当前和已缓解的重度抑郁症患者精神运动障碍的检查:一项RDoC研究。

Journal of psychiatry and brain science Pub Date : 2020-01-01 Epub Date: 2020-04-17 DOI:10.20900/jpbs.20200007
Stewart A Shankman, Vijay A Mittal, Sebastian Walther
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引用次数: 18

摘要

重度抑郁症(MDD)是一个严重的公共卫生问题,治疗效果最好,可能是由于其异质性的临床表现。分析这种异质性的一种方法是研究重度抑郁症的特定特征的作用,这一努力也有助于确定治疗和预防工作的新目标和重点目标。我们的R01关注的是精神运动性障碍的特征(例如,精神运动性躁动(PmA)和发育迟缓(PmR)),这是重度抑郁症的一个特别有害的特征,在重度抑郁症中尚未得到广泛的研究。目的1是比较三组个体——当前重度抑郁症患者(n = 100)、缓解重度抑郁症患者(n = 100)和对照组(n = 50)——对PmR和PmA的多项测量(在实验室和受试者的自然环境中进行评估)。目的2是检查三组运动回路的结构(扩散MRI)和功能(静息状态fMRI)连通性,以及运动回路与PmR和PmA指标之间的关系。目的3是在18个月内对受试者进行三次随访,以评估运动症状是否与整体抑郁症状和功能随时间的推移而变化,和/或基线PmR/PmA是否预测抑郁和功能的进程。Aim 3尤其具有临床意义。发现运动功能和整体抑郁严重程度随时间共同变化,或者运动变量预测整体抑郁严重程度的后续变化,将支持这些新颖、可靠且易于实施的运动评估的潜在临床应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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An Examination of Psychomotor Disturbance in Current and Remitted MDD: An RDoC Study.

Major depressive disorder (MDD) is a serious public health problem that has, at best, modest treatment response-potentially due to its heterogeneous clinical presentation. One way to parse the heterogeneity is to investigate the role of particular features of MDD, an endeavor that can also help identify novel and focal targets for treatment and prevention efforts. Our R01 focuses on the feature of psychomotor disturbance (e.g., psychomotor agitation (PmA) and retardation (PmR)), a particularly pernicious feature of MDD, that has not been examined extensively in MDD. Aim 1 is comparing three groups of individuals-those with current MDD (n = 100), remitted MDD (n = 100), and controls (n = 50)-on multiple measures of PmR and PmA (assessed both in the lab and in the subjects' natural environment). Aim 2 is examining the structural (diffusion MRI) and functional (resting state fMRI) connectivity of motor circuitry of the three groups as well as the relation between motor circuitry and the proposed indicators of PmR and PmA. Aim 3 is following up with subjects three times over 18 months to evaluate whether motor symptoms change in tandem with overall depressive symptoms and functioning over time and/or whether baseline PmR/PmA predicts course of depression and functioning. Aim 3 is particularly clinically significant. Finding that motor functioning and overall depression severity co-vary over time, or that motor variables predict subsequent change in overall depression severity, would support the potential clinical utility of these novel, reliable, and easily administered motor assessments.

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