Physiologically Based Markers of Idiopathic Intracranial Hypertension

特发性颅内高压的生理标志物

• 批准号: 9457463
• 负责人: Heather Elspeth Moss
• 金额: $ 21.13万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9457463
• 关键词: Affect; Aftercare; Age; Analysis of Variance; Anatomy; Area; Award; Biological Markers; Blindness; Blood Pressure; Blood Vessels; Brain; Caliber; Caring; Cell physiology; Cerebrovascular Disorders; Clinical; Clinical Management; Clinical Research; Clinical Trials; Control Groups; Development; Diagnosis; Disease; Disease Outcome; Electrophysiology (science); Ensure; Environment; Equation; Eye; Foundations; Functional disorder; Glaucoma; Goals; Height; Image; Impairment; Incidence; Injury; Institution; Intracranial Hypertension; Intracranial Pressure; K-Series Research Career Programs; Knowledge; Lasers; Leadership; Light; Measures; Mentors; Mentorship; Modeling; Monitor; Morbidity - disease rate; Nerve; Neurology; Obesity; Ophthalmologist; Ophthalmology; Ophthalmoscopes; Optic Disk; Optic Nerve; Optical Coherence Tomography; Outcome; Outcome Measure; Papilledema; Patient Care; Patients; Perimetry; Peripheral; Physicians; Physiologic Intraocular Pressure; Physiological; Physiology; Pilot Projects; Plant Roots; Population; Principal Investigator; Productivity; Pseudotumor Cerebri; Pupil; Request for Applications; Research; Research Personnel; Research Project Grants; Retinal; Retinal Ganglion Cells; Risk; Scanning; Scientific Advances and Accomplishments; Scientist; Spinal Puncture; Spinal Tap; Structure; Swelling; Techniques; Testing; Therapeutic; Thick; Time; Training; Uncertainty; Veins; Vision; Vision research; Visual; Visual Pathways; Visual Psychophysics; Work; base; care outcomes; career; career development; cellular imaging; clinical care; epidemiology study; experience; hypertension treatment; improved; interest; mechanical force; medical schools; non-invasive imaging; ophthalmic artery; optic nerve disorder; patient oriented; predictive marker; pressure; programs; public health relevance; recruit; response; retina blood vessel structure; retinal nerve fiber layer; secondary analysis; success; tool; translational research program; vision science; visual information; young woman

DESCRIPTION (provided by applicant): This application requests a career development award for an academic neuro-ophthalmologist with a scientific interest in idiopathic intracranial hypertension (IIH), a potentially blinding condition that most commonly affects young women. This award will provide the candidate with the necessary mentorship, training and experience to propel her to the level of independent patient oriented researcher focused on advancing diagnosis, clinical care and outcomes of IIH. The candidate is an accomplished early career physician-scientist. In the short term she seeks research career development in the areas of clinical research & epidemiology, visual psychophysics & electrophysiology and neuro-ophthalmic imaging. She will develop her knowledge and capabilities in these areas through coursework, guided study, practical experience and mentored research. This will form the foundation upon which she will build an independent research program in IIH. From this vantage point she will pursue her long term goal of improving clinical care for IIH and other neuro-ophthalmic conditions both as an independent researcher with a strong translational research program and as an expert clinician caring directly for patients. The environment created by the Department, Medical School and Institution is characterized by clinical and research expertise and productivity. There is a proven track record of effectively nurturing early career physician scientists in the fields of ophthalmology and vision research. Departmental and Medical School leadership are committed to providing material, financial and intellectual support to ensure the candidate's development and success. There is a significant clinical need for non-invasive biomarkers that will improve diagnosis and management of IIH. The objective of the research project is to establish physiologically based markers of retinal ganglion cell (RGC) function and retinal vasculature as markers of IIH that detect abnormalities, monitor treatment and distinguish peripheral vision outcomes. This objective will be accomplished with two specific aims: 1. To test the hypothesis that RGC function is impaired and retinal vascular diameters are enlarged in IIH subjects as compared to visually normal control subjects: Electrophysiological and pupil light response based measures of RGC function and image based measures of retinal blood vessel diameter will be compared between IIH subjects with elevated intracranial pressure and control subjects. This will establish that these markers are abnormal in the IIH population. 2. To test the hypothesis that RGC function impairment and retinal vascular dilation recover in IIH subjects with short and long term treatment: Electrophysiological and pupil light response based measures of RGC function and image based measures of retinal blood vessel diameter will be compared within IIH subjects when intracranial pressure is elevated, immediately following short term intracranial pressure lowering by lumbar puncture and following long term intracranial pressure lowering by standard clinical therapy. This will establish that these markers change with treatment of IIH. The results of the proposed study will lay the scientific and technical foundation for the development of these markers as clinical tools and clinical trial outcome measures of IIH. Furthermore, the results will advance scientific understanding of the pathophysiology underlying optic nerve dysfunction and injury in IIH. The project has broader significance because the knowledge gained and technical capabilities developed will have applications to other diseases at the intersection of neurology and ophthalmology such as glaucoma and cerebrovascular disease. The research career development and mentoring plan will transform the candidate into an independent researcher who will make long-lasting contributions to vision science.

描述（由申请人提供）：本申请要求为学术神经疾病学家颁发职业发展奖，对特发性颅内高血压（IIH）具有科学兴趣，这是一种可能影响年轻女性的潜在蒙蔽状况。该奖项将为候选人提供必要的指导，培训和经验，以使她达到专注于诊断，临床护理和IIH结果的独立研究人员的水平。 候选人是一位出色的早期职业医师科学家。在短期内，她在临床研究与流行病学，视觉心理物理学与电生理学以及神经摩托学成像方面寻求研究职业发展。她将通过课程，指导研究，实践经验和指导研究来发展这些领域的知识和能力。这将构成她将在IIH建立独立研究计划的基础。从这个有利的角度来看，她将追求自己的长期目标，即作为具有强大的转化研究计划的独立研究人员，以及直接关心患者的专业临床医生，可以改善对IIH和其他神经性疾病状况的临床护理。 该系，医学院和机构创建的环境的特征是临床和研究专业知识和生产力。在眼科和视力研究领域有效地培养早期职业医师科学家的有效培养的记录。部门和医学院领导层致力于提供材料，财务和智力支持，以确保候选人的发展和成功。 非侵入性生物标志物的临床需求很大，可以改善IIH的诊断和管理。研究项目的目的是建立基于生理的视网膜神经节细胞（RGC）功能和视网膜脉管系统作为IIH的标志物，以检测异常，监测治疗和区分外围视力结果。该目标将以两个具体的目的来完成：1。测试RGC功能受损的假设，与视觉正常对照受试者相比，IIH受试者在IIH受试者中会增大视网膜血管直径：电生理和瞳孔光反应基于RGC功能和图像的测量值将比较具有颅内压升高和对照受试者的IIH受试者之间的视网膜血管直径的测量。这将确定这些标记在IIH人群中是异常的。 2。测试 假设RGC功能障碍和视网膜血管扩张在IIH受试者中恢复具有短期和长期治疗的IIH受试者：电生理和瞳孔光响应基于RGC功能的基于RGC功能的测量和基于图像的基于图像的视网膜血管直径的测量值，而当颅内压升高时，IIH受试者将在IIH中进行比较。 ，紧随短期的颅内压在腰椎降低之后，并在长期通过标准临床疗法降低颅内压。这将确定这些标记随处理IIH的处理而变化。拟议的研究的结果将奠定这些标志物作为临床工具和IIH的临床试验结果指标的发展科学技术基础。此外，结果将提高对IIH中视神经功能障碍和损伤的病理生理学的科学理解。该项目具有更广泛的意义，因为获得的知识和发展的技术能力将在神经病学和眼科（例如青光眼和脑血管疾病）的交集中应用于其他疾病。研究职业发展和指导计划将把候选人转变为一个独立的研究人员，将为视觉科学做出持久的贡献。

项目成果

Clinical Reasoning: An unusual diagnostic triad. Susac syndrome, or retinocochleocerebral vasculopathy.

临床推理：不寻常的诊断三联征。

• DOI: 10.1212/wnl.0000000000001760
• 发表时间: 2015
• 期刊: Neurology
• 影响因子: 9.9
• 作者: Francis,AndrewW;Kiernan,ClaireL;Huvard,MichaelJ;Vargas,Alejandro;Zeidman,LawrenceA;Moss,HeatherE
• 通讯作者: Moss,HeatherE

Predictive Value of International Classification of Diseases Codes for Idiopathic Intracranial Hypertension in a University Health System.

大学卫生系统中特发性颅内高压疾病代码国际分类的预测价值。

• DOI: 10.1097/wno.0000000000001563
• 发表时间: 2022
• 期刊: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
• 作者: Khushzad,Fareshta;Kumar,Riya;Muminovic,Irma;Moss,HeatherE
• 通讯作者: Moss,HeatherE

Unilateral Proptosis, Redness, Diplopia, and Numbness in a Young Woman.

一名年轻女性的单侧突眼、发红、复视和麻木。

• DOI: 10.1001/jamaophthalmol.2016.2129
• 发表时间: 2016
• 期刊: JAMA ophthalmology
• 影响因子: 8.1
• 作者: Ali,MohsinH;Jones,Scott;Moss,HeatherE
• 通讯作者: Moss,HeatherE

IgG4 Disease: Is It or Isn't It?

IgG4 疾病：是还是不是？

• DOI: 10.1097/wno.0000000000000446
• 发表时间: 2017
• 期刊: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
• 作者: Jones,ScottT;Ali,MohsinH;Lin,AmyY;Moss,HeatherE;Srinivasan,Ashok;MacIntosh,PeterW
• 通讯作者: MacIntosh,PeterW

Orbito-Masticatory Syndrome.

眼眶咀嚼综合症。

• DOI: 10.1097/wno.0000000000000354
• 发表时间: 2016
• 期刊: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
• 作者: Mettu,Pradeep;Bhatti,MTariq;El-Dairi,MaysA;Price,EvanB;Lin,AmyY;Alaraj,Ali;Setabutr,Pete;Moss,HeatherE
• 通讯作者: Moss,HeatherE