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3 results on '"Patrick Stetz"'

1. Accelerated neuromodulation therapy for Obsessive-Compulsive Disorder

Author

Nolan R. Williams, Keith D. Sudheimer, Eleanor J. Cole, Andrea D. Varias, Andrea N. Goldstein-Piekarski, Patrick Stetz, Anthony Lombardi, Maria Filippou-Frye, Peter van Roessel, Kelley Anderson, Elizabeth A. McCarthy, Brianna Wright, Thasveen Sandhu, Sindu Menon, Booil Jo, Lorrin Koran, Leanne M. Williams, and Carolyn I. Rodriguez

Subjects
NCT03404609, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Published
2021
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2. Early changes in neural circuit function engaged by negative emotion and modified by behavioural intervention are associated with depression and problem-solving outcomes: A report from the ENGAGE randomized controlled trial

Author

Andrea N Goldstein-Piekarski, Joseph Wielgosz, Lan Xiao, Patrick Stetz, Carlos G. Correa, Sarah E. Chang, Nan Lv, Lisa G. Rosas, Philip W. Lavori, Mark B. Snowden, Elizabeth M. Venditti, Janine M. Simmons, Joshua M. Smyth, Trisha Suppes, Megan A. Lewis, Olusola Ajilore, Jun Ma, and Leanne M. Williams

Subjects
Depression, Obesity, Insula, Amygdala, Problem-solving, Neuroimaging, Medicine, Medicine (General), R5-920
Abstract

Background: Depression exerts a staggering toll that is worsened with co-occurring chronic conditions such as obesity. It is imperative to develop more effective interventions for depression and to identify objective and biological plausible neural mechanisms to understand intervention outcomes. The current study uses functional neuroimaging to determine whether a behavioural intervention changes the negative affect circuit and whether these changes relate to subsequent improvements in both symptom and problem-solving outcomes in depressed patients with co-occurring obesity. Methods: This study (‘ENGAGE’) was a pre-planned element of the randomized controlled trial, ‘RAINBOW’ (ClinicalTrials.gov NCT02246413). 108 depressed patients with obesity were randomized to receive an integrated collaborative care intervention (I-CARE) or usual care. Participants underwent functional neuroimaging using an established facial emotion task at baseline and two months (coinciding with the first two months of intervention focused on problem-solving therapy (‘PST’)). Amygdala, insula and anterior cingulate cortex activation was extracted using pre-planned definitions and standardized methods. The primary health and behavioural outcomes were depression symptom severity and problem-solving ability respectively, assessed at baseline, the main 6-month outcome point and at 12-month follow up. Mediation analyses used an intent-to-treat approach. Findings: PST, relative to usual care, reduced amygdala activation engaged by threat stimuli at two months. This reduction mediated subsequent improvements in depression severity in an intervention-dependent manner. PST did not change insula activation at two months but did temper the strength of the relationship between insula activation and improvements in problem-solving ability. Interpretation: The negative affect circuit may be an important neural target and potential mediator of PST in patients with comorbid obesity. Funding: US National Institutes of Health/National Heart Lung and Blood Institute R01 HL119453 and UH2/UH3 HL132368

Published
2021
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3. The ENGAGE-2 study: Engaging self-regulation targets to understand the mechanisms of behavior change and improve mood and weight outcomes in a randomized controlled trial (Phase 2)

Author

Amruta Barve, Joseph Wielgosz, Janine M. Simmons, Philip W. Lavori, Patrick Stetz, Nan Lv, Aashutos S. Patel, Elizabeth M. Venditti, Joshua M. Smyth, Jun Ma, Mark Snowden, Leanne M. Williams, Ben S. Gerber, Corina R. Ronneberg, Lisa G. Rosas, Nancy E. Wittels, Tessa L. Eckley, Andrea N. Goldstein-Piekarski, Olusola Ajilore, and Lan Xiao

Subjects
Protocol (science), Psychotherapist, Conceptualization, business.industry, media_common.quotation_subject, Behavior change, Translational research, General Medicine, Precision medicine, Article, Antidepressive Agents, law.invention, Self-Control, Sadness, Affect, Mood, Randomized controlled trial, law, Behavior Therapy, Medicine, Humans, Pharmacology (medical), Obesity, business, media_common
Abstract

Despite evidence for effective integrated behavior therapy for treating comorbid obesity and depression, treatment response is highly variable and the underlying neurobiological mechanisms remain unknown. This hampers efforts to identify mechanistic targets in order to optimize treatment precision and potency. Funded within the NIH Science of Behavior Change (SOBC) Research Network, the 2-phased ENGAGE research project applies an experimental precision medicine approach to address this gap. The Phase 1 study focused on demonstrating technical feasibility, target engagement and potential neural mechanisms of responses to an integrated behavior therapy. This therapy combines a video-based behavioral weight loss program and problem-solving therapy for depression, with as-needed intensification of antidepressant medications, and its clinical effectiveness was demonstrated within a parent randomized clinical trial. Here, we describe the ENGAGE Phase 2 (ENGAGE-2) study protocol which builds on Phase 1 in 2 ways: (1) pilot testing of an motivational interviewing-enhanced, integrated behavior therapy in an independent, primarily minority patient sample, and (2) evaluation of a priori defined neural targets, specifically the negative affect (threat and sadness) circuits which demonstrated engagement and malleability in Phase 1, as mediators of therapeutic outcomes. Additionally, the Phase 2 study includes a conceptual and methodological extension to explore the role of microbiome-gut-brain and systemic immunological pathways in integrated behavioral treatment of obesity and depression. This protocol paper documents the conceptualization, design and the transdisciplinary methodologies in ENGAGE-2, which can inform future clinical and translational research in experimental precision medicine for behavior change and chronic disease management. Trial registration: ClinicalTrials.gov #NCT 03,841,682.

Published
2020

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