Developing a clinical translational neuroscience taxonomy for anxiety and mood disorder: protocol for the baseline-follow up Research domain criteria Anxiety and Depression (“RAD”) project

Abstract

BackgroundUnderstanding how brain circuit dysfunctions relate to specific symptoms offers promise for developing a brain-based taxonomy for classifying psychopathology, identifying targets for mechanistic studies and ultimately for guiding treatment choice. The goal of the Research Domain Criteria (RDoC) initiative of the National Institute of Mental Health is to accelerate the development of such neurobiological models of mental disorder independent of traditional diagnostic criteria. In our RDoC Anxiety and Depression (“RAD”) project we focus trans-diagnostically on the spectrum of depression and anxiety psychopathology. Our aims are a) to use brain imaging to define cohesive dimensions defined by dysfunction of circuits involved in reactivity to and regulation of negatively valenced emotional stimulation and in cognitive control, b) to assess the relationships between these dimension and specific symptoms, behavioral performance and the real world capacity to function socially and at work and c) to assess the stability of brain-symptom-behavior-function relationships over time.Methods and designHere we present the protocol for the “RAD” project, one of the first RDoC studies to use brain circuit functioning to define new dimensions of psychopathology. The RAD project follows baseline-follow up design. In line with RDoC principles we use a strategy for recruiting all clients who “walk through the door” of a large community mental health clinic as well as the surrounding community. The clinic attends to a broad spectrum of anxiety and mood-related symptoms. Participants are unmedicated and studied at baseline using a standardized battery of functional brain imaging, structural brain imaging and behavioral probes that assay constructs of threat reactivity, threat regulation and cognitive control. The battery also includes self-report measures of anxiety and mood symptoms, and social and occupational functioning. After baseline assessments, therapists in the clinic apply treatment planning as usual. Follow-up assessments are undertaken at 3 months, to establish the reliability of brain–based subgroups over time and to assess whether these subgroups predict real–world functional capacity over time. First enrollment was August 2013, and is ongoing.DiscussionThis project is designed to advance knowledge toward a neural circuit taxonomy for mental disorder. Data will be shared via the RDoC database for dissemination to the scientific community. The clinical translational neuroscience goals of the project are to develop brain-behavior profile reports for each individual participant and to refine these reports with therapist feedback. Reporting of results is expected from December 2016 onward.Trial registrationClinicalTrials.gov Identifier: NCT02220309. Registered: August 13, 2014.

Anxiety in the elderly

“…Важным клинико-эпидемиологическим фактором является высокая коморбидность тревожных нарушений [9,11]. В группе пациентов с диагностированным ТР 10% име-ют два варианта ТР, у 29% выявляется сочетание тревожного и депрессивного расстройства, а 31% пациентов имеют два ТР и по крайней мере одно депрессивное расстройство [12]. В большинстве случаев первым возникает ТР, которое часто предшествует развитию психосоматических, сердечно-сосудистых и нейродегенеративных заболеваний.…”

A neurociência computacional no estudo dos processos cognitivos

“…It should be noted that the results obtained in general neuroscience and in computational neuroscience are very incipient for the ultimate goal of understanding how the brain represents and computes stimuli. However, the study of neural circuits is already proving useful for obtaining robust and detailed diagnoses of mental disorders (Williams, 2016;Williams et al, 2016), confirming its practical validity. In particular, neural computation studies are very far from a revolutionary impact given the classic problems of Psychology, which attempt to understand the complexity of the human being through several theoretical orientations.…”

“…Despite that, the number of studies that seek out a relation between cognitive processes and their neuroanatomic correlates has increased, such as those using functional magnetic resonance imaging Berman, Jonides, & Nee, 2006;Fornito, Zalesky, & Breakspear, 2015;Van Essen et al, 2013). In fact, much of the effort in the field of neuropsychology contributes to the understanding of such correlates, which have practical application in psychiatric diagnoses and psychological treatments (for a discussion, refer to Williams, 2016;Williams et al, 2016). In this type of approach, the concept of cognition is adapted to the spatial restrictions imposed by the anatomy of the nervous system.…”

For Value or for Worth? Part 2: A Neuroeconomical Thought-Action-Mood-Space Modulated by (Un-)Certainty as Sign- or Goal-tracking

“…Huge global projects like the Research Domain Criteria (RDoC) initiative are under way [83], which astonishingly removed movement from the classical triad [84]. Furthermore especially the understanding of intrinsically dimensional topics, e.g.…”