Endophenotypes of Persistent Post-Concussive Symptoms in Adolescents: CARE4Kids

青少年持续性脑震荡后症状的内表型：CARE4Kids

• 批准号: 10740066
• 负责人: GERARD A. GIOIA
• 金额: $ 6.18万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-08 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740066
• 关键词: Accident and Emergency department; Acute; Adolescent; Algorithms; Behavioral; Biological Markers; Blood; Brain Concussion; Brain imaging; Chronic; Clinic; Clinical; Clinical Management; Common Data Element; Data; Detection; Development; Early identification; Evaluation; Funding; Goals; Image; Individual; Intervention; Measures; Mental Health; National Institute of Neurological Disorders and Stroke; Neurologic; Neuropsychology; Post-Concussion Syndrome; Prevention; Registries; Research; Risk; Science; Self-Injurious Behavior; Site; Sports Medicine; Suicide; Symptoms; Techniques; Testing; Time; Traumatic Brain Injury; Validation; Youth; biomarker development; biomarker validation; cohort; endophenotype; mild traumatic brain injury; neurobehavioral; parent project; persistent symptom; prediction algorithm; predictive marker; primary care clinic; prospective; recruit; risk stratification; screening; suicidal; suicidal risk; symptom cluster; trait

PROJECT SUMMARY/ABSTRACT – Overall The prediction, detection, management and prevention of persistent post-concussive symptoms (PPCS) represent some of the most important neurological challenges in the science of traumatic brain injury (TBI) today. For the purposes of this application, PPCS will refer to post-concussive symptoms lasting ≥3 months, consistent with the National Institute of Neurological Disorders and Stroke Common Data Elements for concussion. We approach this using the concept of endophenotypes, quantitative behavioral traits characterized by objective measures using blood-based, imaging or autonomic measures or other techniques. Understanding the endophenotypes of PPCS will provide opportunities for early identification and potentially for intervention, treatment and prevention. The overarching goal of this application is to develop a predictive algorithm for PPCS endophenotypes in early and middle adolescents (EMA) to inform clinical screening, management and future research. Our specific aims are: Specific Aim 1. In a Development Cohort, develop and characterize individual objective biomarkers predictive of PPCS by combining biomarkers with symptom clusters and neuropsychological function. Biomarkers will be examined in 3 Research Cores: Autonomic, Imaging and Blood- based. Specific Aim 2. To develop and characterize endophenotypes of PPCS in EMA by combining two or more objective biomarkers with symptom clusters and neuropsychological measures. Specific Aim 3. To prospectively validate endophenotype biomarkers from Aims 1 and 2 in a broad group of EMA with concussion (Validation Cohort). Specific Aim 4. To create a clinically useful risk stratification algorithm using validated biomarkers, in conjunction with symptoms and neurobehavioral function, which will predict the development of PPCS. The Development Cohort will be recruited from existing concussion and sports medicine clinics at 6 sites within the Four Corners Youth Consortium (4CYC). This cohort will include subjects presenting from 0-12 months after concussion, will likely be enriched in those with PPCS, and has proven feasible for recruitment into an observational prospective registry. The Validation Cohort will be recruited from the same clinics but also expanded to primary care clinics/networks and emergency departments (acutely/subacutely) and followed to a chronic time point. With this broader and more generalizable cohort, the candidate blood-based, imaging and autonomic biomarkers from the Development Cohort will be tested and validated. It is from these 2nd cohort data that a predictive algorithm (likely combining clinical and biomarker measures) will be developed.

项目摘要/摘要 - 总体 预测，检测，管理和预防持续的后脑症状（PPC） 代表了当今创伤性脑损伤科学（TBI）中一些最重要的神经系统挑战。 出于本申请的目的，PPC将参考持续≥3个月的脑震荡症状，一致 随着国家神经系统疾病和中风研究所的咨询元素。我们 使用内表型的概念，以客观为特征的定量行为特征对此进行方法 使用基于血液的，成像或自主神经元的测量或其他技术进行衡量。了解 PPC的内表型将为早期识别提供机会，并有可能进行干预， 治疗和预防。此应用程序的总体目标是开发一种预测算法 早期和中年青少年（EMA）的PPC内表型为临床筛查，管理 和未来的研究。我们的具体目的是：特定目标1。在开发队列中，发展和表征 通过将生物标志物与症状簇相结合和 神经心理学功能。生物标志物将在3个研究核心中进行检查：自主，成像和血液 - 基于。特定目的2。通过组合两个或 具有症状簇和神经心理学测量的更客观的生物标志物。特定目标3。 前瞻性地验证一组EMA中的AIMS 1和2的内型生物标志物，并通过咨询 （验证队列）。特定目标4。使用经过验证的临床有用的风险分层算法创建一种有用的风险分层算法 生物标志物以及症状和神经行为功能，这将预测 PPC。该开发队列将从现有的咨询和运动医学诊所招募。 四个角落青年联盟（4CYC）的地点。该队列将包括0-12的主题 咨询几个月后，可能会在PPC的人中丰富，并证明可以招募 观察性的前瞻性注册表。验证队列将从同一诊所招募，也将 扩展到初级保健诊所/网络和急诊室（急性/急性），然后 慢性时间点。有了这个更广泛，更具概括的队列，候选人的血液，成像和 开发队列的自主生物标志物将进行测试和验证。它来自这些第二个队列数据 将开发一种预测算法（可能结合临床和生物标志物测量）。

项目成果

CARE4Kids Study: Endophenotypes of Persistent Post-Concussive Symptoms in Adolescents: Study Rationale and Protocol.

CARE4Kids 研究：青少年持续性脑震荡后症状的内表型：研究原理和方案。

• DOI: 10.1089/neu.2023.0073
• 发表时间: 2024
• 期刊: Journal of neurotrauma
• 影响因子: 4.2
• 作者: Giza,ChristopherC;Gioia,Gerard;Cook,LawrenceJ;Asarnow,Robert;Snyder,Aliyah;Babikian,Talin;Thompson,Paul;Bazarian,JefferyJ;Whitlow,ChristopherT;Miles,ChristopherM;Otallah,Scott;Kamins,Joshua;Didehbani,Nyaz;Rosenbaum,PhilipE
• 通讯作者: Rosenbaum,PhilipE