Traumatic Brain Injury and The Aging Brain: Predictors of Clinical Trajectories

创伤性脑损伤和大脑老化：临床轨迹的预测因素

• 批准号: 9763362
• 负责人: Raquel C. Gardner
• 金额: $ 17.5万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-15 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9763362
• 关键词: Acute; Address; Adult; Advanced Development; Affect; Age; Aging; Alzheimer' s Disease; American; Area; Behavior; Behavioral; Biological; Biological Markers; Biometry; Clinical; Clinical assessments; Cognition; Cognitive; Comorbidity; Consensus; Data; Dementia; Diagnosis; Disease; Early Intervention; Educational Background; Elderly; Epidemic; Epidemiology; Etiology; Fellowship; Frequencies; Gender; Goals; Grant; Group Meetings; Hospitalization; Hospitals; Incidence; Interdisciplinary Study; Intervention; Journals; K-Series Research Career Programs; Knowledge; Life; Medical; Mentors; Moods; Motor; Nerve Degeneration; Neurodegenerative Disorders; Neurologic; Neurologist; Outcome; Parkinson Disease; Patients; Pattern; Phase; Population; Prevention; Productivity; Recording of previous events; Research; Research Infrastructure; Research Methodology; Resources; Risk; Risk Factors; Risk stratification; Severities; Site; Soldier; Subgroup; TBI Patients; Time; Training; Training Programs; Traumatic Brain Injury; United States National Institutes of Health; Veterans; Vulnerable Populations; Wages; Work; aged; aging brain; career; clinical phenotype; clinical predictors; design; experience; falls; field study; functional decline; functional outcomes; high risk; improved outcome; innovation; lifestyle factors; normal aging; novel; outcome prediction; patient oriented research; pre-clinical; predict clinical outcome; prevent; prognostic; programs; public health relevance; rate of change; resilience; sedentary lifestyle; skills; success; symposium; tool; treatment strategy

 DESCRIPTION (provided by applicant): In this Paul B. Beeson Patient-Oriented Research Career Development Award (K23) application, the applicant requests 5 years of research and salary support to provide protected time and dedicated training to study the effects of traumatic brain injury (TBI) on the aging brain. The long-term career goal is to become a leader in the nascent field of the study of TBI and brain aging with a focus on clinical predictors and mechanisms of post-TBI neurodegeneration. The specific long-term goal of this research program would be to uncover novel targets for treatment and prevention of post-TBI cognitive, behavioral, motor, and functional decline in high-risk, vulnerable, aging adults. While the candidate - a fellowship-trained behavioral neurologist with a record of productivity in this and related fields - is uniquely qualified to pursue this career trajectory, there are three specific areas in which further training will be critical for optimal success: (1) advanced training in research methods and biostatistics, (2) advanced training in epidemiology of aging with a focus on inter- disciplinary neurological and geriatric predictors and outcomes, and (3) TBI-focused research. Together with her mentoring team, the candidate has developed a rigorous training program that includes the research plan outlined below, formal coursework, one-on-one tutorials, and multi-disciplinary research group meetings, journal clubs, and conferences. The immediate goals of this application are to acquire sufficient preliminary data and skills to submit a successful NIH R01 application and to launch the PI's independent research career. Remarkably, TBI affects nearly 2 million American each year with the highest incidence in late life. While TBI is increasingly recognized as an important risk factor for a variety of neurodegenerative diseases, most notably dementia and Parkinson's disease, the etiology and pattern of cognitive, behavioral, motor, and functional trajectories of older adults after acute or remote TBI as well as clinical predictors of these trajectories are largely unknown. This knowledge gap has stunted research on diagnosis, treatment, and prevention of post-TBI neurodegenerative diseases of aging. The proposed research seeks to address this critical knowledge gap via the following 2 specific aims: (1) to define detailed clinical trajectories and predictors of trajectories after acute TBI in older adults, (2) to define detailed clinical trajectries and predictors of trajectories after remote TBI in older adults. This innovative work will lead to significant advances in the understanding of specific cognitive, behavioral, motor, and functional outcomes after acute and remote TBI in older adults, will identify potentially modifiable clinical predictors of these outcomes, and may generate new hypotheses regarding treatment strategies or biological underpinnings of these outcomes. Thus, the results from this research will directly guide clinical assessment, prognostication, and risk-stratification of older adults wth acute or remote TBI and will advance research to treat or prevent post-TBI neurodegeneration.

 描述（由应用程序提供）：在Paul B. Beeson面向患者的研究职业发展奖（K23）应用程序中，该申请要求提供5年的研究和薪水支持，以提供受保护的时间和专门的培训，以研究创伤性脑损伤（TBI）对衰老大脑的影响。长期职业目标是成为TBI和大脑衰老研究的新生领域的领导者，重点是临床预测因子和TBI后神经变性的机制。该研究计划的具体长期目标是揭示高风险，脆弱，老年人老龄化的TBI认知，行为，运动和功能下降的新目标。 While the candidate - a fellowship-trained behavioral neurologist with a record of productivity in this and related fields - is uniquely qualified to pursue this career trajectory, there are three specific areas in which further training will be critical for optimal success: (1) advanced training in research methods and biostatistics, (2) advanced training in epidemiology of aging with a focus on inter-disciplinary neurologic and geriatric predictors and outcomes, and （3）以TBI为重点的研究。候选人与她的心理团队一起制定了一项严格的培训计划，其中包括以下概述的研究计划，正式课程，一对一的教程以及多学科研究小组会议，期刊俱乐部和会议。此应用程序的直接目标是获得足够的初步数据和技能来提交 成功的NIH R01应用程序，并启动了PI的独立研究生涯。值得注意的是，TBI每年影响近200万美国人，而后期生命中最高的事件。尽管TBI越来越被认为是多种神经退行性疾病的重要危险因素，但最著名的是痴呆症和帕金森氏病，急性或老年人后老年人的认知，行为，运动和功能轨迹的病因和模式 这些轨迹的远程TBI以及这些轨迹的临床预测因子在很大程度上未知。这种知识差距阻碍了TBI神经退行性疾病的诊断，治疗和预防衰老的诊断，治疗和预防。拟议的研究旨在通过以下2个特定目的来解决这一关键知识差距：（1）在老年人中定义急性TBI急性TBI后轨迹的详细临床轨迹和预测指标，以定义老年人远程TBI后远程TBI后详细的临床轨迹和轨迹的预测指标。这项创新的工作将导致对老年人急性和远程TBI的特定认知，行为，运动和功能结果的理解取得重大进展，这将确定对这些结果的潜在可修改的临床预测指标，并可能产生有关这些结果的治疗策略或生物学种族的新假设。这是这项研究的结果将直接指导急性或远程TBI的老年人的临床评估，预后和风险分层，并将提高研究以治疗或预防TBI神经变性后。

项目成果

COMT Val 158 Met polymorphism is associated with nonverbal cognition following mild traumatic brain injury.

COMT Val 158 Met 多态性与轻度创伤性脑损伤后的非语言认知相关。

• DOI: 10.1007/s10048-015-0467-8
• 发表时间: 2016
• 期刊: Neurogenetics
• 影响因子: 2.2
• 作者: Winkler,EthanA;Yue,JohnK;McAllister,ThomasW;Temkin,NancyR;Oh,SamS;Burchard,EstebanG;Hu,Donglei;Ferguson,AdamR;Lingsma,HesterF;Burke,JohnF;Sorani,MarcoD;Rosand,Jonathan;Yuh,EstherL;Barber,Jason;Tarapore,PhirozE;Gar
• 通讯作者: Gar

Linguistic and Cultural Acceptability of a Spanish Translation of the Ohio State University Traumatic Brain Injury Identification Method Among Community-Dwelling Spanish-Dominant Older Adults.

• DOI: 10.1016/j.arrct.2019.100020
• 发表时间: 2019-12
• 期刊: Archives of rehabilitation research and clinical translation
• 作者: Hufstedler HC;Dorsman KA;Rivera EJ;Lanata SC;Bogner JA;Corrigan JD;Fuller SM;Borja XR;Wilson F;Gardner RC
• 通讯作者: Gardner RC