Role of BDNF on Risk Behavior Decision Making

描述（由申请人提供）：这是一项针对西班牙裔城市青少年的5年纵向生物心理社会整合研究，旨在证明神经调节剂BDNF（脑源性神经营养因子）在决策（DM）和艾滋病毒传播风险行为（TRBs）中被忽视的作用。除了有希望的初步研究结果外，这项提议的推动力是佛罗里达州的西班牙裔血清患病率，这几乎是全国水平的两倍。长期以来，佛罗里达州一直是美国的主要疫情中心，最新数据显示，佛罗里达州的艾滋病疫情出乎意料地严峻，在艾滋病累计病例中排名第三，在儿科累计病例中排名第二。由于高风险，青少年被认为是艾滋病毒高危亚群体之一。此外，在2007年的34个州中，佛罗里达州在青少年（13至19岁）感染艾滋病毒/艾滋病的人数方面排名第二（仅次于纽约），其中最集中的是佛罗里达州的迈阿密-戴德县和布劳沃德县，这是该提案的所在地。这突出了加强当前对这些少数民族亚人群的风险和脆弱性因素的理解的紧迫性，特别是在以前的工作中被很大程度上忽视的神经生物学因素，很少在少数民族青少年中进行检查。提出的研究在西班牙裔青少年中测试了一个基于理论的决策模型，该模型强调神经调节剂BDNF，将其评估从酒精/药物使用扩展到性风险行为，在假设障碍可能的框架内：a)改变认知过程；B)与决策和适应等复杂行为的联系；c)与维持心理健康的问题高度相关，尤其是在紧张的情况下。鉴于hiv - trb在青少年大脑发育和糖尿病中起着关键作用，本研究还旨在探讨家庭/环境与青少年神经生化因素在影响hiv - trb中的相互作用。在当地卫生部门的支持下，我们拟招募500名西班牙裔青少年（13-16岁），随访超过2年（3个时间点），以研究生物学和神经心理因素以及生活经历与hiv - trb的相互关系。并捕捉到向后期发展阶段的过渡。拟议的项目是一个跨学科的合作，将贡献新的生物行为知识的目标神经机制，临床解决方案已经存在。目前可用的治疗方法可以改善亚理想的神经化学水平（例如重组BDNF）。此外，由于BDNF涉及决策的情感和认知维度，因此该研究还为将神经生物学整合到这些易感人群的行为干预中提供了一种创新的策略。

DESCRIPTION (provided by applicant): This proposed R01 is a 5-year longitudinal bio-psycho-social integrative study of inner-city Hispanic adolescents, designed as a proof-of-concept of the neglected role of the neuromodulator BDNF (brain derived neurotrophic factor) in decision making (DM) and HIV-Transmission Risk Behaviors (TRBs). In addition to promising preliminary research findings, the impetus for this proposal is Hispanic seroprevalence in Florida, which is nearly twice the national rate. Long a primary U.S. epicenter, the latest available data shows that Florida's HIV epidemic is unexpectedly grim, ranking 3rd in cumulative AIDS cases, 2nd in cumulative pediatric cases. Because of heightened risk-taking, adolescents are considered among the high-risk HIV subgroups. Moreover, among 34 states in 2007, Florida ranked 2nd (behind New York) in the number of adolescents (13 to 19 years) living with HIV/AIDS, with the highest concentration in S. Florida's Miami-Dade and Broward counties, the sites of this proposal. This highlights the urgency for enhancing current understanding of risk and vulnerability factors in these minority subpopulations, particularly neurobiological factors that have been largely neglected in prior work and rarely examined in ethnic minority adolescents. The proposed study tests a theory-grounded- decision making model among Hispanic adolescents, which emphasizes the neuromodulator BDNF, extending its evaluation from alcohol/drug use to sexual risk behavior, in a framework that hypothesizes that disturbances are likely to: a) alter cognitive process; b) link to complex behaviors such as decision making and adaptation; and c) be highly relevant to problems in maintaining psychological well-being, particularly under stressful situations. The study also aims to explore the interaction of family/environment with adolescents' neurobiochemical factors in affecting HIV-TRBs given its pivotal role during adolescent brain development, and DM. With the support of local Health Departments, we propose to recruit 500 Hispanic adolescents (13-16 years), with follow-up over two years (3 time points) to examine the inter-relationships of biological and neuropsychological factors, and life experiences on HIV-TRBs, and to capture transition to later developmental stages. The proposed project is a transdisciplinary collaboration that will contribute new bio-behavioral knowledge to target neural mechanisms for which clinical solutions already exist. Treatments are currently available that may ameliorate suboptimal neurochemical levels (e.g., recombinant BDNF). In addition, because BDNF is implicated in both affective and cognitive dimensions of decision making, the proposed study also offers an innovative strategy for the highly sought-ever goal of integrating neurobiology into behavioral interventions among these susceptible populations.