Effects of Methamphetamine in Traumatic Brain Injury

甲基苯丙胺对脑外伤的影响

• 批准号: 7361558
• 负责人: Kristine Hazel O'Phelan
• 金额: $ 26.7万
• 依托单位: QUEEN'S MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7361558
• 关键词: Acute; Area; Attention; Behavior; Brain Injuries; Brain imaging; Cerebrovascular Circulation; Cerebrum; Cognitive; Communities; Country; Craniocerebral Trauma; Development; Distress; Drug usage; Future; Hawaii; Ice; Illicit Drugs; Injury; Lead; Magnetic Resonance Spectroscopy; Measures; Medical center; Metabolic; Metabolism; Methamphetamine; Morbidity - disease rate; N-acetylaspartate; Neurological outcome; Neurons; Neuropsychological Tests; Outcome; Patients; Perfusion; Perfusion Weighted MRI; Pharmaceutical Preparations; Physiological; Physiology; Population; Prevention education; Production; Protons; Public Health; Public Policy; Recovery; Risk; Risk-Taking; Secondary to; Short-Term Memory; Substance abuse problem; TBI Patients; Testing; Therapeutic; Tissues; Toxic effect; Toxicology; Traumatic Brain Injury; United States; drug of abuse; executive function; hemodynamics; high risk behavior; improved; men; mortality; neurobehavioral; response; trauma centers

DESCRIPTION (provided by applicant): Methamphetamine (METH) is a highly addictive drug of abuse that has been increasing in popularity in this country and around the world. Crystal METH is the drug of choice in Hawaii and is considered by far the most significant drug threat. Substance abuse increases risk taking behavior and as a result many victims of traumatic brain injury (TBI) are also using illicit drugs. Traumatic brain injury is also a significant public health problem in the United States and around the world with 1.5 million cases of TBI in this country each year. Both METH and TBI can independently cause direct toxicity to neurons as well as alter cerebral perfusion. This may lead to cellular distress and increased tissue injury. We propose to study the effect of METH use on cerebral perfusion, cerebral metabolism and neurologic outcome in patients with TBI. Our aims are 1) to evaluate the levels of cerebral N-acetyl aspartate (NAA) and lactate after TBI in subjects who test positive for METH as identified by toxicology testing (METH TBI) and in those who test negative for METH (non-METH TBI), using proton magnetic resonance (MR) spectroscopy, 2) to measure global and regional cerebral perfusion using quantitative magnetic resonance perfusion imaging (pMRI) in METH TBI versus non-METH TBI subjects, and 3) to assess cognitive outcome with neuropsychological testing at 6 months after injury in METH TBI versus non-METH TBI subjects. We hypothesize that 1) METH TBI subjects will display lower NAA and higher lactate levels in pericontusional tissue when compared to non-METH TBI subjects. These findings would provide evidence of increased cellular distress on proton MR spectroscopy. 2) METH TBI subjects will have lower pericontusional CBF when compared to non-METH TBI subjects. 3) METH TBI subjects will have increased neurobehavioral deficits when compared to non-METH TBI subjects. Very little is known about the synergistic effects of METH in patients with TBI. This study will help advance our understanding of the metabolic and hemodynamic changes that may lead to secondary brain injury and impact long term neurobehavioral recovery in patients who use METH prior to sustaining a TBI. The results of the proposed study will lead to a better understanding of the synergistic effects of METH abuse and TBI and may lead to new treatments for patients who present with these co-morbidities. In addition, these findings will be pertinent to public health and may help to inform public policy in the future. The proposed study will improve the understanding of the physiologic and functional consequences of methamphetamine use in patients who have suffered an acute traumatic brain injury. This will help inform public education and prevention efforts in this area. It may also allow the development of specific therapeutic strategies for this population of patients.

描述(申请人提供)：甲基苯丙胺(冰毒)是一种高度成瘾的滥用药物，在这个国家和世界各地越来越受欢迎。冰毒是夏威夷的首选毒品，被认为是迄今为止最严重的毒品威胁。物质滥用增加了冒险行为，因此许多创伤性脑损伤(TBI)的受害者也在使用非法药物。创伤性脑损伤在美国和世界各地也是一个重大的公共卫生问题，美国每年有150万例脑损伤病例。冰毒和脑损伤都可以独立地对神经元造成直接毒性，以及改变大脑灌注量。这可能会导致细胞窘迫和组织损伤增加。我们建议研究冰毒的使用对脑损伤患者的脑血流、脑代谢和神经预后的影响。我们的目标是：1)利用质子磁共振(MR)波谱技术，评估毒理试验(METH TBI)中冰毒检测阳性的受试者和冰毒检测阴性的受试者脑内N-乙酰天冬氨酸(NAA)和乳酸的水平；2)使用定量磁共振灌注成像(PMRI)技术，测量甲氧基脑损伤与非冰毒脑损伤受试者在脑损伤后6个月的整体和局部脑血流灌注；3)通过神经心理测试评估甲氧基丁酸脑损伤受试者与非冰毒脑损伤受试者在伤后6个月的认知结果。我们假设：1)甲基甲基丁酸乙酯脑损伤患者的结节周围组织中NAA水平较低，而乳酸水平高于非甲基甲基乙醇胺脑损伤患者。这些发现将提供质子磁共振波谱上细胞苦恼增加的证据。2)甲基硫代乙酸甲酯脑损伤患者的结节周围脑血流量低于非甲基乙醇性脑损伤患者。3)甲基亚甲基脑损伤患者的神经行为缺陷较非甲基亚甲基脑损伤患者明显增加。关于冰毒对脑外伤患者的协同作用，我们知之甚少。这项研究将有助于加深我们对可能导致继发性脑损伤并影响长期神经行为恢复的代谢和血流动力学变化的理解，这些患者在持续脑外伤前使用冰毒。拟议的研究结果将有助于更好地了解冰毒滥用和脑外伤的协同效应，并可能为患有这些并存疾病的患者提供新的治疗方法。此外，这些发现将与公共卫生相关，并可能有助于为未来的公共政策提供信息。这项拟议的研究将提高对急性脑损伤患者使用甲基苯丙胺的生理和功能后果的理解。这将有助于为这一领域的公共教育和预防工作提供信息。它还可能允许为这类患者开发特定的治疗策略。