientsPatternPharmacologyPhysiciansPropertyProtocols documentationPsychiatric HospitalsPsychiatric therapeutic procedureRandomizedRecoveryReportingResearchResearch PersonnelRiskRisk FactorsRisk ReductionSafetySamplingServicesSuicideSuicide attemptSymptomsTechniquesTestingTrainingTraining TechnicsTraumaTreatment outcomeVariantWorkadaptive learningarmbaseclinical effectcognitive trainingcomparison groupcostdepressed patientdesigneffectiveness trialexperiencefeasibility testingflexibilityfollow-uphigh riskindexinginnovationinpatient psychiatric treatmentinpatient serviceinterestnovelportabilityprogramsprospectivereducing suicidesafety and feasibilitystandard carestandard of caresuicidalsuicidal risktherapy designuptakevirtualweb app
项目摘要
Project Summary. Intravenous ketamine, which displays rapid antidepressant and anti-suicidality properties, is posited to
reverse symptoms by rapidly enhancing neuroplasticity; but surprisingly little is known regarding its feasibility, safety,
and effectiveness for reducing suicidal outcomes among real-world, heterogenous samples at imminent risk. Furthermore,
a significant barrier to clinical adoption is the lack of evidence for durability of ketamine's effects, raising concerns about
illusory recovery and subsequent rebound of suicide risk. We posit that ketamine will rapidly decrease suicidal ideation
and rapidly increase cognitive flexibility in a real-world sample, allowing for rigid, negative biases in cognition to be
rapidly reversed. We further expect these neurocognitive changes will provide a clinical window of opportunity in which
to introduce 1) standard crisis-oriented psychiatric care; and 2) automated cognitive training (CT) techniques, which will
consolidate adaptive forms of cognitive processing (specifically, positive and life-oriented implicit representations of self)
while neuroplasticity remains high. Instantiating adaptive forms of processing (through standard care and/or automated
CT) after first 'priming' the brain with ketamine represents a potentially synergistic treatment approach that could extend
the acute effects of a single ketamine infusion beyond its typical 3-7 day window, efficiently fostering protective anti-
suicidal effects that are both rapid and enduring. In this study, 200 Medical Unit inpatients (age 18-65) will be enrolled by
referral from the psychiatric consultation/liaison service in a large Level 1 trauma hospital, following consult for a
medically serious suicide attempt (SA). Leveraging medical unit physicians who are well-accustomed to utilizing
ketamine infusion routinely in their inpatient medical settings, inpatients will be randomized in a parallel arm design to
receive a single infusion of ketamine “pre-treatment”—shortly prior to subsequent psychiatric inpatient stay—or no-
infusion. Patients will complete acute measures of explicit SI and cognitive target engagement (implicit suicide-self
associations; Aim 1). In a fully crossed (2 x 2 factorial), parallel arm design, patients will then be randomized to receive a
brief web-app-based cognitive training protocol during the post-infusion "window of opportunity," designed to implicitly
reverse negative self-representations, instilling beneficial self-representations in their place, or a sham variant of the same
training. Patients, investigators, and outcome raters will be blinded to treatment condition. Comprehensive
feasibility/safety data will be captured for both intervention components. Remote assessments and the medical record will
then be used to capture SI and SAs over a 12-month naturalistic follow-up to assess whether: ketamine followed by
standard psychiatric inpatient care has a beneficial impact over no-infusion standard-of-care (Aim 2) and active cognitive
training enhances and/or extends the durability of ketamine's effects, potentially providing an exceedingly efficient, low-
cost, portable, non-invasive, safe, and highly dissemination-ready strategy (Aim 3). This study will provide novel
feasibility, safety, and effectiveness data on ketamine's impact among heterogeneous real-world patients at imminent risk
of suicide, and will represent a first attempt to synergistically combine ketamine with both standard and novel (cognitive
training) interventions in a real-world, generalizable setting, in an effort to exploit and extend ketamine's rapid effects.
项目总结。静脉注射氯胺酮,显示出快速抗抑郁和抗自杀的特性,被认为可以
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Rebecca Price其他文献
Rebecca Price的其他文献
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{{ truncateString('Rebecca Price', 18)}}的其他基金
Experimental Manipulation of OFC Function and Behavioral Context: Towards an Integrative Translational Model of Compulsive Behaviors
OFC 功能和行为背景的实验操作:建立强迫行为的综合转化模型
- 批准号:
10094322 - 财政年份:2020
- 资助金额:
$ 62.85万 - 项目类别:
Experimental Manipulation of OFC Function and Behavioral Context: Towards an Integrative Translational Model of Compulsive Behaviors
OFC 功能和行为背景的实验操作:建立强迫行为的综合转化模型
- 批准号:
10678859 - 财政年份:2020
- 资助金额:
$ 62.85万 - 项目类别:
Experimental Manipulation of OFC Function and Behavioral Context: Towards an Integrative Translational Model of Compulsive Behaviors
OFC 功能和行为背景的实验操作:建立强迫行为的综合转化模型
- 批准号:
10264883 - 财政年份:2020
- 资助金额:
$ 62.85万 - 项目类别:
Effectiveness of a Synergistic, Neuroplasticity-Based intervention for Rapid and Durable Suicide Risk Reduction
基于神经可塑性的协同干预措施对快速、持久降低自杀风险的有效性
- 批准号:
10471401 - 财政年份:2020
- 资助金额:
$ 62.85万 - 项目类别:
Experimental Manipulation of OFC Function and Behavioral Context: Towards an Integrative Translational Model of Compulsive Behaviors
OFC 功能和行为背景的实验操作:建立强迫行为的综合转化模型
- 批准号:
10452669 - 财政年份:2020
- 资助金额:
$ 62.85万 - 项目类别:
Effectiveness of a Synergistic, Neuroplasticity-Based intervention for Rapid and Durable Suicide Risk Reduction
基于神经可塑性的协同干预措施对快速、持久降低自杀风险的有效性
- 批准号:
10684238 - 财政年份:2020
- 资助金额:
$ 62.85万 - 项目类别:
Testing a Synergistic, Neuroplasticity-Based Intervention for Depressive Neurocognition
测试针对抑郁神经认知的基于神经可塑性的协同干预措施
- 批准号:
9376450 - 财政年份:2017
- 资助金额:
$ 62.85万 - 项目类别:
Testing a Synergistic, Neuroplasticity-Based Intervention for Depressive Neurocognition
测试针对抑郁神经认知的基于神经可塑性的协同干预措施
- 批准号:
9796295 - 财政年份:2017
- 资助金额:
$ 62.85万 - 项目类别:
Testing a Synergistic, Neuroplasticity-Based Intervention for Depressive Neurocognition
测试针对抑郁神经认知的基于神经可塑性的协同干预措施
- 批准号:
10201427 - 财政年份:2017
- 资助金额:
$ 62.85万 - 项目类别:
Testing the causal role of orbitofrontal cortex in human compulsive behavior: a non-invasive brain stimulation study
测试眶额皮质在人类强迫行为中的因果作用:一项非侵入性脑刺激研究
- 批准号:
9292806 - 财政年份:2017
- 资助金额:
$ 62.85万 - 项目类别:
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