MRI Markers of Feedback Timing during Learning in Individuals with TBI with and without Clinical Depression

患有或不患有临床抑郁症的 TBI 个体学习期间反馈时间的 MRI 标记

• 批准号: 10586081
• 负责人: Ekaterina Dobryakova
• 金额: $ 38.55万
• 依托单位: KESSLER FOUNDATION, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586081
• 关键词: Address; Area; Brain; Brain Injuries; Caregiver Burden; Clinical; Cognition; Cognitive; Collaborations; Data; Depressed mood; Development; Diagnostic; Disadvantaged; Dissociation; Educational process of instructing; Effectiveness; Environment; Exhibits; Feedback; Fostering; Functional Magnetic Resonance Imaging; Funding; Goals; Health Care Costs; Heart; Impairment; Individual; Inpatients; Intervention; Interview; Investigation; Knowledge; Learning; Lentiform nucleus structure; Link; Magnetic Resonance Imaging; Major Depressive Disorder; Measures; Memory; Mental Depression; Mission; National Institute of Neurological Disorders and Stroke; Nervous System; Neuropsychology; Outpatients; Parkinson Disease; Participant; Pathway interactions; Patients; Performance; Persons; Phase; Population; Prevalence; Probability; Process; Protocols documentation; Publishing; Qualifying; Quality of life; Recording of previous events; Rehabilitation Outcome; Rehabilitation therapy; Research; Standardization; Structure; Testing; Translating; Traumatic Brain Injury; Verbal Learning; brain circuitry; clinical practice; clinically significant; cognitive process; comorbidity; depressive symptoms; design; executive function; experience; experimental study; functional independence; improved; innovation; knowledge base; magnetic resonance imaging biomarker; neural circuit; neuromechanism; novel; recruit; rehabilitation strategy; standardize measure

Project Summary/Abstract The overall objective of the proposed project is to investigate brain mechanisms during learning in individuals with traumatic brain injury (TBI) with and without clinical depression. Such knowledge can help guide rehabilita- tion strategies and reduce the burden of TBI. Feedback about the accuracy of one’s actions can improve learn- ing by informing individuals whether their action is correct or not. Individuals with depression have been shown to have learning deficits and altered brain activity during learning compared to healthy individuals when feed- back is presented immediately. Impaired learning through immediate feedback has also been observed in Par- kinson’s disease (PD) patients. However, PD patients are able to learn from feedback when it is presented af- ter a delay through engagement of separate neural mechanisms. We show that individuals with TBI exhibit def- icits in learning through immediate feedback that are likely exacerbated by depressive symptoms. Deficits in learning through immediate feedback can lead to perseveration of incorrect actions and decreased strategy use during rehabilitation. However, there is no evidence directly examining the neural mechanisms of learning in individuals with TBI with and without depression. The proposed research fills this gap. The identification of the neural mechanisms associated with learning in individuals with TBI with and without clinical depression will inform 1) scientific knowledge about the effect of depression on the injured brain, 2) TBI interventions about the effectiveness of feedback and its timing, and 3) the development of generalized interventions for other clinical populations that require rehabilitation and have high occurrence of depression. These objectives lie at the heart of the mission of the NINDS as they will broaden “fundamental knowledge about the brain and nervous system” associated with learning in TBI. The knowledge gained from fulfilling the above objectives will “reduce the burden” of learning deficits after TBI. To test our hypotheses, TBI participants will be recruited based on structured clinical interview. Qualified participants will perform an experiment where they study word pairs out- side of the functional magnetic resonance imaging (MRI) scanner. Then, in the MRI, participants will see word pairs in multiple-choice format, along with novel distractors, and select the correct paired-associate. After each choice, feedback will be experimentally manipulated to be presented either immediately or after a 25-minute delay. During the final phase outside of the MRI, participants complete a second diagnostic paired-associate multiple-choice assessment to evaluate the influence of immediate vs. delayed feedback on learning. We hy- pothesize that depressed individuals with TBI will show improvements in learning from delayed compared to immediate feedback. This learning dissociation will occur because learning through delayed feedback relies on neurocircuitry that is not negatively affected by TBI and depression. Non-depressed individuals without TBI and clinically depressed individuals without TBI will also be recruited to differentiate the influences of depres- sion from the impact of TBI on the brain.

项目总结/摘要 该项目的总体目标是研究个体学习过程中的大脑机制 创伤性脑损伤（TBI）伴或不伴临床抑郁症。这些知识可以帮助指导康复- 减少TBI的负担。关于一个人动作准确性的反馈可以提高学习- 通过告知个人他们的行为是否正确来进行。患有抑郁症的人 与健康人相比，在学习过程中有学习缺陷和大脑活动改变， 后面马上介绍。通过即时反馈的学习受损也被观察到， 帕金森病（PD）患者。然而，PD患者能够从反馈中学习，当反馈被呈现时， 称为通过独立神经机制参与延迟。我们发现TBI患者表现出明显的- 通过即时反馈学习，这可能会因抑郁症状而加剧。赤字 通过即时反馈进行学习可能会导致错误行为的持续和策略的减少 康复期间使用。然而，没有证据直接检查学习的神经机制 有抑郁症和无抑郁症的TBI患者。这项研究填补了这一空白。的识别 在伴有或不伴有临床抑郁症的TBI患者中，与学习相关的神经机制将 告知1）关于抑郁症对受伤大脑影响的科学知识，2）关于 反馈的有效性及其时机，以及3）为其他临床 需要康复和抑郁症高发的人群。这些目标在于 NINDS的使命的核心，因为他们将扩大“关于大脑和神经系统的基本知识， 系统”与TBI中的学习相关。从实现上述目标中获得的知识将“减少 创伤性脑损伤后的学习障碍为了验证我们的假设，TBI参与者将根据以下因素招募： 结构化临床访谈合格的参与者将进行一项实验，他们研究单词对- 功能性磁共振成像（MRI）扫描仪的侧面。然后，在核磁共振成像中，参与者将看到 以多项选择的形式，沿着与新的干扰物配对，并选择正确的配对联想。每次 选择，反馈将被实验性地操纵，以立即或25分钟后呈现。 延迟在MRI以外的最后阶段，参与者完成第二次诊断配对 多项选择评估，以评估即时与延迟反馈对学习的影响。我们- 假设患有TBI的抑郁个体在学习方面会有所改善， 即时反馈。这种学习分离的发生是因为通过延迟反馈的学习依赖于 神经回路不会受到TBI和抑郁症的负面影响。无TBI的非抑郁个体 没有TBI的临床抑郁症患者也将被招募，以区分抑郁症的影响， TBI对大脑的影响。