Volumetric MRSI Evaluation of Traumatic Brain Injury

创伤性脑损伤的体积 MRSI 评估

• 批准号: 8013887
• 负责人: Andrew A. Maudsley
• 金额: $ 33.52万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8013887
• 关键词: Accounting; Affect; Age; Anisotropy; Blast Injuries; Brain; Brain Concussion; Brain Injuries; Brain region; Choline; Clinic; Clinical assessments; Closed head injuries; Cognitive; Craniocerebral Trauma; Development; Diffusion Magnetic Resonance Imaging; Evaluation; Exhibits; Functional disorder; Gray unit of radiation dose; Head; Headache; Health; Image; Image Analysis; Individual; Injury; Lobar; Location; Magnetic Resonance Imaging; Maps; Measurement; Measures; Membrane; Metabolic; Metabolic Marker; Metabolism; Methods; Minor; N-acetylaspartate; Neuronal Dysfunction; Neurons; Normal Range; Outcome; Outcome Measure; Patients; Pattern; Performance; Post-Concussion Syndrome; Post-Traumatic Headaches; Protons; Public Health; Reaction; Recovery of Function; Relaxation; Reporting; Severities; Signal Transduction; Sports; Symptoms; Testing; Time; Tissues; Traumatic Brain Injury; Water; base; cognitive function; expectation; follow-up; functional outcomes; improved; magnetic resonance spectroscopic imaging; neuroimaging; neuropsychological; outcome forecast; restoration; spectroscopic imaging; white matter

DESCRIPTION (provided by applicant): The primary aim of this project is to develop objective measures for evaluation of mild and moderate Traumatic Brain Injury (MTBI) using advanced MR neuroimaging methods. MTBI represents a major public health problem for which the current assessment measures are limited in their ability to quantify the severity of injury or to indicate possible outcomes. The pilot period of this project has demonstrated that Volumetric Magnetic Resonance Spectroscopic Imaging (MRSI) at 3 Tesla can detect widespread metabolic changes in the brain that correlate with the degree of injury, even for mild injury and in the absence of significant structural MRI findings. It is now proposed to extend this study to improve characterization of these changes and to evaluate the use MRSI and diffusion-weighted MRI measures for prognosis of functional outcomes following mild and moderate closed-head injury. Measurements will include N-Acetylaspartate and choline, metabolic markers known to be sensitive to neuronal dysfunction and membrane turnover, and Fractional Anisotropy, which reflects the degree of neuronal organization. Results will be correlated with findings from structural MRI, initial clinical assessments, and neuropsychological evaluation of functional outcomes at multiple time points after injury. A secondary aim of this study is to examine possible associations between post- concussive symptoms, which are debilitating and persistent consequences in a fraction of this patient group, and neuroimaging measures. A third aim is to optimize the quantitative and multiparametric neuroimaging measures to improve characterization of the spatial extent and the degree of metabolic consequences of the injury, and their associations with functional outcome measures. It is hypothesized that the improved sensitivity and spatial coverage of the proposed neuroimaging measures will improve characterization of mild and moderate injury. PUBLIC HEALTH RELEVANCE: This project will evaluate improved quantitative MR neuroimaging methods for assessment of the metabolic and micro-structural changes associated with mild brain injury. These objective measures will guide treatment and patient management decisions following mild head trauma, as well as providing expectations for long-term consequences of the injury. Patient groups affected by this common injury include sports-related injuries and blast-related concussion.

描述（由申请人提供）：该项目的主要目的是使用先进的MR神经影像学方法制定客观评估轻度和中度创伤性脑损伤（MTBI）。 MTBI代表了一个主要的公共卫生问题，目前的评估措施在量化伤害严重程度或指出可能的结果的能力方面受到限制。该项目的试验期表明，在3特斯拉处的体积磁共振光谱成像（MRSI）可以检测到大脑的广泛代谢变化，这些变化与损伤程度相关，即使是轻度损伤，也没有明显的结构MRI发现。现在建议扩展这项研究，以改善这些变化的表征，并评估使用MRSI和扩散加权MRI测量，以预后轻度和中度闭合损伤后功能结局的预后。测量值将包括N-乙酰天冬氨酸和胆碱，已知对神经元功能障碍和膜转换敏感的代谢标记以及反映神经元组织程度的分数各向异性。结果将与结构MRI，初步临床评估的发现以及受伤后多个时间点的功能结果的神经心理学评估相关。这项研究的次要目的是检查脑震荡后症状之间的可能关联，这些症状在该患者组的一部分和神经成像措施中都使人衰弱和持续的后果。第三个目的是优化定量和多参数神经影像学措施，以改善损伤的空间范围和代谢后果的特征，以及它们与功能结果指标的关联。假设提出的神经影像措施的灵敏度和空间覆盖范围的提高将改善轻度和中度损伤的表征。公共卫生相关性：该项目将评估改进的定量MR神经影像学方法，以评估与轻度脑损伤相关的代谢和微结构变化。这些客观的措施将指导轻度头部创伤后的治疗和患者管理决策，并提供对损伤长期后果的期望。受这种常见伤害影响的患者组包括与运动有关的伤害和与爆炸有关的脑震荡。