Structural and Functional Neuroimaging of Post Traumatic Stress Disorder and Cognitive Impairment in World Trade Center Responders

世贸中心急救人员创伤后应激障碍和认知障碍的结构和功能神经影像

• 批准号: 9340137
• 负责人: BENJAMIN J LUFT
• 金额: $ 59.97万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9340137
• 关键词: Structural; Functional; Neuroimaging; Post; Traumatic

Project Summary World Trade Centers (WTC) responders exposed to extreme psychological trauma have high rates of PTSD, which is independently associated both with cognitive impairment and with significant alteration in the brain. In the Stony Brook WTC Health Program cohort, nearly 20% of responders developed DSM-IV PTSD since 9/11. Their current average age is 54, placing them at the cusp of the risk period for cognitive decline. In order to provide a baseline for anticipated cognitive changes, the Stony Brook arm of the WTC Health Program began assessing cognitive functioning in 2014. In the first 2,400 responders screened with the Montreal Cognitive Assessment (MoCA), the rate of moderate-to-severe cognitive impairment (scores <20) was 2.6%, and the association with WTC-PTSD was highly significant. WTC responders were also exposed to a mix of neurotoxic airborne particles of different size including respirable, nano-sized and ultrafine, metals, PCB, dioxins and solvents. Recent literature shows that nanoparticles, defined as a particle <0.1μm in at least one dimension, can reach the brain through the olfactory pathway and cause long-term neuro-degeneration. Therefore, neurotoxicity may be due to chronic neuro-inflammation caused by oxidative stress induced by the inhaled particles and via involvement of immune system. The purpose of this application is to better understand brain dysfunction among responders with cognitive impairment and Post Traumatic Stress Disorders. That is, similar to the growing body of research on veterans with PTSD, it is of fundamental importance to determine if there are unique structural patterns in the brain associated with cognitive impairment in WTC responders. We thus propose to use in vivo magnetic resonance imaging (MRI) techniques, including functional MRI (fMRI) and positron emission tomography (PET/MRI) imaging to examine these patterns. This application is a pilot study of 120 SBU-WTC responders, 30 with cognitive impairment (MoCA <20) and PTSD, 30 with cognitive impairment without PTSD, 30 with normal cognitive functioning (MoCA>26) and PTSD, 30 with normal cognitive functioning without PTSD. All responders will be matched on age and occupation as well as 30 non-WTC exposed, matched controls with MoCA scores >26. We hope to improve the understanding of mechanisms underlying the potential neuro-cognitive effect from WTC exposure. The ultimate goal of this project is to provide a basis to prevent potential WTC responders' mental health deterioration. The study results will also provide important and novel information for the understanding and prevention of neurodegenerative disorders in the population at large.

项目摘要 暴露于极端心理创伤的世界贸易中心（WTC）反应者的PTSD率很高， 这与认知障碍和大脑的显着改变都独立相关。 Stony Brook WTC健康计划队列，几乎20％的响应者自9/11以来就开发了DSM-IV PTSD。 他们目前的平均年龄为54岁，使他们处于认知能力下降的风险时期的风口浪尖。为了 WTC健康计划的Stony Brook部门开始了预期的认知变化的基准 评估2014年认知功能。 评估（MOCA），中度至重度认知障碍的速率（评分<20）为2.6％，而该认知障碍的速度为2.6％ 与WTC-PTSD的关联非常重要。 WTC响应者还暴露于神经毒性的混合物中 具有不同大小的空气颗粒，包括可呼吸，纳米尺寸和超细颗粒，金属，PCB，二恶英和 解决方案。最近的文献表明，在至少一个维度中定义为粒子<0.1μm的纳米颗粒， 可以通过嗅觉途径到达大脑，并导致长期神经脱生。所以， 神经毒性可能是由于遗传性诱导的氧化应激引起的慢性神经炎症 颗粒并通过免疫系统的参与。 该应用的目的是更好地了解认知反应者的大脑功能障碍 损害和创伤后应激障碍。也就是说，类似于对退伍军人的研究的不断增长 使用PTSD，确定大脑中是否存在独特的结构模式至关重要 与WTC响应者中的认知障碍有关。因此，我们建议使用体内磁共振 成像（MRI）技术，包括功能性MRI（fMRI）和正电子发射断层扫描（PET/MRI） 成像检查这些模式。 该应用是一项针对120个SBU-WTC响应者，30个认知障碍（MOCA <20）和 PTSD，30没有PTSD的认知障碍，30，具有正常认知功能（MOCA> 26）和 PTSD，30，具有正常认知功能，没有PTSD。所有响应者将在年龄和 占用以及30个非WTC暴露的，匹配的对照，MOCA得分> 26。 我们希望能够提高对潜在神经认知作用的机制的理解 WTC暴露。该项目的最终目标是提供一个基础，以防止潜在的WTC响应者 心理健康定义。研究结果还将为 了解和预防整个人群中的神经退行性疾病。