Outcomes of Traumatic Brain Injury in Children

儿童脑外伤的后果

• 批准号: 6605181
• 负责人: KEITH O YEATES
• 金额: $ 10.29万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6605181
• 关键词: adolescence (12-20); behavior; brain injury; child (0-11); children; clinical research; cognition; epidemiology; functional ability; growth /development; human subject; interview; longitudinal human study; problem solving

DESCRIPTION (provided by applicant): The applicant is seeking a K02 (Independent Scientist Award) to continue building a program of research focusing on the outcomes of childhood traumatic brain injury (TBI). His objectives are (1) to investigate how children's development following TBI is related to severity of injury, age at injury, and time since injury; (2) to examine the role of environmental factors as moderators of recovery from TBI; and (3) to study the relationships between focal brain lesions, cognitive and social problem-solving skills, and "real world" social functioning following TBI. He has been a Co-Investigator on a prospective, longitudinal study of moderate to severe TBI in school-age children, and currently is Principal Investigator on an NICHD-funded research grant to study the outcomes of mild closed head injuries (CHI) in children and adolescents (see below). His future research efforts will include studies of TBI in preschool children and of the effects of TBI on children's social development. His proposed career development plan will enhance his skills in statistical methods pertinent to his research, including (a) analysis of longitudinal data, (b) treatment of missing data, and (c) robust statistical methods. He also will obtain additional training in the responsible conduct of research. The specific aims of the research are to examine the (1) natural history, (2) prediction, and (3) consequences of post-concussive symptoms in children with mild CHI. The study will involve 200 8 to 15 year old children with mild CHI and 100 with mild orthopedic injuries not involving the head in a concurrent cohort/prospective research design. The children and their families are assessed four times during the first year post injury (i.e., at 1 week, 1 month, 3 months, and 12 months post-injury). Post-concussive symptoms are assessed using rating scales and interviews, with both children and parents as informants. Predictors of post-concussive symptoms include injury characteristics, cognitive abilities, and non-injury related child and family variables. Outcomes include school performance, health utilization, and other aspects of child and family functioning. The study will examine three major hypotheses: (1) Children with mild CHI display more post-concussive symptoms than children with mild orthopedic injuries. (2) The incidence of post-concussive symptoms is related to (a) injury characteristics, (b) impairments in cognitive skills, and (c) non-injury related child and family factors. (3) Severe post-concussive symptoms are associated with more child disability. The findings will help resolve the scientific controversy regarding the outcomes associated with mild CHI, and will assist physicians and other health care providers in identifying and managing the sequelae of mild CHI.

描述（由申请人提供）：申请人正在寻求 K02（独立科学家奖），以继续建立一个专注于儿童创伤性脑损伤 (TBI) 结果的研究计划。他的目标是 (1) 调查 TBI 后儿童的发育与受伤严重程度、受伤年龄和受伤后时间之间的关系； (2) 研究环境因素作为 TBI 恢复调节因素的作用； (3) 研究局灶性脑损伤、认知和社会问题解决能力以及 TBI 后“现实世界”社会功能之间的关系。他曾是一项针对学龄儿童中度至重度 TBI 的前瞻性纵向研究的联合研究员，目前是 NICHD 资助的一项研究经费的首席研究员，该研究经费旨在研究儿童轻度闭合性头部损伤 (CHI) 的结果和青少年（见下文）。他未来的研究工作将包括学龄前儿童创伤性脑损伤以及创伤性脑损伤对儿童社会性发展的影响的研究。他提出的职业发展计划将提高他在与其研究相关的统计方法方面的技能，包括（a）纵向数据分析，（b）缺失数据的处理，以及（c）稳健的统计方法。他还将获得负责任的研究行为方面的额外培训。该研究的具体目的是检查轻度 CHI 儿童脑震荡后症状的 (1) 自然史、(2) 预测和 (3) 后果。该研究将纳入 200 名患有轻度 CHI 的 8 至 15 岁儿童和 100 名患有轻度骨科损伤（不涉及头部）的并行队列/前瞻性研究设计。儿童及其家人在受伤后第一年（即受伤后 1 周、1 个月、3 个月和 12 个月）接受四次评估。脑震荡后症状是通过评定量表和访谈进行评估的，儿童和家长都是知情人。脑震荡后症状的预测因素包括损伤特征、认知能力以及非损伤相关的儿童和家庭变量。结果包括学校表现、健康利用率以及儿童和家庭功能的其他方面。该研究将检验三个主要假设：(1) 患有轻度 CHI 的儿童比患有轻度骨科损伤的儿童表现出更多的脑震荡后症状。 (2) 脑震荡后症状的发生率与 (a) 损伤特征、(b) 认知技能损伤以及 (c) 非损伤相关的儿童和家庭因素有关。 (3) 严重的脑震荡后症状与更多的儿童残疾有关。这些发现将有助于解决有关轻度 CHI 相关结果的科学争议，并将帮助医生和其他医疗保健提供者识别和管理轻度 CHI 的后遗症。