Endophenotypes of Persistent Post-Concussive Symptoms in Adolescents: CARE4Kids

项目摘要/摘要-研究项目 脑震荡或轻度创伤性脑损伤是儿童获得性脑损伤最常见的类型。 和青少年。虽然大多数患有脑震荡的年轻人在2-4周内恢复，但相当一部分 (15%-30%)需要更长的时间来恢复和发展持续性脑震荡后症状(PPCS)。这群人 经历更差的功能，更多的疼痛，并寻求更多的医疗评估和治疗。 早期和中期青少年(EMA)的长期损害会导致发育轨迹的改变 以及长期的残疾。PPCS没有一个统一的定义，预测算法在很大程度上 根据非特异性的主观临床症状。此外，目前还没有很好的预防措施 策略或有针对性的治疗。开发客观的生物标志物是一个重大的公共卫生挑战 这更好地预测了PPCS，这将为改进预测提供机会，潜在的预防 干预措施和基于潜在生物学机制的新疗法。这是这个项目的中心目标 无墙的CARE4儿童中心发现客观的自主、成像和基于血液的生物标志物 当与神经心理学和神经体征和症状相结合时， 预测EMA中的PPCS。一旦确定，这些生物标记物和临床措施将在更多的 推广了群，发展成一种改进的PPCS预测算法。目标的联动 对不同临床表型(在本申请中称为内表型)的生物学措施将提供 对不同类型的PPCS的机械理解。假设内表型可能有相同的 有偏头痛、自主神经障碍、焦虑、抑郁或其他常见症状的病理生物学 PPC。通过了解PPCS的潜在神经生物学，将有可能开发机制- 以预防或治疗措施为基础。

PROJECT SUMMARY/ABSTRACT – Research Project Concussion or mild traumatic brain injury (mTBI) is the most common type of acquired brain injury in children and adolescents. While the majority of youth with concussion recover within 2-4 weeks, a substantial subset (15-30%) take longer to recover and develop persistent post-concussive symptoms (PPCS). This group experiences worse function, more pain and seeks a greater amount of medical assessments and treatments. Prolonged impairments in early and middle adolescents (EMA) can result in changes in developmental trajectory and long-term disability. There is no single agreed upon definition for PPCS and predictive algorithms are largely based on nonspecific subjective clinical symptoms. Furthermore, there are currently no good preventive strategies or targeted treatments. It is a major public health challenge to develop objective biological markers that better predict PPCS, which will provide the opportunity for improved prognostication, potential preventive interventions and new therapeutics based on underlying biological mechanisms. It is the central goal of this CARE4Kids Center Without Walls to discover objective autonomic, imaging and blood-based biomarkers that, when integrated with neuropsychological and neurological signs and symptoms, will optimally predict PPCS in EMA. Once identified, these biomarkers and clinical measures will then be validated in a more generalized group and developed into an improved predictive algorithm for PPCS. The linkage of objective biological measures to different clinical phenotypes (termed endophenotypes in this application) will provide a mechanistic understanding of different types of PPCS. It is hypothesized that endophenotypes may share pathobiology with migraine, dysautonomia, anxiety, depression or other symptoms commonly seen in those with PPCS. By understanding the underlying neurobiology of PPCS, it will become possible to develop mechanism- based prevention or treatment measures.