Testing the predictive power of neural connectivity: Suicidal ideation in youth exposed to maltreatment

项目摘要/摘要 为了响应国家卫生局、国会和NIMH的号召，这项拟议的研究将 调查高危人群中自杀意念和行为的神经标记物 自杀(即有虐待儿童史的青少年)。虐待儿童与青少年密切相关 然而，虐待儿童本身并不能很好地预测未来的自杀意念和行为。 行为。对未来自杀想法和行为的预测是至关重要的，目前可能受到缺乏 关于已知自杀危险因素的神经基础的知识。虐待儿童影响 大脑中与情绪调节有关的区域的功能。此外，情绪调节可能是一个关键过程 潜在的自杀念头和行为。拟议中的研究将前瞻性地考察整个网络。 大脑网络中的功能连接与情绪调节有关，是自杀意念的预测因子 有虐待儿童史和没有虐待儿童史的两个独立的青少年样本。这项工作将探索 在广泛使用的情绪中，额叶边缘(例如，背外侧前额叶皮质-杏仁核)的连接 有和无自杀意念和虐待儿童的青少年的调节任务和静息状态扫描 历史。此外，这项工作将检验神经连接作为自杀意念的预期预测因子。 根据以前的研究，预计同时存在虐待儿童和自杀意念的青少年 病史将显示，与患有虐待儿童或 只有自杀意念史，并控制着年轻人。此外，还假设弱的额缘 在这两个青年样本中，连接性将前瞻性地预测未来1-2年内的自杀意念。这里 我们有非凡的能力交叉验证我们从一个样本到另一个独立样本的发现 青春年华。结合使用基于实验的范例、功能网络连接和 创新的纵向交叉验证发现，拟议的研究在以下方面取得了实质性进展 这一领域几乎完全依赖于横断面的、单一的告密者、关于自杀的回顾报告 想象力。来自两个独立样本的参与者(总计N=340名8-16岁的青年；支持数据收集 由2名NIMH资助的R01)，有一系列虐待儿童和自杀意念史的人完成了基线 评估和fMRI扫描，前瞻性地跟踪~1-2年，并完成额外的fMRI扫描。 我们将结合传统的连通性分析(图论)和前沿的数据驱动算法来 交叉验证基线和随访(~1-2年)中的神经网络连接结果。研究结果： 目前的研究可能会确定自杀念头和行为的具体风险标志，从而使我们能够显著 提高前瞻性预测。提高对青少年自杀的神经基础的了解对于 解决这一重大的公共卫生问题。该项目直接响应国家的行动号召。 关于青年自杀，并将对这一领域作出重大贡献。

Project Summary/Abstract In response to national calls from the Surgeon General, Congress, and NIMH, the proposed research will investigate neural markers of suicidal ideation and behavior in one of the most vulnerable populations at risk for suicide (i.e., youth with a history of child maltreatment). Child maltreatment is robustly related to youth suicidal ideation and behavior; yet, child maltreatment alone is a poor predictor of future suicidal ideation and behavior. Prediction of future suicidal ideation and behavior is critical and may be currently limited by a lack of knowledge regarding neural underpinnings of known risk factors for suicide. Child maltreatment affects functioning in brain regions implicated in emotion regulation. Further, emotion regulation may be a key process underlying suicidal ideation and behavior. The proposed research will prospectively examine network wide functional connectivity in brain networks implicated in emotion regulation as a predictor of suicidal ideation in two independent samples of youth with and without histories of child maltreatment. This work will explore frontolimbic (e.g., dorsolateral prefrontal cortex—amygdala) connectivity during a widely-used emotion regulation task and resting state scan among youth with and without suicidal ideation and child maltreatment histories. Further, this work will examine neural connectivity as a prospective predictor of suicidal ideation. Based on previous research, it is expected that youth with both child maltreatment and suicidal ideation histories will demonstrate weak frontolimbic connectivity compared to youth with either child maltreatment or suicidal ideation histories alone and control youth. Further, it is hypothesized that weak frontolimbic connectivity will prospectively predict suicidal ideation across ~1-2 years across both samples of youth. Here we have the remarkable ability to cross-validate our findings from one sample in an independent sample of youth. Using a combination of experimental lab-based paradigms, functional network connectivity, and an innovative longitudinal, cross-validation of findings, the proposed research offers a substantial advance within the field that almost exclusively has relied on cross-sectional, single informant, retrospective reports of suicidal ideation. Participants from two independent samples (total N = 340 youth ages 8-16; data collection supported by 2 NIMH funded R01s) with a range of child maltreatment and suicidal ideation histories complete a baseline assessment and fMRI scan, are followed prospectively for ~1-2 years, and complete an additional fMRI scan. We will combine traditional connectivity analysis (graph theory) and a cutting-edge data-driven algorithm to cross-validate neural network connectivity findings from baseline and follow-up (~1-2 years). Findings from the current study may identify concrete markers of risk for suicidal ideation and behavior allowing us to significantly improve prospective prediction. Advancing knowledge of neural underpinnings of youth suicide is critical for addressing this significant public health concern. This project directly addresses national calls for action regarding youth suicide and stands to substantially contribute to the field.