Circadian Dysfunction, Encephalopathy, and Cognitive Outcomes after Critical Illness

昼夜节律障碍、脑病和危重疾病后的认知结果

基本信息

批准号：
9509574
负责人：
Matthew Brandon Maas
金额：
$ 17.66万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-01 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9509574
关键词：
Acute Affect Anesthesiology Area Arousal Award Biological Markers Biology Biometry Blood Blood specimen Body Temperature Brain Brain Injuries Cessation of life Chronic Circadian Rhythms Clinical Clinical Research Clinical assessments Cognition Cognitive Coma Confusion Critical Care Critical Illness Data Delirium Development Plans Diffuse Electroencephalography Encephalopathies Excretory function Failure Foundations Functional disorder Glasgow Coma Scale Goals Health Homeostasis Hormones Hospitalization Hour Immune system Impaired cognition Impairment Inflammatory Intensive Care Units Intervention Investigation Light Link Measurement Measures Melatonin Mentored Patient-Oriented Research Career Development Award Mentors Metabolism Methods Middle Insomnia Monitor Morbidity - disease rate Nervous System Trauma Neurobehavioral Manifestations Neurologic Neurologist Neurology Neurons Neurophysiology - biologic function Outcome Pathologic Processes Patients Pattern Pharmaceutical Preparations Physiological Psyche structure Recovery Research Research Design Research Methodology Research Personnel Risk Role Science Severities Sleep Sleep Deprivation Specialist Standardization Survivors Symptoms Testing Therapeutic Time Toxin Training Training Programs Translating United States National Institutes of Health Universities Urine alertness brain abnormalities brain dysfunction brain electrical activity career career development cognitive function confusion assessment method cytokine design experience hormonal signals improved outcome innovation instrument knowledge base mental state mortality negative affect neurological recovery neurophysiology novel strategies patient oriented research prevent professor programs public health relevance research clinical testing skills

项目摘要

DESCRIPTION (provided by applicant): This application entitled "Circadian Dysfunction, Encephalopathy, and Cognitive Outcomes after Critical Illness" is being submitted by Dr. Matthew Maas for a Mentored Patient-Oriented Research Career Development Award. The circadian rhythm is a brain-controlled pattern of neurologic and hormonal signals that influence alertness, sleep, metabolism, body temperature, immune system activity, and other fundamental body functions that maintain homeostasis and health. Research over the last several years has shown that basic cellular health in the brain is negatively affected when the circadian rhythm is abnormal. Moreover, there is evidence that disruption of the circadian rhythm is common and severe in critically ill patients. Critically ill patients suffer inordinate risk of encephalopathy a condition of generalized brain dysfunction that can range in severity from mild to severe (coma), and those patients who develop encephalopathy are at increased risk of death or poor cognitive function for months or years after their illness. Neither the impact of circadian disruption during clinical illness nor the underlying causes of encephalopathy are well understood. This proposal will investigate whether disruption of the circadian rhythm is linked to the risk of encephalopathy and poor cognitive outcomes in critically ill patients. To accomplish this task, we will utilize methods that have been used to study circadian function in healthy patients, including non-invasive electrical recording of brain activity and blood samples to detect the level of the brain hormone melatonin, and combine them with critical care research methods for assessing encephalopathy and cognitive outcomes. Establishing whether a true association exists between these phenomena will allow us to develop strategies to prevent or treat circadian dysfunction with the goal of improving outcomes for severely ill patients. Dr. Maas is a neurologist and critical care specialist now appointed as an Assistant Professor of Neurology and Anesthesiology at Northwestern University. His overarching career goal is to improve the outcome of neurologic injuries in critically ill patients. His clinical training and prior experienes with patient-oriented research make him an ideal candidate to carry out this cross-disciplinary research. He will be supported by a team of experienced investigators with complementary expertise. Dr. Phyllis Zee, his primary mentor, is an expert in the field of circadian biology. Drs Andrew Naidech and Shyam Prabhakaran are accomplished researchers who study complications that affect outcomes for severely ill patients with neurologic injury. This award is mentored program designed to combine the experience of conducting this study with a career development plan for Dr. Maas. The training program will help him build his knowledge base around the science of circadian biology, methods used by neuroscientists to monitor brain function, study design, biostatistics, and other clinical research skills, with the goal the he wil become a productive independent clinical researcher.

描述（由申请人提供）：这份题为“昼夜节律功能障碍、脑病和危重疾病后的认知结果”的申请由 Matthew Maas 博士提交，以获得以患者为导向的研究职业发展奖。昼夜节律是大脑控制的。影响警觉性、睡眠、新陈代谢、体温、免疫系统活动和其他维持体内平衡的基本身体功能的神经和激素信号模式过去几年的研究表明，当昼夜节律异常时，大脑的基本细胞健康会受到负面影响。此外，有证据表明，危重患者的昼夜节律紊乱是常见且严重的。患有脑病的风险极高，这是一种全身性脑功能障碍，其严重程度从轻度到重度不等（昏迷），并且那些发生脑病的患者在患病后数月或数年内死亡或认知功能不良的风险增加。的影响期间昼夜节律紊乱临床疾病和脑病的根本原因尚不清楚，该提案将调查昼夜节律的破坏是否与脑病的风险有关。为了完成这项任务，我们将利用用于研究健康患者昼夜节律功能的方法，包括对大脑活动和血液样本进行无创电记录来检测大脑激素水平。褪黑激素，并将其与评估脑病和认知结果的重症监护研究方法相结合，确定这些现象之间是否存在真正的关联，将使我们能够制定预防或治疗昼夜节律功能障碍的策略，以改善重症患者的预后。马斯是一名神经科医生和重症监护专家，现被任命为西北大学神经病学和麻醉学助理教授。他的首要职业目标是改善危重患者神经损伤的治疗效果。他是进行这项跨学科研究的理想人选，他的主要导师 Phyllis Zee 博士是昼夜节律生物学领域的专家，他将得到经验丰富的研究人员团队的支持。 Andrew Naidech 和 Shyam Prabhakaran 是研究人员，他们完成了影响神经损伤重症患者治疗结果的并发症研究。该奖项是一项指导计划，旨在将进行这项研究的经验与 Maas 博士的职业发展计划相结合。帮助他围绕昼夜节律生物学科学、神经科学家用来监测大脑功能的方法、研究设计、生物统计学和其他临床研究技能建立知识库，目标是让他成为一名富有成效的独立临床研究员。