U of Cincinnati Bipolar Disorder Imaging & Treatment Research Center (BITREC)

双相情感障碍是一种动态的、进行性的疾病，其治疗决策是凭经验做出的。 神经影像学有助于确定双相情感障碍的神经生理学模型，通过识别治疗反应和疾病进展的标记物和预测因子，为改善治疗分配提供了希望。我们建议UC双相情感障碍成像和治疗研究中心（BITREC）来实现这一承诺。指导该中心的总体假设和组织主题是双相情感障碍是由特定脑系统内的脑代谢功能障碍引起的（即，前边缘网络），可以 使用磁共振成像（MRI）和波谱学（MRS）监测对治疗的反应。 在这个中心，我们将整合MRI和MRS与结果的措施和治疗试验，以开发特定的神经生理学模型的治疗反应早期在双相情感障碍的过程。 这些模型将提供识别治疗反应的标志物和预测因子的方法，以个性化药物处方，从而最大限度地减少情感复发，预防疾病进展，并改善长期病程。为了实现我们的目标，我们将整合我们丰富的经验和现有资源，以创建特定的研究和管理核心;这些核心将用于建立BITREC基础设施。有了这个基础设施，我们将招募一个大样本的双相患者在病程早期（在重大疾病进展之前），以及一个队列的高危受试者（青少年没有双相情感障碍，但有双相父母）。这些受试者将被要求参与整合MRI、MRS、治疗和临床结局的特定项目，以完善双相情感障碍神经生理学的现有模型。我们将使用这些模型，以便 确定治疗反应的特定神经生理学标志物，以阐明不同药物对双相神经生理学的影响。然后，我们将使用这些标记物来开发双相情感障碍治疗反应和疾病进展的特定神经生理学预测因子。最后，我们将把这些模型应用于高危患者（在第一次躁狂发作之前），以预防或延迟双相情感障碍的发作。

Bipolar disorder is a dynamic, progressive illness in which treatment decisions are made empirically. Neuroimaging has helped to define neurophysiological models of bipolar disorder that offer the promise of improving treatment assignment by identifying markers and predictors of treatment response and disease progression. We propose the UC Bipolar Disorder Imaging & Treatment Research Center (BITREC) to meet this promise. The overall hypothesis and organizing theme guiding this center is that bipolar disorder results from dysfunctional brain metabolism within specific brain systems (i.e., the anterior limbic network) that can be monitored in response to treatments using magnetic resonance imaging (MRI) and spectroscopy (MRS). In this center, we will integrate MRI and MRS with outcome measures and treatment trials in order to develop specific neurophysiological models of treatment response early in the course of bipolar disorder. These models will provide the means to identify markers and predictors of treatment response to individualize medication prescription, thereby minimizing affective recurrences, preventing disease progression, and improving long-term course of illness. In order to achieve our goals, we will integrate our extensive prior experience and current resources to create specific research and administrative cores; these cores will be used to establish the BITREC infrastructure. With this infrastructure in place, we will recruit a large sample of bipolar patients early in the course of illness (prior to significant illness progression), as well as a cohort of at-risk subjects (adolescents without bipolar disorder, but with bipolar parents). These subjects will be asked to participate in specific projects integrating MRI, MRS, treatment and clinical outcome in order to refine existing models of the neurophysiology of bipolar disorder. We will use these models in order to identify specific neurophysiological markers of treatment response in order to clarify the effects that different medications have on bipolar neurophysiology. We will then use these markers to develop specific neurophysiological predictors of treatment response and illness progression in bipolar disorder. Finally, we will apply these models to at-risk patients (prior to developing a first manic episode) in order to prevent or delay the onset of bipolar disorder.