Testing the predictive power of neural connectivity: Suicidal ideation in youth exposed to maltreatment

项目总结/摘要 为了响应来自卫生部长、国会和NIMH的全国性呼吁，拟议的研究将 在最脆弱的高危人群中研究自杀意念和行为的神经标志物 对于自杀（即，有虐待儿童史的青少年）。虐待儿童与青少年密切相关 自杀意念和行为;然而，单独虐待儿童是未来自杀意念的不良预测因素， 行为预测未来的自杀意念和行为是至关重要的，目前可能受到缺乏 关于已知自杀风险因素的神经基础的知识。虐待儿童会影响 在大脑中与情绪调节有关的区域起作用。此外，情绪调节可能是一个关键过程， 潜在的自杀想法和行为拟议的研究将前瞻性地检查网络范围 脑网络中与情绪调节有关的功能连接作为自杀意念的预测因素 两个独立的样本，有和没有虐待儿童的历史。这项工作将探索 额缘（例如，背外侧前额叶皮层-杏仁核）的连接性 有无自杀意念和虐待儿童青少年的调节任务和静息状态扫描 历史此外，这项工作将检查神经连接作为自杀意念的前瞻性预测因子。 根据以往的研究，预计同时存在虐待儿童和自杀意念的青少年 历史将证明与儿童虐待或虐待儿童的青少年相比， 自杀意念史和对照组青年。此外，据推测，弱额缘 在两个青年样本中，连接性将前瞻性地预测约1-2年内的自杀意念。这里 我们有非凡的能力交叉验证我们的发现，从一个独立的样本， 青年使用基于实验室的范例，功能网络连接和 创新的纵向，交叉验证的结果，拟议的研究提供了一个实质性的进步， 这个领域几乎完全依赖于自杀的横截面，单一的线人，回顾性报告， 构思能力来自两个独立样本的参与者（共N = 340名8-16岁的青少年;数据收集支持 由2名NIMH资助的R 01），有一系列儿童虐待和自杀意念史，完成基线 评估和fMRI扫描，前瞻性随访约1-2年，并完成额外的fMRI扫描。 我们将结合联合收割机传统的连通性分析（图论）和尖端的数据驱动算法， 交叉验证基线和随访（约1-2年）的神经网络连接结果。Findings from the 目前的研究可以确定自杀意念和行为风险的具体标志，使我们能够显著地 改善前瞻性预测。提高对青少年自杀的神经基础的认识是至关重要的 解决这一重大公共卫生问题。该项目直接响应国家行动呼吁 关于青少年自杀的问题，并将为该领域做出重大贡献。

Project Summary/Abstract In response to national calls from the Surgeon General, Congress, and NIMH, the proposed research will investigate neural markers of suicidal ideation and behavior in one of the most vulnerable populations at risk for suicide (i.e., youth with a history of child maltreatment). Child maltreatment is robustly related to youth suicidal ideation and behavior; yet, child maltreatment alone is a poor predictor of future suicidal ideation and behavior. Prediction of future suicidal ideation and behavior is critical and may be currently limited by a lack of knowledge regarding neural underpinnings of known risk factors for suicide. Child maltreatment affects functioning in brain regions implicated in emotion regulation. Further, emotion regulation may be a key process underlying suicidal ideation and behavior. The proposed research will prospectively examine network wide functional connectivity in brain networks implicated in emotion regulation as a predictor of suicidal ideation in two independent samples of youth with and without histories of child maltreatment. This work will explore frontolimbic (e.g., dorsolateral prefrontal cortex—amygdala) connectivity during a widely-used emotion regulation task and resting state scan among youth with and without suicidal ideation and child maltreatment histories. Further, this work will examine neural connectivity as a prospective predictor of suicidal ideation. Based on previous research, it is expected that youth with both child maltreatment and suicidal ideation histories will demonstrate weak frontolimbic connectivity compared to youth with either child maltreatment or suicidal ideation histories alone and control youth. Further, it is hypothesized that weak frontolimbic connectivity will prospectively predict suicidal ideation across ~1-2 years across both samples of youth. Here we have the remarkable ability to cross-validate our findings from one sample in an independent sample of youth. Using a combination of experimental lab-based paradigms, functional network connectivity, and an innovative longitudinal, cross-validation of findings, the proposed research offers a substantial advance within the field that almost exclusively has relied on cross-sectional, single informant, retrospective reports of suicidal ideation. Participants from two independent samples (total N = 340 youth ages 8-16; data collection supported by 2 NIMH funded R01s) with a range of child maltreatment and suicidal ideation histories complete a baseline assessment and fMRI scan, are followed prospectively for ~1-2 years, and complete an additional fMRI scan. We will combine traditional connectivity analysis (graph theory) and a cutting-edge data-driven algorithm to cross-validate neural network connectivity findings from baseline and follow-up (~1-2 years). Findings from the current study may identify concrete markers of risk for suicidal ideation and behavior allowing us to significantly improve prospective prediction. Advancing knowledge of neural underpinnings of youth suicide is critical for addressing this significant public health concern. This project directly addresses national calls for action regarding youth suicide and stands to substantially contribute to the field.