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Multimodal Profiling of Response to Pediatric Comprehensive Behavioral Intervention for Tics

儿科抽动综合行为干预反应的多模式分析

基本信息

批准号：
10743782
负责人：
Christine A Conelea
金额：
$ 79.23万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-12 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10743782
关键词：
Affect Age Behavior Behavior Therapy Behavioral Brain Child Childhood Chronic Clinical Clinical Trials Clinical assessments Code Data Decision Making Electroencephalography Elements Functional Magnetic Resonance Imaging Future Gilles de la Tourette syndrome Goals Impairment Improve Access Impulsivity Intervention Knowledge Link Literature Logistic Regressions Measurement Measures Mental disorders Methods Modeling Motor Movement Multi-Institutional Clinical Trial Obsessive-Compulsive Disorder Outcome Outcome Measure Outpatients Patient-Focused Outcomes Patients Procedures Process Provider Research Rest Sampling Seminal Severities Signal Transduction Symptoms Therapeutic Tic disorder Work Youth associated symptom behavior measurement behavior observation bench-to-bedside translation biobehavior clinical practice design efficacy trial experience follow up assessment functional magnetic resonance imaging/electroencephalography improved indexing individualized medicine magnetic resonance imaging/electroencephalography member motor control multidisciplinary multimodality neural neuropsychiatric disorder neuropsychiatric symptom neuroregulation novel patient engagement predicting response predictive marker predictive modeling primary care setting profiles in patients prognostic indicator psychosocial repetitive behavior research and development response skills standard care support network therapeutic target therapy development tic suppression treatment adherence treatment planning vocalization

项目摘要

PROJECT SUMMARY The overall objective of this proposal is to conduct the first mechanistic clinical trial of pediatric Comprehensive Behavioral Intervention for Tics (CBIT) to identify bio-behavioral predictors and correlates of response and the most potent aspects of CBIT delivery. Chronic tics affect 1-3% of youth in the US and are a disabling neuropsychiatric symptom associated with multiple childhood-onset mental disorders. CBIT is the current first-line, gold-standard treatment for tics and focuses on skills to enhance voluntary tic suppression and reduce tic triggers. However, about 50% of youth do not benefit from CBIT. The current study aims to use multimodal measurements to identify predictors of response (for whom does CBIT work?), the therapeutic processes that activate change (what are the potent aspects of CBIT delivery?), and correlates of response (what changes occur in patients whose tics improve?). Study hypotheses, based on the literature and our preliminary data, predict that CBIT relies upon, engages, and strengthens connectivity within and between functional brain networks that support top-down control over motor functions. Youth ages 10-17 years with chronic tics (N = 100) will complete a course of 8 outpatient, weekly sessions of CBIT and pre-, post-, and 3-month follow up assessments. Multimodal assessments will include: 1) neural measures of functional connectivity among the brain's large-scale functional networks using fMRI and EEG during rest and tic expression and suppression, 2) direct-observation behavioral measurement of tics, and 3) psychosocial measures, including assessments of clinical symptoms and patient-centered outcome measures informed by preliminary data and our Patient Advisory Board. CBIT process will be assessed via a novel video-based behavioral coding of CBIT sessions. This project has the potential to directly benefit patients both immediately and in the long-term. Results will have a downstream impact on clinical practice by informing individualized treatment planning and efforts to streamline and improve CBIT quality. Results will also have an upstream impact on treatment development by identifying novel neural targets for intervention and strategies for improving CBIT outcomes via refinement or adjunctive procedures.

项目总结