Neuroeconomics of Framing Effects and Risk Attitudes in Early Dementia

描述（由申请人提供）：这是一份申请K23奖的申请，申请对象是加州大学旧金山分校的行为神经学家邱文思博士。此次K23奖将为蒋博士提供必要的支持，以实现以下目标：(1)成为以患者为导向的痴呆症研究专家；(2)对老年人、阿尔茨海默病和额颞叶痴呆患者的决策行为和功能进行MRI研究；(3)利用半结构化的信息访谈来表征阿尔茨海默病和额颞叶痴呆的现实决策错误；(4)运用神经经济学衍生的工具和框架来解释患者的行为；(5)将新的分析技术应用于痴呆的功能性MRI；(6)发展独立的研究事业。为了实现这些目标，蒋博士组建了一个由两位共同主要导师组成的指导团队。Howard Rosen博士是一名行为神经学家，他领导着加州大学旧金山分校的阿尔茨海默病护理中心，并共同指导着加州大学旧金山分校的行为神经学培训项目；马克·德·埃斯波西托博士是一名行为神经学家和神经科学家，他领导着加州大学伯克利分校的小亨利·h·惠勒脑成像中心。指导团队包括两名合作者：乔尔·克莱默博士，加州大学旧金山分校的神经心理学家，在测量痴呆症的行为变化方面有经验；以及加州大学伯克利分校（UC Berkeley）的神经经济学家徐明（Ming Hsu）博士，他擅长将经济模型应用于神经数据。最后，顾问约翰·纽豪斯博士是一名统计学家，他将协助生物统计分析和培训。财务决策失误会给患者及其家人带来灾难性的后果，也是痴呆症的最早症状之一。因此，了解痴呆症中这些错误的神经基础将有助于早期诊断、风险预测、危害预防和设计干预措施以改善决策。最近在决策神经科学方面的研究为理解决策偏差方面的错误提供了一个框架，比如扭曲财务判断的框架效应。蒋博士的研究将使用多种技术来研究决策偏差和冒险行为如何受到年龄、阿尔茨海默病和额颞叶痴呆的影响，这两种疾病对行为和判断的影响非常不同。在行为层面，Chiong博士将使用既定的神经经济学任务来评估框架效应和衰老和早期疾病的风险敏感性。（目的1）在神经层面，他将使用功能性MRI来评估这些疾病中的大规模神经网络扰动如何影响财务决策。（目标2）在临床层面，他将使用神经经济学框架内的信息者访谈来描述患者在现实世界中所犯的财务决策错误。（目的3）这些研究将促进我们对痴呆症这一重要早期症状的理解，为未来研究其在早期诊断中的重要性，以及为改善决策的行为和政策干预奠定基础。

DESCRIPTION (provided by applicant): This is an application for a K23 award for Dr. Winston Chiong, a behavioral neurologist at the University of California, San Francisco. This K23 award will provide Dr. Chiong with the support necessary to accomplish the following goals: (1) to become expert at patient-oriented research in dementia; (2) to conduct behavioral and functional MRI investigations of decision-making in aging and in patients with Alzheimer's disease and frontotemporal dementia; (3) to characterize real-world decision-making errors in Alzheimer's disease and frontotemporal dementia using semi-structured informant interviews; (4) to apply tools and frameworks derived from neuroeconomics in interpreting patients' behaviors; (5) to apply new analytic techniques to functional MRI in dementia; and (6) to develop an independent research career. To achieve these goals, Dr. Chiong has assembled a mentoring team with two co-primary mentors. Dr. Howard Rosen is a behavioral neurologist who directs the UCSF State of California Alzheimer's Care Center and co-directs the UCSF Behavioral Neurology Training Program; and Dr. Mark D'Esposito is a behavioral neurologist and neuroscientist who directs the Henry H. Wheeler Jr. Brain Imaging Center at UC Berkeley. The mentoring team includes two collaborators: Dr. Joel Kramer, a neuropsychologist at UCSF with experience in measuring behavioral change in dementia; and Dr. Ming Hsu, a neuroeconomist at UC Berkeley with expertise in applying economic models to neural data. Finally, consultant Dr. John Neuhaus is a statistician who will assist in biostatistical analysis ad training. Financial decision-making errors can have disastrous consequences for patients and their families, and are among the earliest symptomatic indicators of dementia. Understanding the neural bases of these errors in dementia will therefore aid in early diagnosis, risk prediction harm prevention, and devising interventions to improve decision-making. Recent work in the neuroscience of decision-making provides a framework for understanding such errors in terms of decision-making biases, such as framing effects that distort financial judgment. Dr. Chiong's research will use a variety of techniques to study how decision-making biases and risk- taking are affected by aging and by Alzheimer's disease and frontotemporal dementia, two illnesses with very different effects on behavior and judgment. At a behavioral level, Dr. Chiong will use an established neuroeconomic task to assess framing effects and risk sensitivity in aging and in early disease. (Aim 1) At a neural level, he will use functional MRI to assess how large-scale neural network perturbations in these diseases affect financial decision-making. (Aim 2) And at a clinical level, he will use informant interviews within a neuroeconomic framework to characterize the financial decision-making errors that patients make in the real world. (Aim 3) These studies will advance our understanding of this important early symptom in dementia, setting the stage for future investigations of its significance in early diagnosis, and for behavioal and policy interventions to improve decision-making.