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

项目摘要/摘要 创伤性脑损伤(TBI)是一个全球性的问题，会导致一系列不同的健康后果。TBI是一种 法医群体的主要关切--最近全国公众呼吁进行研究突显了这一问题 卫生机构[1]。事实上，超过60%的囚犯有脑外伤病史，这一比例是 总人口(8.5%)[2，3]。脑外伤是导致犯罪的危险因素[3，4]，即使是轻微的脑损伤也会增加发病率。 冒险行为、药物使用和未来的犯罪行为[2，4]。在过去的十年里，我们的团队一直 由美国国立卫生研究院持续资助，从4000多名囚犯中收集详细的临床和神经成像方案 男人和女人。我们利用一对独特的双移动核磁共振装置，直接部署在安全的 法医设施的场地，使开展这项研究成为可能。我们的数据集包括多模式 神经成像方案、全面的临床评估、神经心理评估和脑外伤病史。全 在我们的N&GT；4000名罪犯中，有4000人同意参加纵向随访研究。对于这个项目，我们将 开始对n=300名年龄在35岁以上的人进行纵向研究，检查将区分哪些变量 与认知障碍有关的轨迹。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下降测量和基于成像的分类 用于识别脑损伤和合并症的工具(例如，药物滥用、精神病评分、 抑郁等)。我们还将研究脑损伤概况和共病情况如何随着时间的推移而变化。 这些独特的资源可用于检查服务严重不足的人群，这使这一点令人兴奋 有潜力在理解个人风险需求和分歧方面开辟新天地的项目 脑外伤和神经退行性疾病的转归。

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.