PREDICTING PRESCHOOL PSYCHOPATHOLOGY WITH BRAIN CONNECTIVITY IN PRETERM NEONATES

 描述（由申请人提供）：每年，早产影响大约12%的婴儿出生在美国。早产儿患精神疾病的几率更高，包括多动症和自闭症，以及相关的注意力和社交缺陷。为了解决导致极早产儿结局的因素，医学研究所建议采用多学科方法，研究重点是确定新生儿发育的预测因素，包括社会，情感和行为结果。该指导以患者为导向的职业发展奖（K23）的目的是使候选人能够制定一项资助的研究计划，旨在了解新生儿结构和功能性大脑连接与早产儿精神疾病结局之间的关系。候选人的长期目标是成为一名独立的临床研究者，研究高危婴儿精神疾病结局的神经影像学表现。为了实现这一目标，提出了三个关键领域的培训和指导：1）应用先进的脑MRI分析技术，特别是扩散张量成像和静息状态功能连接，2）提高设计，解释和分析发展性精神病理学纵向研究的技能，3）模拟累积的心理社会风险暴露和脑行为关系的关键协变量。该奖项的研究计划将在培训计划和专家导师和顾问的跨学科团队的支持下实施。本K23提案中的项目将通过以下方式解决早产儿精神疾病发病率增加的不明病因：1）全面评估学龄前期间的精神症状，特别关注ADHD和自闭症症状，2）将新生儿微结构和功能连接的改变与儿童早期的ADHD和ASD症状相关，以及3）探索关键的心理社会风险因素是否也会影响不良的社会情绪和精神结果。这项拟议的研究增加了一个全面的精神和社会情绪评估在学龄前期间在捕获的样本早产儿纵向跟踪自出生以来，新生儿的结构和静息状态功能连接MRI数据可用。该项目提供了一个前所未有的机会来解决这个关键的科学问题，并在神经科学研究的前沿机构提供了一个独特的培训机会。候选人致力于进一步发展早产儿新生儿神经影像学和学龄前精神病理学领域的专业知识。来自这些研究活动的数据将支持R01应用程序的开发，该应用程序跟踪本研究人群到学龄期的发育精神病理学轨迹和随后的大脑发育。该项目可以在大脑可塑性显著改善早产儿精神预后的时期内提供早期识别和有针对性的干预策略。

 DESCRIPTION (provided by applicant): Each year, preterm birth affects roughly 12% of babies born in the United States. Children born preterm have higher rates of psychiatric disorders, including ADHD and autism, and related attentional and social deficits. To address the factors contributing to outcomes in very preterm infants, the Institute of Medicine recommended a multidisciplinary approach with research focused on identifying neonatal predictors of development including social, emotional and behavioral outcomes. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a funded research program aimed at understanding the relationship between neonatal structural and functional brain connectivity and psychiatric outcomes in preterm infants. The candidate's long-term goal is to become an independent clinical investigator studying the neuroimaging manifestations of psychiatric outcomes in high-risk infants. To achieve this goal, training and mentorship are proposed in three key areas: 1) applying advanced brain MRI analysis techniques, specifically diffusion tensor imaging and resting state functional connectivity, 2) enhancement of skills in the design, interpretation and analysis of longitudinal studies of developmental psychopathology and 3) modeling cumulative psychosocial risk exposure and key covariates of brain-behavior relationships. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and advisors. The project in this K23 proposal will address the unexplained etiology of increased rates of psychiatric disorders in preterm children by 1) comprehensively evaluating psychiatric symptoms during the preschool period with a particular focus on ADHD and autism symptoms, 2) relating alterations in neonatal microstructural and functional connectivity to ADHD and ASD symptoms during early childhood as well as 3) exploring whether key psychosocial risk factors also impact poor social-emotional and psychiatric outcomes. The proposed study adds a comprehensive psychiatric and social-emotional assessment during the preschool period in a captured sample of premature children longitudinally followed since birth for whom neonatal structural and resting state functional connectivity MRI data are available. This project provides an unprecedented opportunity to address this key scientific question and a unique training opportunity at an institution at the forefront of neuroscience research. The candidate is committed to further developing expertise in the area of neonatal neuroimaging and preschool psychopathology in preterm populations. Data from these research activities will support the development of an R01 application tracking developmental psychopathology trajectories and subsequent brain development of this study population into school-age. This project could inform early identification and targeted intervention strategies during a period of significant brain plasticity improving psychiatric outcomes for preterm children.