Longitudinal study of sleep duration, reward and cognitive control circuits, and vulnerability for depression and suicidal ideation during adolescence

项目摘要 青春期开始了抑郁和自杀以及失眠的脆弱时期。短时睡眠 时长在年轻人中非常普遍(即44%的高中生报告睡眠时间不超过6小时 晚上)，是抑郁、自杀和其他负面后果的危险因素。失眠是 假设通过扰乱奖赏和认知控制神经来影响症状内化 小路。这些大脑网络在青春期继续发育，与发育和 保持抑郁，并已被证明对急性睡眠限制敏感 试验性工作。我们的发现是奖赏和认知控制回路中的钝化激活 睡眠限制(与睡眠延长相比)提供了涉及睡眠不足的合理机制 在发展内在化精神病理学的道路上。扩展这项工作的下一个关键步骤是 检查睡眠不足的累积影响，自然而然地检查睡眠与大脑的关系 并检查这些指标在多大程度上预测抑郁症和 自杀。这些都是我们提出的研究的目标。我们建议从210名年龄为11.5岁的青年中抽取- 14.5(66%女性)，目前在7年级、8年级或9年级，代表习惯性睡眠的连续体 持续时间，但确保50%的睡眠时间为7小时或更少。参与者将在接下来的4年里接受跟踪调查 在青春期抑郁发作的高峰期，通过活动描记每年评估睡眠 和行为测量(奖励学习、认知控制)，以及基线(7-9年级)的fMRI扫描 两年后(9-11年级)复习。基于互联网的自我报告评估将每季度收集一次 (每3个月；总共14-16个月)，以检查睡眠变化之间更细微的时间关联 持续时间、抑郁症状和自杀意念。在这个为期4年的纵向设计中，我们将研究如何 睡眠时间的减少会影响奖赏和认知控制，以及睡眠和这些机制 共同预测随后的抑郁症状和自杀意念。睡眠不足可能是一个重要的- 然而，精神病理学的脆弱性因素是可以改变的。理解与睡眠相关的时间关联 心理健康--以及神经机制的作用--将有助于更好地针对睡眠进行干预 通过确定何时和在谁身上，他们将得到最好的指导。研究结果将为 开发新的干预措施，加强现有的(睡眠或心理健康)治疗，和/或改变公众 改善青少年睡眠的政策(即推迟开学时间)，并最终防止内在性障碍。

Project Summary Adolescence begins a period of vulnerability for depression and suicidality, as well as for sleep loss. Short sleep duration is extremely common in youth (i.e., 44% of high school students report 6 or less hours of sleep on school nights), and is a risk factor for depression, suicidality, and other negative outcomes. Sleep loss is hypothesized to exert an influence on internalizing symptoms by disrupting reward and cognitive control neural pathways. These brain networks continue to develop during adolescence, are implicated in the development and maintenance of depression, and have been shown to be sensitive to acute sleep restriction in our prior experimental work. Our findings of blunted activation within both reward and cognitive control circuitry following sleep restriction (as compared to sleep extension) provide plausible mechanisms by which sleep loss is involved in the pathway to developing internalizing psychopathology. The next critical step to extend this line of work is to examine the cumulative effects of insufficient sleep, to examine sleep-brain relationships naturalistically during the school year, and to examine the extent to which these predict longitudinal changes in depression and suicidality. These are the goals of our proposed study. We propose to enroll a sample of 210 youth ages 11.5– 14.5 (66% female), who are currently in the 7th, 8th, or 9th grades, representing a continuum of habitual sleep duration, but ensuring 50% with 7 or fewer hours of sleep. Participants will then be followed for the next 4 years during the peak risk for depression onset during adolescence, with annual assessments of sleep via actigraphy and behavioral measures (reward learning, cognitive control), along with fMRI scans at baseline (7th–9th grade) and repeated 2 years later (in 9th–11th grade). Self-report internet-based assessments will be collected quarterly (every 3 months; 14–16 in total) to examine more nuanced temporal associations between changes in sleep duration, depression symptoms, and suicidal ideation. In this longitudinal 4-year design, we will examine how declining sleep duration influences reward and cognitive control, and whether sleep and these mechanisms jointly predict subsequent depression symptoms and suicidal ideation. Insufficient sleep may be an important— yet modifiable—vulnerability factor for psychopathology. Understanding the temporal associations linking sleep and mental health—as well as the role of neural mechanisms—will help better target sleep-focused interventions by determining when, and in whom, they would best be directed. Study findings will provide leverage for developing novel interventions, augmenting existing (sleep or mental health) treatments, and/or changing public policy (i.e., later school start times) to improve adolescent sleep, and ultimately, prevent internalizing disorders.