ATTENTION AND RELATED FUNCTIONAL BRAIN NETWORKS IN PEDIATRIC ANXIETY DISORDERS

项目摘要 焦虑症是儿童中最常见的一类精神疾病，影响高达30%的个体 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， 社会和学术障碍，并在发展其他精神疾病的风险增加， 成年人了虽然成功的治疗与延长到成年的益处有关，但许多儿童 即使有最好的治疗方法，症状仍然很严重。显然需要新的早期干预措施 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：“了解心灵，大脑和行为，从而减少 精神疾病的负担”功能性大脑网络是大脑区域的集合， 共同的功能。在功能性脑网络水平上理解病理学具有巨大的希望 为解开发展，病因学，和治疗精神疾病，如小儿焦虑症。 考虑到这个框架，这个指导病人为导向的职业发展奖（K23）的目的 是使候选人能够开发一个研究计划，调查功能性大脑网络的变化 儿童期焦虑症申请人的长期目标是利用功能性大脑网络来预测 纵向过程，治疗反应，并为儿童焦虑症开发新的治疗方法。帮助 为了实现这一目标，本申请中的培训计划满足了申请人在临床 发展性精神病理学研究培训和指导提供：1）临床评估 儿童研究目的，2）理解情感和认知发展，3）儿科 神经影像学，4）纵向研究设计和分析，以及5）治疗开发。研究计划 该项目与培训计划密切相关，并包括多学科团队的援助 导师和顾问。这项研究计划验证了一个假设，即在一个特定的基因组中， 功能网络，腹侧注意网络（货车），与焦虑障碍的发展有关。 货车的一般改变被认为是通过增加注意力的方向来导致焦虑。 威胁性的刺激为了验证这些假设，年龄在8-12岁之间的患有和不患有焦虑症的儿童， 在前瞻性设计中，使用神经影像学和行为学方法进行两次评估，间隔24个月。数据 本研究的结果将用于为更明确的R 01项目提供信息，该项目将绘制发展 腹侧注意网络与高危儿童焦虑发展的关系 焦虑症的发作从这个应用程序的结果预计将有立即治疗 的影响，通过确定治疗开发是否应该针对腹侧注意力网络。这 该提案还开发了一个框架，用于检查其他功能性脑网络病理生理学 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.