Effect of Biomechanical Force Exposure on Cognition and Brain Activation in TBI

描述(由申请人提供)：在美国，每年有300,000人遭受运动性脑震荡。运动性脑震荡和亚脑震荡的短期和长期影响尚不清楚，反复受伤的累积影响也不清楚。显而易见的是，结果存在巨大的差异，尽管这种差异的原因尚不清楚。这项提议的主要主题是，个人暴露在生物力学力量中是影响结果的关键因素。这包括两个主要组成部分：单次撞击的特征(例如，线加速度、旋转加速度、方向等)和暴露在生物机械力下的历史(例如，对之前几天和几周内撞击的频率和强度的测量)。我们建议利用现场头部撞击监测、认知测试和脑功能成像方面的技术进步，首次了解什么类型的头部撞击，在什么情况下，在哪些人身上，对大脑功能造成什么影响。对生物力学力量的急性(脑震荡后)和累积(赛季前到赛季后一个月)监测都是有意义的，并将进行评估。三组学生运动员(有脑震荡的足球/曲棍球运动员，没有脑震荡的队友，匹配的非冲击性运动运动员)将在三个时间点(季前赛、季后赛和脑震荡后一周内)使用标准化认知电池和功能磁共振成像(FMRI)进行研究。撞击参数将使用基于头盔的加速度计单元直接测量。这项研究的结果应该会产生关于运动相关创伤性脑损伤的生物力学和遗传学的重要信息，导致更多知情的回归比赛指南，并提供关于累积的轻微头部损伤的影响的客观信息。

DESCRIPTION (provided by applicant): 300,000 individuals sustain sports concussions each year in the U.S. The short and long-term effects of sports concussions and sub-concussive impacts are not known, nor are the cumulative effects of repeated injuries understood. What is clear is that there is enormous variability in outcome, although the reasons for this variability are not understood. The overarching theme of this proposal is that an individual's exposure to biomechanical forces is a critical factor influencing outcome. This has two broad components: the characteristics of a single impact (e.g. linear acceleration, rotational acceleration, direction etc.), and the history of exposure to biomechanical forces (e.g. measures of frequency and intensity of impacts over the preceding days and weeks). We propose to use technological advances in on-field head impact monitoring, cognitive testing, and functional brain imaging to learn for the first time what types of head impacts, under what circumstances, in which individuals, cause what effects in brain function. Both acute (post-concussive) and cumulative (pre to one-month post season) monitoring of biomechanical forces are of interest and will be assessed. Three groups of student athletes (football/hockey players with concussion, teammates without concussion, matched non-impact sport athletes) will be studied at three time points (preseason, postseason, and within one week of a concussion) using a standardized cognitive battery and functional MRI (fMRI). Impact parameters will be directly measured using helmet-based accelerometer units. Results of this study should yield important information on the biomechanics and genetics of sports-related traumatic brain injury, lead to more informed return-to-play guidelines, and provide objective information regarding the effects of cumulative minor head injuries.