Emotion Regulation in Children of Parents with Bipolar Disorder

描述(申请人提供)：NIMH指导的以患者为导向的研究职业发展(K-23)奖申请的目的是支持我的长期职业目标，即整合创新的神经成像技术和情绪调节机制，以了解双相情感障碍(BD)的神经发育。我之前的培训是现象学和磁共振成像(MRI)形态计量分析，对有患BD家族风险的儿童进行分析。以前对双相情感后代的神经影像研究的一个局限性是，对这一脆弱队列中潜在的情绪调节机制的评估不充分，独立于与疾病发病相关的混淆，如共生精神疾病、药物暴露和物质使用。因此，为了实现我的职业目标，即最大限度地将体内神经成像技术应用于高危临床人群，我建议通过参与与拟议研究活动相辅相成的课程工作、教学读物、指导和体验式学习活动，获得整合儿科情绪调节和调节障碍调查、功能磁共振成像(FMRI)、磁共振波谱(MRS)、统计分析和研究伦理行为的专业知识。BD是一种流行的、终生的、进行性疾病，通常始于青春期或成年早期。BD的一个主要症状是情绪失调。大脑和小脑区域，包括前额叶皮质、腹侧纹状体、杏仁核、海马体和小脑虫，已被证明调节患有BD的儿童和青少年的情绪过程，并有家族风险。我的短期目标是应用功能磁共振成像和MRS，结合情感神经科学中使用的奖励和信息处理范式，阐明青春期前儿童患BD的家族风险的情绪调节的功能和神经化学基础。在这个项目中获得的数据将为未来的纵向研究提供信息，以促进我们对这种疾病发展过程中涉及的风险和保护因素的理解。拟议的综合研究和培训计划，加上斯坦福大学强大的研究环境，将促进我成为BD神经发育领域的独立研究员。

DESCRIPTION (provided by applicant): The purpose of this NIMH Mentored Patient-Oriented Research Career Development (K-23) Award application is to support my long-term career objective of integrating innovative neuroimaging techniques and mechanisms of emotion regulation to understand the neurodevelopment of Bipolar Disorder (BD). My previous training is in the phenomenology and Magnetic Resonance Imaging (MRI) morphometric analyses of children at familial risk for developing BD. One limitation of previous neuroimaging studies in bipolar offspring is the inadequate assessment of the potential underlying mechanisms of emotion regulation in this vulnerable cohort, independent of confounds associated with illness onset, such as co-occurring psychiatric conditions, medication exposure, and substance use. Therefore, to achieve my career goal of maximizing the application of in vivo neuroimaging techniques to at-risk clinical populations, I propose to gain expertise integrating pediatric investigations of emotion regulation and dysregulation, functional (fMRI), magnetic resonance spectroscopy (MRS), statistical analyses, and the ethical conduct of research by participating in course work, didactic readings, mentoring, and experiential learning activities that complement the proposed research activities. BD is a prevalent, life-long, progressive disease that typically begins in adolescence or early adulthood. A cardinal symptom of BD is emotion dysregulation. Brain and cerebellar regions, including the prefrontal cortex, ventral striatum, amygdala, hippocampus, and cerebellar vermis have been shown to modulate emotional processes in children and adolescents with, and at familial risk for, BD. My short-term goal is to apply fMRI and MRS, in conjunction with reward and information-processing paradigms used in affective neuroscience, to elucidate the functional and neurochemical bases for emotion regulation in preadolescent children at familial risk for developing BD. Data obtained in this project will inform future longitudinal studies to facilitate the advancement of our understanding of risk and protective factors that are involved in the development of this illness. The proposed integrated research and training programs, together with the strong research environment of Stanford University, will foster my development into an independent investigator in the field of the neurodevelopment of BD.