SUBCORTICAL MICROVASCULAR DISEASE IN DEPRESSION

这五年指导临床科学家发展的目标 奖项是成为一个独立的研究者在发病机制， 皮质下微血管疾病的预防和治疗 老年抑郁症 该奖项将帮助被提名者发展技能 在以下领域：临床研究方法学和统计学， 定量磁共振成像（MRI）分析， 脑小动脉疾病，以及认知功能和 老年抑郁症的临床表现。 将利用这些技能对下列方面的作用进行试点研究： 老年抑郁症患者皮质下微血管病变 研究 将采用病例对照设计，比较两组老年人 有或无高水平皮质下 微血管疾病 具体目标是寻找 高血压负荷，认知功能，抑郁现象学， 以及认知和日常生活活动能力（ADL）下降率。 辅助分析将关联MRI的区域分布 高强度与认知功能障碍的模式，将 评价载脂蛋白E4等位基因的存在作为 微血管疾病的发展。 这项研究的结果 应该对预防、预后和 治疗与微血管疾病相关的老年抑郁症。 被提名者计划提交一份关于皮层下的RO1级补助金 老年抑郁症的微血管疾病 在完成授标之前进行试点研究。被提名人 计划建立一个高质量的形态测量成像实验室， 将被用作一个资源的一些临床研究， 精神病学和临床神经科学系。 的 被提名人进一步计划在发展一个 老年医学博士后临床研究培训 神经精神病学博士

The objective of this five year Mentored Clinical Scientist Development Award is to become an independent investigator in the pathogenesis, prevention, and treatment of subcortical microvascular disease in geriatric depression. The award will help the nominee develop skills in the following areas: clinical research methodology and statistics, quantitative magnetic resonance imaging (MRI) analysis, pathogenesis of cerebral small artery disease, and assessment of cognitive function and clinical manifestations of geriatric depression. These skills will be utilized to conduct a pilot study of the role of subcortical microvascular disease in geriatric depression. The study will use a case control design to compare two groups of geriatric depressed inpatients with and without high levels of subcortical microvascular disease. The specific aim is to look for differences in hypertensive burden, cognitive function, phenomenology of depression, and rate of decline in cognition and activities of daily living (ADLs). Subsidiary analyses will correlate the regional distribution of MRI hyperintensities with the pattern of cognitive dysfunction, and will evaluate the presence of apolipoprotein E4 alleles as a marker for the development of microvascular disease. The findings from this study should have important implications for prevention, prognosis, and treatment of geriatric depression associated with microvascular disease. The nominee plans to submit an RO1 level grant on subcortical microvascular disease in geriatric depression based on results obtained in the pilot study prior to the completion of the award. The nominee plans to develop a high quality morphometric imaging laboratory which will be used as a resource for a number of clinical studies in the departments of psychiatry and clinical neurosciences at Brown. The nominee further plans on assuming a leadership role in developing a post-doctoral clinical research training program in geriatric neuropsychiatry at Brown University.