This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) that will enable Dr. LaFrance to continue to develop his programmatic line of research in the treatment of psychogenic nonepileptic seizures (NES). NES resemble epileptic seizures, but have no associated epileptiform activity with the behaviors. NES have no single cause and are associated with underlying psychological problems and co-morbid psychiatric diagnoses. Patients with NES are often difficult to manage, severely disabled and frequently encountered in neurology, psychiatry, and emergency departments. The disorder is not responsive to antiepileptic drugs (AEDs), and a number of patients with NES are inappropriately treated with aggressive and invasive measures. Dr. LaFrance's training goals are to: 1) Develop expertise in designing and executing clinical trials studying treatments for patients with NES. 2) Gain expertise in biostatistical analysis, for designing and evaluating clinical and interventional studies. 3) Develop skills with specific psychotherapies for integrating psychosocial treatments in NES research. 4) Gain additional expertise in the field of epilepsy, focusing on epilepsy monitoring techniques. These training goals will be achieved through a 5 year research program that utilizes 1) the resources available at the Brown Medical School, 2) the experienced mentorship provided by Drs. Ivan Miller, Gabor Keitner and Andrew Blum and the expertise of the assembled consultant team, 3) focused coursework and clinical experiences, and 4) the proposed clinical intervention research project. The proposed research extends the natural progression of Dr. LaFrance's current research in NES under his NIH/Brown Institutional T32 fellowship. The application builds on Dr. LaFrance's clinical training in neurology and psychiatry by providing research experience in grantsmanship, research design, and exposure to combined modality interventions.
The Specific Aims of this application are 1) to investigate the efficacy of sertraline in treatment of psychogenic NES and its co-morbid psychiatric disorders and 2) to identify predictors of response to treatment and to identify potential mechanisms of NES.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23NS045902-04
Application #
7090598
Study Section
NST-2 Subcommittee (NST)
Program Officer
Fureman, Brandy E
Project Start
2003-07-01
Project End
2008-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
4
Fiscal Year
2006
Total Cost
$162,975
Indirect Cost
Name
Rhode Island Hospital
Department
Type
DUNS #
075710996
City
Providence
State
RI
Country
United States
Zip Code
02903
Williams, Benjamin; Jalilianhasanpour, Rozita; Matin, Nassim et al. (2018) Individual differences in corticolimbic structural profiles linked to insecure attachment and coping styles in motor functional neurological disorders. J Psychiatr Res 102:230-237
Jalilianhasanpour, Rozita; Williams, Benjamin; Gilman, Isabelle et al. (2018) Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders. J Psychosom Res 107:55-61
Perez, David L; Williams, Benjamin; Matin, Nassim et al. (2018) Anterior hippocampal grey matter predicts mental health outcome in functional neurological disorders: an exploratory pilot study. J Neurol Neurosurg Psychiatry 89:1221-1224
Perez, David L; Matin, Nassim; Barsky, Arthur et al. (2017) Cingulo-insular structural alterations associated with psychogenic symptoms, childhood abuse and PTSD in functional neurological disorders. J Neurol Neurosurg Psychiatry 88:491-497
Valente, Kette D; Rzezak, Patricia; LaFrance Jr, W Curt (2015) Standard medical care for psychogenic nonepileptic seizures in Brazil. Epilepsy Behav 45:128-35
Lafrance Jr, W Curt; Deluca, Marie; Machan, Jason T et al. (2013) Traumatic brain injury and psychogenic nonepileptic seizures yield worse outcomes. Epilepsia 54:718-25
LaFrance Jr, W Curt; Alosco, Michael L; Davis, Jennifer Duncan et al. (2011) Impact of family functioning on quality of life in patients with psychogenic nonepileptic seizures versus epilepsy. Epilepsia 52:292-300
LaFrance Jr, W C; Keitner, G I; Papandonatos, G D et al. (2010) Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures. Neurology 75:1166-73
Benbadis, S R; LaFrance Jr, W C; Papandonatos, G D et al. (2009) Interrater reliability of EEG-video monitoring. Neurology 73:843-6
LaFrance Jr, W Curt; Syc, Stephanie (2009) Depression and symptoms affect quality of life in psychogenic nonepileptic seizures. Neurology 73:366-71

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