About the study

We are seeking to better understand the neural mechanisms behind depression and anxiety in adolescents. Through the use of detailed clinical assessments and MRI protocols by the Human Connectome Project, we seek to determine if measures of brain structure and function obtained from neuroimaging can be used to sufficiently predict illness progression and ultimately yield more effective guidelines for diagnosis and treatment.

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For Interested Teens And Parents

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Launched in 2015, the BANDA study is among the first of several projects funded by the National Institute of Health (NIH) to study a disease population using data collection protocols from the The Human Connectome Project, a multi-institutional project seeking to build a comprehensive map of neural connections in the human brain. Headed by researchers at the McGovern Institute for Brain Research at the Massachusetts Institute of Technology, and in collaboration with research teams at McLean Hospital, Boston University, and Mass General Hospital, this study aims to probe adolescent depression and anxiety at multiple levels of analysis, collecting MRI and clinical/behavioral data from adolescents with depression or anxiety disorders, comparing them with healthy controls, and utilizing algorithms and brain imaging software to map out relevant circuits in the brain. The goal is to determine whether we can find reliable biomarkers for these disorders which can be used to more accurately predict clinical outcomes.

Why depression and anxiety?

Depression and anxiety disorders affect as many as one in four adolescents in the United States, with many carrying symptoms into adulthood. They often occur together, and through a multitude of characterizations may not only impact the general quality of life of the individual, but have also been found to be highly correlated to several leading causes of death in teenagers and young adults such as suicide and substance abuse accidents. While progress has been made in understanding these illnesses, our knowledge of the biological mechanisms behind them is still limited - often making treatment challenging to appropriate in a clinical setting. By attempting to map out the brain signatures of depression and anxiety at an age critical for mental development, the BANDA study aims to discover new insights into the underlying neurobiology and improve the way in which we approach these major psychiatric disorders.

Source of Participants

The Child Program at the Center for Anxiety and Related Disorders (CARD) at BU is an interdisciplinary research and treatment program devoted to expanding and improving the quality and accessibility of evidence based mental health care for young children and their families. The Child Program at CARD provides state of the art treatment for children aged 3-17 with anxiety disorders and related mood disorders, and maintains a substantial patient flow due to its well-established clinical infrastructure. It has received both local/national media attention for its grant supported research programs for youth and their families.

Child Cognitive Behavioral Therapy program at MGH is a Harvard Medical School-affiliated major medical center serving the entire New England area. The Child CBT program serves children ages 3-24 years, receiving 10-20 referrals per week with the vast majority of referrals being for anxiety. Aside from the program, recruits will be among those presenting to the general child outpatient psychiatry department at MGH. The outpatient psychiatric clinics register 30,000 visits per year, and evaluate more than 200 new patients per month. All social class strata and ethnic and racial groups are represented in the MGH patient population, and the study will not exclude any participants on the basis of race, ethnicity, social background or gender. This group has successfully met enrollment targets for past grants and, given our large catchment area and ongoing clinical efforts in childhood anxiety, we are well positioned to recruit the proposed sample.

McLean Hospital is a comprehensive mental health care system committed to providing a full range of high quality, cost effective, mental health services to patients, their families and the larger community. The Hospital is dedicated to training mental health professionals, to supporting basic and clinical research to understand the causes of mental illnesses, and to developing effective new means for prevention and treatment. Since 1811, McLean has been a world leader in the treatment of mental illness, research on mental illnesses, and in training generations of mental health care providers. McLean is an affiliate of MGH and a member of the Partners HealthCare System, Inc., which allows for comprehensive coordination of medical and psychiatric services. A major teaching facility of Harvard Medical School, McLean maintains the largest program of research in neuroscience and psychiatry of any private psychiatric hospital in the US.

Study Visits

  • Study visit 1 occurs at any one of the three clinical sites, and it involves clinical characterization of the participant, an evaluation of inclusion and exclusion criteria, and the administration of behavioral tasks organized by the National Institute of Health and the Human Connectome Project.

  • Study visit 2 occurs at the MGH Martinos Center. It involves an MRI scanning session using the Human Connectome Project imaging protocol (structural, diffusion-weighted, resting-state, and task-based functional MRI) as well as an administration of a behavioral task measuring attentional bias using EyeLink eyetracking software.

  • The two study visits occur within two weeks of each other. After the study visits are concluded, the participants are asked to complete follow-up clinical assessments at 6 and 12 months after the last study visit. In particular, self-report questionnaires are administered online at 6 months, and clinical interviews are conducted at 12 months in person during an on-site visit.

Scan Data Harmonization

Task-based fMRI

We will compare the time-series signal-to-noise ratio (TSNR) between sites. We will test for site differences in the activation maps from each task.

Resting-state fMRI

We will compare the TSNR between sites. We will test for site differences in correlation, partial-correlation, regularized correlation maps, time-series power spectra, and group network maps.

Structural MRI

The sMRI scans will be processed with FreeSurfer to extract cortical surface reconstructions, cortical parcellations, and subcortical segmentations. We will test for site differences in FreeSurfer-derived measures, such as cortical thickness, surface area of cortical regions, and volume of subcortical structures.

Diffusion-weighted MRI

We will process the dMRI scans with Tracts Constrained by Underlying Anatomy (TRACULA), our fully automated method for reconstructing major WM pathways. We will test for site differences in anisotropy and diffusivity measures obtained from each pathway. We will perform these tests both for average measures over an entire pathway, as well as at different cross-sections along a pathway. We will also compare the estimated diffusion orientations, as derived by fitting the orientation distribution function (ODF) or FSL’s ball-and-stick model.

What to expect as a potential participant

If you or your child are interested in participating, please sign up through any of the clinical sites in the next section.

The first step is a phone screening, when one of our researchers will ask you some questions to determine if you are a good fit for the study. From there, there will be two main study sessions. For the first session, you and your parent will visit one of the clinical sites (BU, MGH, or McLean) and complete a series of clinical questionnaires and tests. For the second session, you will visit the MGH Martinos Center in Charlestown where you will perform a short behavioral task, fill out a few more questionnaires, and then take part in the MRI portion of the study.

About the MRI

An MRI machine uses a big magnet to excite the water molecules in your body, causing them to rotate out of their original positions. The machine then captures the new positions of the molecules at different times and creates an image of your brain. The procedure is very safe (as long as there is no metal near the machine), and unlike CT or PET scans, MRIs do not use ionizing radiation. Before even entering the scanner room, we will have performed a thorough screening to be sure that the MRI is safe for you.

On the day of your MRI appointment, we will meet with you beforehand and give you an overview of what to expect with the scanner and what you'll have to do. You will also take this time to practice the tasks that you will perform while inside the scanner (there will be a projector screen inside the scanner from which you will switch between watching a movie and performing the tasks). The entire procedure will last about two hours, and if you feel unsafe or uncomfortable at any point inside the scanner you can let us know and we will take you out right away. You will be in control during the entirety of the scan session, and we will be carefully monitoring you the whole way through. For more information about what you can expect from participating in an MRI scan, please check out this video by the Martinos Center.

Following the two main visits, there will be a six month follow-up for you to complete online and lastly, a twelve month in-person visit where you return to the clinical site to answer some questions. All the data that we collect from your participation will be analyzed using algorithms developed by the researchers in the study, and will become an integral part of our investigation into the brain connectivity of adolescents with anxiety or depression.