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Subtle Motor Functioning and Functional Connectivity in Youth Medically Cleared after Mild TBI

轻度创伤性脑损伤后，青少年的细微运动功能和功能连接已得到医学证实

基本信息

批准号：
10330469
负责人：
Stacy Jennifer Marcus Suskauer
金额：
$ 66.67万
依托单位：
HUGO W. MOSER RES INST KENNEDY KRIEGER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-02-13 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10330469
关键词：
Accounting Adverse effects Adverse event Age Attention Behavioral Brain Brain Concussion Brain Injuries Brain region Caring Child Chronic Clinical Clinical assessments Cognitive Data Dorsal Education Evaluation Fingers Frequencies Goals Gold Image Injury Intervention Long-Term Effects Longitudinal Studies Measures Medical Morbidity - disease rate Motor Movement Musculoskeletal Neurologic Examination Outcome Pattern Performance Physical Examination Physiological Physiology Play Public Health Race Recovery Rest Risk Task Performances Time United States Youth adverse outcome aged behavior measurement clinically relevant clinically significant cognitive function cohort contact sports emotional functioning experience health related quality of life high risk injured interest mild traumatic brain injury motor deficit motor impairment musculoskeletal injury novel peer psychologic return to sport sex

项目摘要

PROJECT SUMMARY Youth mild traumatic brain injury (mTBI, concussion) is a public health problem in the United States. Youth are felt to be particularly at risk for adverse outcomes from additive injury during recovery from mTBI. Thus, a critical aspect of care is determining when a child has recovered from mTBI such that a child can be medically cleared to return to sports and other high risk recreational activities without increased risk for adverse short- or long-term outcomes. While mTBI is defined as a physiological brain injury, current clinical measures for determining medical clearance to return to play after mTBI are not directly tried to brain physiology. The overall goal of this project is to evaluate markers of brain physiology in youth medically cleared to return to play after mTBI and how these markers relate to adverse events over the year following medical clearance. Specifically, we will investigate whether youth who have been medically cleared from mTBI by experts using the current gold-standard of clinical assessments show more subtle motor signs and/or anomalous functional brain connectivity compared to peers who have never had a mTBI and how long these findings persist. We will also evaluate whether motor and imaging findings predict rate of re-injury (musculoskeletal or mTBI) or clinically significant changes in emotional or cognitive functioning or health-related quality of life over the year following medical clearance. The aims of this project are to 1) evaluate whether youth medically cleared after mTBI show more subtle motor signs on a clinically-feasible measure at medical clearance and 3 and 12 months later, 2) evaluate for between-group differences in functional connectivity of resting state (default mode and dorsal attention) networks with premotor and motor brain regions at medical clearance and 3 and 12 months later, 3) determine if subtle motor signs are associated with functional brain connectivity in youth medically cleared after mTBI, and 4) evaluate the relationship between motor and imaging findings and occurrence of adverse events over the year following medical clearance. We will evaluate 70 youth aged 10-17 within 3 weeks of being medically cleared as recovered from mTBI and will re-evaluate the same youth 3 and 12 months later. We will similarly evaluate 70 age- and sex-matched youth who have never had a mTBI at three time points, baseline and 3 and 12 months later. At each time point we will compare groups with respect to motor subtle signs and functional connectivity of the dorsal attention network and default mode network with premotor and primary motor regions in the brain, both at rest and during a motor task. We will evaluate whether anomalous functional connectivity patterns in the mTBI group are associated with the presence of subtle motor signs. Lastly, we evaluate the relationship between motor and imaging findings and occurrence of re-injury or clinically significant change in functioning over the year following medical clearance. This project will help determine the adequacy of current clinical measures for evaluating medical clearance after youth mTBI and will set the stage for devising and evaluating strategies to reduce short- and long-term risks related to youth mTBI.

项目摘要青少年轻度创伤性脑损伤（mTBI，脑震荡）是美国的一个公共卫生问题。青年是在从mTBI恢复期间，感觉特别有附加损伤的不良后果的风险。因此护理的关键方面是确定儿童何时已经从mTBI中恢复，使得儿童可以在医学上允许恢复体育和其他高风险娱乐活动，而不会增加不良短期或短期风险。长期成果。虽然mTBI被定义为生理性脑损伤，但目前的临床措施确定体检合格后才能返回发挥mTBI不直接尝试脑生理。整体这个项目的目标是评估年轻人的大脑生理学指标，这些年轻人在医学上被证明可以重返赛场， mTBI以及这些标志物与体检合格后一年内不良事件的关系。具体地说，我们将调查那些已经被专家从医学上清除了mTBI的年轻人，临床评估的金标准显示更微妙的运动体征和/或异常的大脑功能与从未患过mTBI的同龄人相比，这些结果持续了多久。我们还将评估运动和影像学检查结果是否可预测再损伤率（肌肉骨骼或mTBI）或临床一年后情绪或认知功能或健康相关生活质量发生重大变化体检合格该项目的目的是1）评估mTBI后青年是否在医学上被清除在体检合格时以及3个月和12个月后， 2)评估静息状态（默认模式和背侧模式）功能连接的组间差异在体检合格时以及3个月和12个月后，3）确定微妙的运动体征是否与医学上清除后的年轻人的功能性大脑连接有关 mTBI，以及4）评估运动和成像结果与不良事件发生之间的关系在体检合格后的一年内。我们将在3周内对70名10-17岁的青少年进行评估，在医学上被清除为从mTBI中恢复，并将在3个月和12个月后重新评估同一青年。我们将类似地，在三个时间点（基线）评估了70名年龄和性别匹配的从未患过mTBI的青年， 3个月和12个月后。在每个时间点，我们将比较各组的运动细微体征，背侧注意网络和缺省模式网络与前运动和初级运动的功能连接大脑中的运动区域，无论是在休息时还是在运动任务中。我们将评估是否异常 mTBI组中的功能连接模式与细微运动体征的存在相关。最后，我们评估了运动和影像学表现与再损伤或体检合格后一年内功能发生具有临床意义的变化。这个项目将有助于确定当前临床措施是否足以评估青年mTBI后的医疗许可，并将为制定和评估战略奠定基础，以减少与青年mTBI相关的短期和长期风险。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Subtle Motor Signs and Executive Functioning in Chronic Paediatric Traumatic Brain Injury: Brief Report.

慢性小儿创伤性脑损伤中的微妙运动体征和执行功能：简要报告。

DOI：
10.1080/17518423.2019.1655676
发表时间：
2020
期刊：
Developmental neurorehabilitation
影响因子：
1.3
作者：
Crasta,JewelE;Slomine,BethS;Mahone,EMark;Suskauer,StacyJ
通讯作者：
Suskauer,StacyJ

Altered white matter diffusivity and subtle motor function in a pilot cohort of adolescents with sports-related concussion.

DOI：
10.1080/02699052.2022.2034181
发表时间：
2022-02-23
期刊：
BRAIN INJURY
影响因子：
1.9
作者：
Crasta, Jewel E.;Tucker, Robert N.;Robinson, Joshua;Chen, Hsuan Wei;Crocetti, Deana;Suskauer, Stacy J.
通讯作者：
Suskauer, Stacy J.

The Effect of Age and Competition Level on Subtle Motor Performance in Adolescents Medically Cleared Postconcussion: Preliminary Findings.