Comprehensive White-matter Microstructure-informed Analytical Methods to Elucidate Neurobiological Mechanisms of Sports-related Concussion (SRC)

综合白质微观结构分析方法阐明运动相关脑震荡 (SRC) 的神经生物学机制

• 批准号: 10608132
• 负责人: Jaroslaw Harezlak
• 金额: $ 37.19万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10608132
• 关键词: Acute; Address; Affect; Anatomy; Animal Model; Area; Assessment tool; Autopsy; Axon; Biological; Biomechanics; Brain; Brain Concussion; Brain Injuries; Centers for Disease Control and Prevention (U.S.); Characteristics; Classification; Clinical; Clinical Management; Clinical assessments; Cohort Studies; Data; Databases; Diffuse Axonal Injury; Diffusion; Diffusion Magnetic Resonance Imaging; Disease Pathway; Education; Functional disorder; Future; Goals; Heterogeneity; Human; Image; Impaired cognition; Individual; Injury; Maps; Measures; Methods; Microscopic; Minority; Modernization; Multimodal Imaging; Nature; Neurites; Neurodegenerative Disorders; Outcome; Outcome Measure; Pathologic; Pathology; Pathway interactions; Pattern; Persons; Phenotype; Physiological; Play; Public Health; Recovery; Reporting; Research; Role; Sampling; Severities; Signs and Symptoms; Spatial Distribution; Specificity; Sports; Standardization; Structure; Subgroup; Symptoms; Techniques; Time; Traumatic Brain Injury; United States; analytical method; axon injury; chronic traumatic encephalopathy; college; density; head impact; high risk; high school; in vivo; individual variation; injured; injury recovery; mild traumatic brain injury; nervous system disorder; neurobiological mechanism; neuroimaging; neuropathology; novel; psychological distress; tool; white matter; white matter change

Project Abstract Sports-related concussion (SRC), while often regarded as the mildest form of traumatic brain injury (TBI), is nevertheless a significant public health issue. Based on the estimates by the Centers for Disease Control, 1.6 to 3.8 million SRCs occur annually among high school and collegiate athletes. Athletes sustaining acute concussion have a wide spectrum of clinical signs and symptoms including psychological distress, cognitive impairment, and somatic symptoms. In some cases, these symptoms persist, and people with mild TBI may be at higher risk for neurodegenerative diseases, future TBI, and, in cases of repetitive injuries, chronic traumatic encephalopathy. While standardized assessment tools are useful in the clinical management of acute concussion, the underlying pathophysiology of SRC and the time course of physiological recovery after injury remain unclear. There is an immediate need to address the heterogeneity in the long-term consequences of SRC to facilitate concussion management. The proposed research aims to understand why some concussed athletes have prolonged recovery time and, more importantly, how to detect such extreme cases. Diffuse axonal injury is generally believed to be the initial white matter neuropathology associated with mild TBI. Nevertheless, this microscopic injury is more difficult to detect in human mild TBI. Modern diffusion MRI techniques offer increased biological specificity for describing white-matter alterations. Therefore, the goal of the proposed research is to determine whether these novel axonal metrics: (1) provide indirect evidence of diffuse axonal injury in human SRC; (2) help to explain heterogeneity in individual recovery trajectories; and (3) inform our understanding of the relationship between axonal injury in SRC and clinical manifestations of SRC.

项目摘要 运动相关脑震荡 (SRC) 虽然通常被认为是最轻微的创伤性脑损伤 (TBI)，但 然而，这是一个重大的公共卫生问题。根据疾病控制中心的估计，1.6 高中和大学运动员每年发生 380 万次 SRC。运动员持续急性 脑震荡具有广泛的临床体征和症状，包括心理困扰、认知障碍 损伤和躯体症状。在某些情况下，这些症状持续存在，患有轻度 TBI 的人可能会 患神经退行性疾病、未来 TBI 的风险较高，并且在重复性损伤的情况下，慢性损伤 外伤性脑病。虽然标准化评估工具在临床管理中很有用 急性脑震荡、SRC 的潜在病理生理学以及术后生理恢复的时间过程 伤势尚不清楚。从长远来看，迫切需要解决异质性问题 SRC 的后果，以促进脑震荡管理。拟议的研究旨在了解原因 一些脑震荡运动员的恢复时间很长，更重要的是，如何检测这种极端情况 案例。 弥漫性轴突损伤通常被认为是与轻度相关的最初白质神经病理学 创伤性脑损伤。然而，这种微观损伤在人类轻度 TBI 中更难检测到。现代扩散磁共振成像 技术为描述白质改变提供了更高的生物学特异性。因此，目标是 拟议的研究是为了确定这些新颖的轴突指标是否：（1）提供间接证据 人类 SRC 的弥漫性轴突损伤； （2）有助于解释个体恢复轨迹的异质性；和（3） 帮助我们了解 SRC 轴突损伤与 SRC 临床表现之间的关系。