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中情绪回路的变化 创伤后早期几周预测创伤后应激障碍与非创伤后应激障碍在数月和数年后的诊断 创伤(具体目标1)。这项拨款进一步研究了大脑情绪回路的渐进性变化 与创伤后数周至一年的创伤后应激障碍症状进展有关(具体目标2)。这个 批准的研究设计需要从急诊科(ED)招募283名创伤患者 在144名受试者中提供超过一年的纵向抽样，其中约35%(50名受试者)可能会发展 创伤后应激障碍。在最初的3.7年中，研究人员的招募和纵向保留按计划进行，直到 新冠肺炎大流行在第四年预先阻止了招聘，并在2020年3月后减少了留住。由于 联邦、州、县和托莱多大学的强制性指南，研究团队不得不修改 在试图保持进展的情况下制定协议。修改后的程序包括，例如，通过电话、在线同意 调查和虚拟诊断访谈，经常对研究区域进行消毒，并提供与MRI兼容的 个人防护装备(PPE)，用于研究人员和对象。大流行的中断也 需要在科目招聘和留用方面作出更大努力。程序上的变化正在逐渐允许我们 恢复研究，并一直有效地保护受试者和研究人员。然而，这是有代价的 不可避免的、意想不到的减速和成本。完成建议的抽样和最终数据 分析，这项请求的行政补充将为这些意外成本提供担保，并对 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.