SUBCORTICAL MICROVASCULAR DISEASE IN DEPRESSION

指导临床科学家发展的五年目标 大奖是成为发病机制的独立研究者， 大脑皮层下微血管病的防治 老年性抑郁症。该奖项将帮助被提名者发展技能 在以下领域：临床研究方法和统计， 定量磁共振成像(MRI)分析，发病机制 大脑小动脉疾病及认知功能和认知功能评估 老年期抑郁症的临床表现。 这些技能将被用来进行一项关于 老年抑郁症中的皮质下微血管疾病。这项研究 将采用病例对照设计对两组老年人进行比较 伴有和不伴有皮质下高水平抑郁的住院患者 微血管疾病。具体目标是寻找不同之处 高血压负担，认知功能，抑郁症现象学， 以及认知和日常生活活动能力(ADL)的下降速度。 辅助分析将关联核磁共振成像的区域分布 高强度与认知功能障碍的模式，并将 评估载脂蛋白E4等位基因的存在是否为 微血管疾病的发展。这项研究的发现 应该对预防、预后和 老年抑郁症合并微血管疾病的治疗。 被提名者计划在皮质下提交RO1级别的资助 基于研究结果的老年抑郁症中的微血管疾病 在完成授奖前的试点研究中。被提名人 计划发展一个高质量的形态测量成像实验室 将被用作多项临床研究的资源 布朗大学精神病学和临床神经科学系。这个 被提名人进一步计划在制定 老年医学博士后临床研究培训计划 布朗大学的神经精神病学。

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.