2/2-CO2 Reactivity as a Biomarker of Non-Response to Exposure-Based Therapy

2/2-CO2 反应性作为暴露治疗无反应的生物标志物

基本信息

项目摘要

PROJECT SUMMARY/ABSTRACT Exposure-based therapy is an effective first-line treatment for anxiety-, obsessive-compulsive and trauma- and stressor-related disorders. 1–6 However, many patients fail to respond or achieve remission with exposure- based therapy, 7–11 resulting in “unnecessary” prolonged suffering, loss of productivity, and poorly used resources. Making available a biomarker assay that can aid clinicians and patients in treatment selection has the potential to have considerable public health impact. Basic research on fear extinction - a core mechanism of action of exposure-based therapy - may inform the development of a biomarker for the selection (yes/no) of exposure-based therapy. Growing evidence links 12,13 14–16 orexin system activity to deficits in fear extinction.17–20 Our group has demonstrated that reactivity to CO2 challenge, which is a safe, affordable and easy-to-implement procedure, can serve as a proxy for orexin system activity and predicts fear extinction deficits in rodents.21 Building upon this basic research, the goal for the propo sed study is to validate CO2 reactivity as a biomarker of exposure-based therapy non-response. To this end, we will assess CO2 reactivity in 600 adults meeting for one or more fear- or anxiety-related disorders prior to providing open, state-of-the art, transdiagnostic exposure-based therapy. By incorporating CO2 reactivity into a multivariate model predicting treatment non-response that also includes reactivity to hyperventilation as well as a number of related and theoretically-relevant prognostic variables, we will establish the mechanistic specificity and the additive predictive value of the putative biomarker. By developing models independently within two study sites and predicting the other site's data, we will validate that the results are likely to generalize to future clinical samples. The proposed study represents a necessary stage in translating basic research to strategies for treatment selection. The investigation addresses an important public health issue by testing an accessible clinical assessment strategy - informed by basic research - that may lead to a more effective treatment selection (personalized medicine) for patients with anxiety- and fear-related disorders and enhance our understanding of the mechanisms governing exposure-based therapy.
项目总结/摘要 基于暴露的治疗是焦虑、强迫和创伤的有效一线治疗- 和压力相关的疾病1-6然而,许多患者在暴露后没有反应或缓解- 基于治疗,7-11导致“不必要的”长期痛苦,生产力下降, 资源提供一种生物标志物测定,可以帮助临床医生和患者进行治疗选择, 有可能对公共卫生产生重大影响。 对恐惧消退的基础研究--基于恐惧的治疗的核心作用机制--可能会为我们提供信息。 开发用于选择(是/否)基于胰岛素的治疗的生物标志物。增长的证据链接 12,13 14–16 食欲素系统活动对恐惧防御缺陷的影响。17 -20我们的研究小组已经证明,对CO2的反应性 Challenge是一种安全、负担得起且易于实施的程序,可以作为增食欲素的替代品 系统活动和预测啮齿动物的恐惧灭绝缺陷。 在此基础研究的基础上,该提案的目标是 sed研究是为了验证CO2反应性, 基于胰岛素的治疗无应答的生物标志物。 为此,我们将评估 CO2反应性 600人 在提供开放的,最先进的, transdiagnosis转诊断therapy治疗.通过将CO2反应性纳入多变量模型预测 治疗无反应,还包括对过度换气的反应以及一些相关的 理论上相关的预后变量,我们将建立机制的特异性和加性 推定生物标志物的预测价值。通过在两个研究中心独立开发模型, 预测其他网站的数据,我们将验证结果可能推广到未来的临床 样品 这项拟议中的研究是将基础研究转化为治疗策略的一个必要阶段 选择.这项调查通过测试一种可获得的临床试验, 评估策略-由基础研究提供信息-可能导致更有效的治疗选择 (个性化医疗)的患者焦虑和恐惧相关的疾病,并提高我们的理解, 以自我为基础的治疗机制。

项目成果

期刊论文数量(0)
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Michael W. Otto其他文献

Constructing a model of change: Clinical commentary on a complex case
  • DOI:
    10.1016/s1077-7229(00)80013-9
  • 发表时间:
    2000-12-01
  • 期刊:
  • 影响因子:
  • 作者:
    Michael W. Otto
  • 通讯作者:
    Michael W. Otto
The effects of physical activity on sleep: a meta-analytic review
  • DOI:
    10.1007/s10865-015-9617-6
  • 发表时间:
    2015-01-18
  • 期刊:
  • 影响因子:
    2.900
  • 作者:
    M. Alexandra Kredlow;Michelle C. Capozzoli;Bridget A. Hearon;Amanda W. Calkins;Michael W. Otto
  • 通讯作者:
    Michael W. Otto
Long-term outcome after acute treatment with alprazolam or clonazepam for panic disorder.
使用阿普唑仑或氯硝西泮急性治疗惊恐障碍后的长期结果。
  • DOI:
    10.1097/00004714-199308000-00005
  • 发表时间:
    1993
  • 期刊:
  • 影响因子:
    2.9
  • 作者:
    M. Pollack;Michael W. Otto;G. Tesar;Lee S. Cohen;Samantha Meltzer;Jerrold F. Rosenbaum
  • 通讯作者:
    Jerrold F. Rosenbaum
Cognitive-behavioral therapy for social anxiety disorder: model, methods, and outcome.
社交焦虑症的认知行为治疗:模型、方法和结果。
Quick start file for the panel "Labour market and social security" (PASS): analysing the PASS data using SPSS/PASW
“劳动力市场和社会保障”(PASS) 小组的快速启动文件:使用 SPSS/PASW 分析 PASS 数据
  • DOI:
  • 发表时间:
    2015
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Benjamin Fuchs;S. Lödel;Michael W. Otto
  • 通讯作者:
    Michael W. Otto

Michael W. Otto的其他文献

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{{ truncateString('Michael W. Otto', 18)}}的其他基金

2/2-CO2 Reactivity as a Biomarker of Non-Response to Exposure-Based Therapy
2/2-CO2 反应性作为暴露治疗无反应的生物标志物
  • 批准号:
    10363061
  • 财政年份:
    2022
  • 资助金额:
    $ 56.54万
  • 项目类别:
Engaging Working Memory and Distress Tolerance to Aid Smoking Cessation
调动工作记忆和抗压能力来帮助戒烟
  • 批准号:
    9928212
  • 财政年份:
    2018
  • 资助金额:
    $ 56.54万
  • 项目类别:
Engaging Working Memory and Distress Tolerance to Aid Smoking Cessation
调动工作记忆和抗压能力来帮助戒烟
  • 批准号:
    9767106
  • 财政年份:
    2018
  • 资助金额:
    $ 56.54万
  • 项目类别:
Improving Therapeutic Learning in Depression: Proof of Concept
改善抑郁症的治疗学习:概念证明
  • 批准号:
    8621206
  • 财政年份:
    2014
  • 资助金额:
    $ 56.54万
  • 项目类别:
Enhancing Panic and Smoking Reduction Treatment with D-Cycloserine
使用 D-环丝氨酸增强恐慌和减少吸烟治疗
  • 批准号:
    8731846
  • 财政年份:
    2013
  • 资助金额:
    $ 56.54万
  • 项目类别:
Enhancing Panic and Smoking Reduction Treatment with D-Cycloserine
使用 D-环丝氨酸增强恐慌和减少吸烟治疗
  • 批准号:
    8790514
  • 财政年份:
    2013
  • 资助金额:
    $ 56.54万
  • 项目类别:
1/3-Exposure D-Cycloserine Enhancement and Genetic Modulators in Panic Disorder
恐慌症中的 1/3 暴露 D-环丝氨酸增强剂和遗传调节剂
  • 批准号:
    7795774
  • 财政年份:
    2008
  • 资助金额:
    $ 56.54万
  • 项目类别:
Excellence In Training: The Center for Anxiety and Related Disorders at BU
卓越培训:波士顿大学焦虑及相关疾病中心
  • 批准号:
    7558423
  • 财政年份:
    2008
  • 资助金额:
    $ 56.54万
  • 项目类别:
Excellence In Training: The Center for Anxiety and Related Disorders at BU
卓越培训:波士顿大学焦虑及相关疾病中心
  • 批准号:
    8268550
  • 财政年份:
    2008
  • 资助金额:
    $ 56.54万
  • 项目类别:
Excellence In Training: The Center for Anxiety and Related Disorders at BU
卓越培训:波士顿大学焦虑及相关疾病中心
  • 批准号:
    7693703
  • 财政年份:
    2008
  • 资助金额:
    $ 56.54万
  • 项目类别:

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