ATTENTION AND RELATED FUNCTIONAL BRAIN NETWORKS IN PEDIATRIC ANXIETY DISORDERS

项目总结 焦虑症是儿童中最常见的一类精神疾病，影响高达30%的人 在他们十八岁生日之前。患有焦虑症的孩子通常会经历重要的家庭， 社交和学习障碍，患其他精神障碍的风险增加，如 成年人。尽管成功的治疗与延续到成年的益处有关，但许多儿童 即使使用最好的治疗方法，仍具有高度的症状性。显然需要新的早期干预措施 对于这种高度流行的疾病。国家精神卫生研究所的使命声明提供了一个 寻找新疗法的一般方法：“了解精神、大脑和行为，从而减少 通过研究来减轻精神疾病的负担。功能大脑网络是大脑区域的集合，具有 一种常见的功能。在脑功能网络的水平上理解病理学有着巨大的希望 用于解锁精神疾病的发展、病因和治疗，如儿童焦虑症。 考虑到这一框架，这个以患者为导向的导师职业发展奖(K23)的目的是 是为了使应聘者能够开发一个研究项目，研究大脑功能网络的变化 在儿童焦虑症中。申请者的长期目标是使用功能大脑网络来预测 纵向病程，治疗反应，并开发儿童焦虑症的新疗法。帮助 为了实现这一目标，本申请中的培训计划满足了申请者对临床培训的需求 发展性精神病理学研究。培训和指导在以下方面提供：1)临床评估 儿童研究，2)了解情绪和认知发展，3)儿科 神经影像，4)纵向研究设计和分析，5)治疗发展。的研究计划 该项目与培训计划密切相关，并包括一个多学科小组的协助。 导师和顾问。这项研究提案检验了一种假设，即一种特定的变化 功能性网络，即腹侧注意网络(VAN)，与焦虑症的发展有关。 面包车中的一般变化被认为是通过增加注意力的方向来导致焦虑的 威胁性刺激。为了检验这些假设，患有和不患有焦虑症的8-12岁儿童 在前瞻性设计中，使用神经成像和行为方法进行两次评估，间隔24个月。数据 这项研究将被用来为一个更明确的R01项目的申请提供信息，该项目绘制了开发 高危幼儿腹侧注意网络与焦虑发展的关系 焦虑症的发作。这项申请的结果预计会立即得到治疗 通过确定治疗开发是否应该针对腹侧注意网络而产生的影响。这 Proposal还开发了一个框架，用于检查额外的脑网络功能病理生理学 与儿童焦虑症有关。

PROJECT SUMMARY Anxiety disorders are the most common class of mental illness in children, affecting up to 30% of individuals prior to their eighteenth birthday. Children who develop an anxiety disorder often experience significant family, social, and academic impairments and are at increased risk for developing additional psychiatric disorders as adults. Although successful treatment has been linked to benefits that extend into adulthood, many children remain highly symptomatic even with the best available treatments. New early interventions are clearly needed for this highly prevalent condition. The mission statement of the National Institute of Mental Health offers a general approach to finding new treatments: “to understand mind, brain, and behavior, and thereby to reduce the burden of mental illness through research.” Functional brain networks are collections of brain regions with a common function. Understanding pathology at the level of functional brain networks holds enormous promise for unlocking the development, etiology, and treatment of mental illnesses such as pediatric anxiety disorders. With this framework in mind, the purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a research program investigating alterations in functional brain networks in childhood anxiety disorders. The applicant's long-term goal is to use functional brain networks to predict longitudinal course, treatment response, and develop new treatments for pediatric anxiety disorders. To help achieve this goal, the training plan in this application addresses the applicant's need for training in clinical developmental psychopathology research. Training and mentorship are provided in: 1) clinical assessments of children for research purposes, 2) understanding emotional and cognitive development, 3) pediatric neuroimaging, 4) longitudinal study design and analysis, and 5) treatment development. The research plan for this project is closely linked to the training plan and includes the assistance of a multidisciplinary team of mentors and consultants. The research proposal tests the hypothesis that alterations in one particular functional network, the ventral attention network (VAN), are associated the development of anxiety disorders. General alterations in the VAN are proposed to result in anxiety by increasing the orientation of attention to threatening stimuli. To test these hypotheses, children ages 8-12 years with and without anxiety disorders are assessed twice, 24 months apart, using neuroimaging and behavioral methods in a prospective design. Data from this study will be used to inform an application for a more definitive R01 project that maps developmental relations between the ventral attention network and development of anxiety in young at-risk children before the onset of anxiety disorders. Results from this application are expected to have immediate treatment implications, by determining whether treatment development should target the ventral attention network. This proposal also develops a framework for examining additional functional brain network pathophysiology associated with pediatric anxiety disorders.