7T Neurosurgical Mapping Protocol for Endoscopic Resection of Skull Base Tumors

项目摘要 尽管在大量COVID-19患者中观察到神经系统症状，但一项前瞻性研究发现， 旨在用先进的多模态神经成像方法扫描康复的COVID-19患者， 被执行。关于SARS-CoV-2病毒对中枢神经系统的持续影响， 神经系统，高分辨率磁共振成像（MRI）是理想的非侵入性工具， 这些影响以及感染机制。在这项工作中，我们将利用高分辨率和增强 多模态7特斯拉（7 T）成像提供的对比，以研究结构、血管、功能和 与COVID-19的病理生理学相关的大脑中的连接变化。特别是，我们将揭示， 在前所未有的细节，大脑异常造成的SARS-CoV-2感染，以及闪耀着更明亮的 由于病毒感染通过脑干导致呼吸动力丧失的可能联系。影像学表现 将与临床神经系统症状和神经心理学测量相关。3个患者亚组 我们的前瞻性研究将招募：有神经系统症状的非癌症患者， 呼吸机，不需要呼吸机的有神经系统症状的癌症患者，以及 严重呼吸窘迫需要换气还将对临床脑进行回顾性研究 在西奈山卫生系统看到的一组有神经系统症状的COVID-19患者的MRI扫描， 该分析的结果将有助于7 T研究的患者选择和持续性 相对于短暂的神经影响。我们的研究福尔斯属于我们在“7 T”上的R 01应用范围 颅底肿瘤内镜切除术的神经外科标测方案”，因为我们正在应用类似的 多模式7 T成像技术，以揭示大脑中的详细解剖结构并表征疾病的影响 在这两项研究中。我们将简单地将队列扩展到包括COVID-19康复患者，并进一步优化 脑干成像将适用于这两项研究。我们的研究符合《通知》的目标 NCI宣布的关于COVID-19的行政补充的特别关注，因为它解决了 不同癌症患者群体对SARS-CoV-2感染的不同反应的可能性， COVID-19中枢神经系统疾病。

Project Summary Although neurological symptoms are being observed in a high number of COVID-19 patients, a prospective study aimed at scanning recovered COVID-19 patients with advanced multi-modal neuroimaging methods has yet to be performed. There is much to be learned about the persisting effects of the SARS-CoV-2 virus on the central nervous system, and high-resolution magnetic resonance imaging (MRI) is the ideal non-invasive tool to reveal these effects as well as mechanisms of infection. In this work, we will leverage the high resolution and enhanced contrasts offered by multi-modal 7 Tesla (7T) imaging to study the structural, vascular, functional, and connectomic changes in the brain related to the pathophysiology of COVID-19. In particular, we will reveal, in unprecedented detail, brain abnormalities resulting from the SARS-CoV-2 infection as well as shine a brighter light on possible links to loss of respiratory drive due to viral infection through the brain stem. Imaging findings will be correlated to clinical neurological symptoms and neuropsychological measures. Three patient subgroups will be recruited for our prospective study: non-cancer patients with neurological symptoms who did not require a ventilator, cancer patients with neurological symptoms who did not require a ventilator, and patients who had severe respiratory distress and required ventilation. A retrospective study will also be performed on clinical brain MRI scans for a group of COVID-19 patients with neurological symptoms, seen at Mount Sinai Health System, and outcomes of this analysis will aid in patient selection for the 7T study and additional analysis of persisting versus transient neurological effects. Our study falls within the scope of our R01 application on “7T Neurosurgical Mapping Protocol for Endoscopic Resection of Skull Base Tumors” as we are applying similar multimodal 7T imaging techniques to reveal detailed anatomy in the brain and to characterize effects of disease in both studies. We will simply extend the cohort to include COVID-19 recovered patients and further optimize imaging in the brain stem which will be applicable to both studies. Our study aligns with the goals of the Notice of Special Interest announced by the NCI for administrative supplements on COVID-19 as it addresses potential for differential responses among diverse cancer patient populations to SARS-CoV-2 infection or COVID-19 disease in central nervous system.