Using Resting State Functional MRI to Predict Cognitive Decline among World Trade Center Responders

痴呆症是导致残疾和死亡的第五大常见原因，在 美国人口。它是一种代价高昂的疾病，估计每年超过2360亿美元，是 只有既无法预防也无法治愈的头号死因。痴呆症通常是 其次是较轻形式的认知障碍(CI)。这一委员会成员之前的研究 调查小组发现，CI在世贸中心应急者中更常见， 相对于年龄匹配的标准样本，在两项单独的研究中约为12%-14%。 此外，在石溪健康监测中心99名响应人员的不同样本中 计划(其中一半有CI)也由该团队研究，减少全球平均皮质厚度 脑梗死组有21/34个亚区厚度。而脑梗塞的病因学 WTC应答者中的情况尚不清楚，初步数据表明阿尔茨海默氏症的神经病理 可能是一个主要来源，反映在受影响的特定认知领域(例如，记忆)， 以及血浆生物标志物和内侧和颞叶皮质萎缩。除了……之外 获得了结构神经成像数据、静息状态功能磁共振(RS-fMRI)数据 在99名WTC应答者的样本中，大约一半的人在 扫描(Time Ascan)。鉴于最近关于遥感数据作为一组稳定的 用于了解疾病风险的生物标记物，该提案首先寻求利用这些现有的 用于确定有无CI的人之间的RS连接性差异的数据，以及 与内存和处理速度的关系。作为第二个目标，它将识别关系 在初始扫描后四年的RS-fMRI网络连接和认知指标中 在80名参与者中(Time Ascan®Time BCOG)。作为一个探索性的目标，它将描述 25名进行性认知功能减退患者RS网络连通性的变化 四年以上，通过添加RS-fMRI，25人认知功能持续未受损超过四年 在为期两年的研究期间，在初次扫描(时间B扫描)后四年进行扫描。这些 结果将为一项旨在确定(更大样本)如何以及程度的研究提供信息 RS fMRI指标可用于预测WTC应答者的认知变化。

Dementia is the fifth most common cause of disability and death with a lifetime risk of 40% in the U.S. population. It is a costly disease, with estimates exceeding $236 billion annually, and is the only top cause of death for which neither a prevention nor cure is available. Dementia is typically preceded by milder forms of cognitive impairment (CI). Previous research by members of this investigative team have found that CI is more common among World Trade Center responders, relative to age-matched normative samples, approximating 12-14% in two separate studies. Further, among a different sample of 99 WTC responders in the Stony Brook health monitoring program (half of whom had CI) also studied by this team, reduced global mean cortical thickness and thickness across 21/34 subregions was found among those with CI. While the etiology of CI among WTC responders is unknown, preliminary data suggests that Alzheimer’s neuropathology may be one major source, as reflected in specific cognitive domains impacted (e.g., memory), as well as plasma biomarkers and atrophy of enthorhinal and temporal cortices. In addition to structural neuroimaging data, resting state functional MRI (RS-fMRI) data have been acquired among a sample of 99 WTC responders, approximately half of whom had CI at the time of scanning (Time Ascan). Given recent findings on the significance of RS data as a stable set of biomarkers for understanding disease risk, this proposal seeks first to leverage these existing data for determining RS connectivity differences among those with and without CI, as well as relationships with memory and processing speed. As a second aim, it will identify relationships among metrics of RS-fMRI network connectivity and cognition four years following the initial scan among 80 participants (Time Ascan®Time Bcog ). As an exploratory aim, it will characterize changes in RS network connectivity among 25 participants with progressing cognitive decline over four years and 25 with continued unimpaired cognition over four years by adding a RS-fMRI scan four years following the initial scan (Time Bscan) during the two-year study period. These results will inform a study that will aim to identify (with a larger sample) how and to what extent RS fMRI metrics can be used for predicting cognitive change in WTC responders.