A longitudinal study of traumatic brain injury in a high-risk population

项目概要/摘要 创伤性脑损伤（TBI）是一个全球性的问题，它会导致各种各样的健康后果。TBI是一个 法医群体的主要担忧--最近全国公众呼吁研究这一问题 卫生机构[1]。事实上，超过60%的囚犯有TBI的历史，这一比例是其他囚犯的七倍。 总人口（8.5%）[2，3]。TBI是一种致犯罪的风险因素[3，4]，即使是轻度TBI也会增加发病率 冒险行为，物质使用和未来犯罪[2，4]。在过去的十年里，我们的团队一直 由NIH持续资助，从4000多名被监禁的患者中收集详细的临床和神经影像学协议。 男人和女人我们利用一对独特的双移动的MRI单元，直接部署在安全的 法医设施的基础上，使之能够进行这项研究。我们的数据集包括多模态 神经影像学方案、全面的临床评估、神经心理学评估和TBI病史。所有 在我们的n>4000名罪犯中，有4000人同意参加纵向跟踪研究。对于这个项目，我们将 开始对n=300名35岁以上的人进行纵向研究，检查将区分 与认知障碍相关的轨迹。我们还将利用先进的神经成像工具 由我们的团队开发，提供基于大脑的认知衰退和基于成像的分类措施 用于识别脑损伤和共病状况的工具（即，滥用药物，精神病评分 抑郁症等）。我们还将研究脑损伤概况和共病状况如何随时间变化。 这些独特的资源的可用性，以检查这个高度不足的人口，使这是一个令人兴奋的 该项目有可能在我们对个人风险需求和不同风险需求的理解方面开辟新天地。 TBI和神经退行性疾病的结果。

Project Summary/Abstract Traumatic brain injury (TBI) is a global concern that precipitates a diverse set of health consequences. TBI is a major concern in forensic populations -- an issue recently highlighted by calls for research by national public health institutions [1]. Indeed, upwards of 60% of inmates have a history of TBI, a rate seven times higher than the general population (8.5%) [2, 3]. TBI is a criminogenic risk factor [3, 4] and even mild TBI increases the rates of risk-taking behavior, substance use, and future offending [2, 4]. Over the last decade our team has been continuously funded by NIH to collect detailed clinical and neuroimaging protocols from over 4000 incarcerated men and women. We utilize a unique pair of twin mobile MRI units that are deployed directly on the secure grounds of forensic facilities, making it possible to conduct this research. Our dataset includes multimodal neuroimaging protocols, thorough clinical assessment, neuropsychological evaluations, and histories of TBI. All of our n>4000 offenders have consented to participate in longitudinal follow-up studies. For this project, we will commence a longitudinal study on n=300 individuals aged 35+, examining variables that will differentiate trajectories associated with cognitive impairments. We will also leverage advanced neuroimaging tools developed by our team to provide brain-based measures of cognitive decline and imaging-based classification tools for identifying brain injuries and comorbid conditions (i.e., substance abuse, psychopathy scores, depression, etc.). We will also examine how the brain injury profiles and comorbid conditions change over time. The availability of these unique resources to examine this highly underserved population makes this an exciting project with the potential to break new ground in our understanding of individual risk needs and divergent outcomes in TBI and neurodegenerative disease.