Study of early brain alterations that predict development of chronic PTSD

项目摘要 创伤经历会导致一些人（但不是所有人）患上创伤后应激障碍（PTSD）， 创伤幸存者R01基金的重点是识别人类大脑情感回路的变化， 创伤后早期数周，预测随后的PTSD与非PTSD诊断在数月后， 创伤（具体目标1）。该基金进一步研究了大脑情感回路的渐进变化， 与创伤后数周到一年的PTSD症状进展相关（具体目标2）。的 批准的研究设计需要从急诊科（ED）招募283名创伤患者， 在144名受试者中提供一年以上的纵向采样，其中约35%（50名受试者）可能会发生 创伤后应激障碍在最初的3.7年中，研究招募和纵向保留按计划进行，直到 2019冠状病毒病疫情于二零二零年三月后于第四年阻止招聘及减少留用。由于 联邦、州、县和托莱多大学的强制性指导方针，研究小组不得不修改 试图保持进展。修改的程序包括，同意通过电话，在线 调查和虚拟诊断访谈，经常消毒研究区域，并提供MRI兼容 研究人员和受试者的个人防护设备（PPE）。流行病的破坏也 需要在受试者招募和保留方面加大努力。程序上的变化逐渐使我们能够 恢复研究，并有效保护受试者和研究人员。然而，这是在价格 不可避免的、无法预料的减速和成本。完成拟定取样和最终数据 分析，这一要求的行政补充将承担这些意外费用， 完成原计划的工作。

Project Summary Traumatic experience leads to development of posttraumatic stress disorder (PTSD) in some, but not all, trauma survivors. The funded R01 grant is focused on identifying human brain emotion circuit changes within early post-trauma weeks that predict subsequent PTSD versus non-PTSD diagnosis in the months-years after trauma (Specific Aim 1). The grant further examines progressive changes in brain emotion circuits that associate with PTSD symptom progression from weeks to a year after the trauma (Specific Aim 2). The approved study design requires recruiting 283 traumatized patients from Emergency Departments (EDs) to provide longitudinal sampling over a year in 144 subjects, about 35% (50 subjects) of which will likely develop PTSD. Study recruiting and longitudinal retention progressed as planned over the initial 3.7 years until the COVID-19 pandemic forestalled recruitment and reduced retention after March 2020 during year 4. Due to federal, state, county, and University of Toledo mandatory guidelines, the research team has had to modify protocols in attempts to maintain progress. Modified procedures include e.g., consent over the phone, online surveys and virtual diagnostic interviews, disinfecting study areas frequently, and providing MRI compatible personal protection equipment (PPE) to study personnel and subjects. Pandemic disruptions have also required increased efforts in subject recruitment and retention. Procedural changes are gradually allowing us to resume the study and have been effective in protecting subjects and researchers. However, this is at the price of unavoidable, unanticipated slow-downs and costs. To complete the proposed sampling and final data analyses, this requested Administrative Supplement will underwrite these unexpected costs and is critical for completing the originally planned work.