EVALUATION OF MILD TRAUMATIC BRAIN INJURY PATIENTS

轻度创伤性脑损伤患者的评估

• 批准号: 8356711
• 负责人: HARVEY LEVIN
• 金额: $ 0.24万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356711
• 关键词: Address; Adolescent; Age; Biological Markers; Blood; Brain; Brain Concussion; Brain imaging; Brain region; Cause of Death; Cerebrospinal Fluid; Cerebrum; Clinical Research; Cognition; Cognitive; Conscious; Data Analyses; Diffusion Magnetic Resonance Imaging; Emotional; Episodic memory; Evaluation; Funding; Grant; Hand; Health; Hour; Image; Impairment; Injury; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Mediation; Modeling; Morbidity - disease rate; National Center for Research Resources; Orthopedics; Outcome; Patients; Persons; Post-Concussion Syndrome; Predisposition; Principal Investigator; Relative (related person); Research; Research Infrastructure; Resources; Selection Criteria; Serum; Short-Term Memory; Source; Stress; Symptoms; TBI Patients; Traumatic Brain Injury; United States National Institutes of Health; Weight; X-Ray Computed Tomography; cost; disability; executive function; functional outcomes; functional status; gray matter; health related quality of life; information processing; neurobehavioral; neurobehavioral test; processing speed; prospective; statistics; white matter; young adult

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. ABSTRACT Traumatic brain injury (TBI) is a leading cause of death and disability in adolescents and young adults and therefore represents a major health problem. Although mild traumatic brain injury (MTBI) is generally nonfatal in this age range, the neurobehavioral effects can persist for months and their mediation by changes in the brain is poorly understood. To gain understanding of changes in brain imaging and neurobehavioral function over three months post-MTBI relative to orthopedic injury (OI), Aim 1 addresses changes in the integrity of cerebral white matter as measured by diffusion tensor imaging (DTI), hemorrhagic lesions seen on susceptibility weighted imaging, and the magnetization transfer ratio on magnetization transfer imaging. Aim 1 also addresses changes in brain region volumes of white matter, gray matter, and cerebrospinal fluid by analysis of magnetic resonance imaging. Aim 1 also investigates the relation of serum biomarkers of MTBI obtained from a blood draw at baseline to the brain imaging variables and whether the concentrations of these biomarkers differentiate MTBI and OI groups. Aim 2 measures change over three months post-injury in MTBI patients relative to the OI group in information processing speed, working memory, episodic memory, and executive functions and the relation of changes in these cognitive domains to brain imaging findings and to functional outcome. Aim 3 measures change over three months in post-concussion symptoms, posttraumatic stress symptoms, emotional status, functional status, and health-related quality of life (HRQL). Aim 3 also studies change in cognitive post-concussion symptoms in relation to brain imaging variables and the relation of change in cognitive, emotional, and somatic post-concussion symptoms to functional outcome and HRQL. We propose a prospective, longitudinal study of 220 right-handed patients, age 14-30 years old, including 88 with MTBI, 44 patients with TBI associated with moderate impairment of consciousness, and 88 patients with OI without brain insult. Selection criteria for the two TBI groups include computed tomography within 24 hours post-injury that shows no brain lesions. All groups would undergo a baseline assessment within 96 hours post-injury, including assessment of pre-injury status, brain imaging, blood draw for surrogate biomarkers, and neurobehavioral testing including cognition, post-concussion and posttraumatic stress symptoms, emotional status, functional status, and HRQL. Brain imaging would be repeated at three months post-injury, and neurobehavioral assessment would be repeated at both one and three months post-injury. Multivariate statistics and the general linear mixed model would be used to analyze the data. By helping to understand the relation of changes in brain imaging to neurobehavioral changes after MTBI in young persons, this studys findings may suggest ways to reduce morbidity and enhance outcomes.

该子项目是利用资源的众多研究子项目之一 由 NIH/NCRR 资助的中心拨款提供。子项目的主要支持 并且子项目的主要研究者可能是由其他来源提供的， 包括其他 NIH 来源。 子项目可能列出的总成本 代表子项目使用的中心基础设施的估计数量， NCRR 赠款不直接向子项目或子项目工作人员提供资金。 抽象的 创伤性脑损伤 (TBI) 是青少年和年轻人死亡和残疾的主要原因，因此是一个重大的健康问题。虽然轻度创伤性脑损伤 (MTBI) 在这个年龄段通常是非致命的，但其神经行为影响可能会持续数月，而且人们对它们通过大脑变化的调节作用知之甚少。为了了解 MTBI 后三个月内与骨科损伤 (OI) 相关的脑成像和神经行为功能的变化，目标 1 解决通过扩散张量成像 (DTI) 测量的脑白质完整性的变化，在磁化率加权成像，以及磁化转移成像的磁化转移比。目标 1 还通过磁共振成像分析来解决大脑区域白质、灰质和脑脊液体积的变化。目标 1 还研究了从基线抽血获得的 MTBI 血清生物标志物与脑成像变量的关系，以及这些生物标志物的浓度是否区分 MTBI 和 OI 组。目标 2 测量 MTBI 患者相对于 OI 组在受伤后三个月内信息处理速度、工作记忆、情景记忆和执行功能的变化，以及这些认知领域的变化与脑成像结果和功能结果的关系。目标 3 衡量三个月内脑震荡后症状、创伤后应激症状、情绪状态、功能状态和健康相关生活质量 (HRQL) 的变化。目标 3 还研究脑震荡后认知症状的变化与脑成像变量的关系，以及脑震荡后认知、情绪和躯体症状变化与功能结果和 HRQL 的关系。我们提议对 220 名年龄 14-30 岁的右利手患者进行一项前瞻性纵向研究，其中包括 88 名 MTBI 患者、44 名伴有中度意识障碍的 TBI 患者和 88 名没有脑损伤的成骨不全患者。两个 TBI 组的选择标准包括受伤后 24 小时内的计算机断层扫描，显示没有脑损伤。所有小组将在受伤后 96 小时内接受基线评估，包括评估受伤前状态、脑成像、抽血寻找替代生物标志物以及神经行为测试，包括认知、脑震荡后和创伤后应激症状、情绪状态、功能状态和 HRQL。将在受伤后三个月重复进行脑成像，并在受伤后一个月和三个月重复进行神经行为评估。将使用多元统计和一般线性混合模型来分析数据。通过帮助了解年轻人 MTBI 后脑成像变化与神经行为变化的关系，这项研究结果可能会提出降低发病率和改善结果的方法。