MUSICA - MUsic and Speech Induced Cerebral Activation

音乐 - 音乐和言语诱发的大脑激活

基本信息

批准号：
10426522
负责人：
Ayham Alkhachroum
金额：
$ 18.21万
依托单位：
UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-06-01 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10426522
关键词：
Acute Acute Brain Injuries Age Awareness Biological Markers Biometry Brain Brain Injuries Caring Cerebrum Cessation of life Clinical Cognitive Color Coma Conscious Consciousness Disorders Data Data Science Development Electroencephalogram Electrophysiology (science)Family Family member Functional Magnetic Resonance Imaging Goals Hospitalization Injury Intensive Care Intensive Care Units Knowledge Language Measures Mentors Modeling Monitor Motor Music Neurologic Neurologic Examination Neurosciences Research Outcome Outcome Measure Patients Pattern Predictive Value Prognosis Prospective Studies Radiologic Finding Recovery Recovery of Function Research Personnel Scientist Signal Transduction Societies Speech Stimulus Testing Training Traumatic Brain Injury Traumatic Brain Injury recovery Uncertainty United States National Institutes of Health Withdrawal auditory stimulus base clinical practice cognitive function cognitive neuroscience follow-up functional independence life-sustaining therapy loved ones mortality neurophysiology novel novel strategies phrases preservation prognostication recruit relating to nervous system research study response severe injury trauma centers

项目摘要

Project Summary/Abstract Severe traumatic brain injury (TBI) has a high mortality, largely driven by the early withdrawal of life-sustaining therapies during hospitalization. This critical decision is influenced by whether patients remain unresponsive after TBI. Current models use age, basic neurological assessment, and radiological findings as predictors of recovery. Bedside neurological examinations are examiner dependent, and often misclassify patients as unresponsive despite preserved awareness. Current approaches to predicting recovery of consciousness and functional recovery lack accuracy. Brain activation using a task-based functional magnetic resonance imaging or electroencephalogram (EEG) measure preserved awareness in clinically unresponsive patients, known as covert consciousness. Covert consciousness indicates a higher chance of recovery after acute brain injury. Most research studies examining covert consciousness have not been performed in the acute, intensive care setting (ICU) when clinicians discuss the patients’ goals of care with families. Music and spoken words are auditory stimuli to which unresponsive brain-injured patients may easily attend. Our preliminary data provide the scientific premise and the feasibility of using brain activation to music and spoken words in the ICU as a biomarker to detect covert consciousness after TBI. We hypothesize that preserved brain activation to music and spoken words may indicate preserved basic cognitive functions and subsequently predict recovery after TBI. In this study, we propose using a personalized prognostication approach shortly after severe brain injury using our assessment battery MUSICA (MUsic and Speech Induced Cerebral Activation). Our assessment battery MUSICA encompasses brain activation to [1] classical music; [2] words, phrases, and sentences; [3] congruent and incongruent sentences. Using MUSICA, we aim to identify covert consciousness in unresponsive TBI patients in the ICU (AIM 1). We will also determine if brain activation to MUSICA can be used to predict recovery after TBI (AIM 2). A total of 80 unresponsive TBI patients will be recruited from a high-volume level 1 trauma center during the ICU stay. We will test patients’ brain activation to MUSICA and compare their responses to responses from 20 healthy subjects (AIM 1). We will assess global, functional, and cognitive outcomes at 1-, 3- and 6-month follow-up to determine the predictive value of MUSICA (AIM 2). Results from this study will change the current prognostication paradigms in clinical practice after severe TBI using an electrophysiologic signature to music and spoken words.

项目概要/摘要严重创伤性脑损伤 (TBI) 的死亡率很高，主要原因是早期撤回维持生命的药物这一关键决定取决于患者是否仍无反应。目前的模型使用年龄、基本神经学评估和放射学结果作为 TBI 后的预测因素。床旁神经系统检查取决于检查者，并且经常将患者错误分类为尽管保留了意识，但仍无反应。使用基于任务的功能磁共振成像进行大脑激活缺乏准确性。或脑电图（EEG）测量临床无反应患者的保留意识，称为隐蔽意识。隐蔽意识表明急性脑损伤后恢复的机会较高。研究尚未在急性重症监护环境中进行隐性意识检查研究 (ICU) 当新来者与家人讨论患者的护理目标时音乐和口语是听觉的。我们的初步数据提供了科学依据。在 ICU 中使用大脑对音乐和口语的激活作为生物标志物的前提和可行性我们发现了 TBI 后保留的大脑对音乐和语言的激活。词语可能表明基本认知功能得以保留，并随后预测 TBI 后的恢复。研究中，我们建议在严重脑损伤后不久使用个性化预测方法评估电池 MUSICA（音乐和言语诱导大脑激活）我们的评估电池。音乐包括 [1] 古典音乐的大脑激活；[2] 单词、短语和句子 [3] 一致；和不一致的句子，我们的目标是识别无反应的 TBI 中的隐性意识。我们还将确定 MUSICA 的大脑激活是否可用于预测康复情况。 TBI 后（AIM 2）将从大量 1 级创伤中招募总共 80 名无反应的 TBI 患者。在 ICU 住院期间，我们将测试患者对 MUSICA 的大脑激活情况，并比较他们对 MUSICA 的反应。我们将评估 20 名健康受试者的反应（AIM 1），即 1-、3- 的总体、功能和认知结果。确定 MUSICA (AIM 2) 预测价值的 6 个月随访结果将发生变化。当前严重 TBI 后临床实践中使用电生理特征的预测范式音乐和口语。