Identification of Athletes at Risk for Traumatic Brain Injuries

识别有脑外伤风险的运动员

• 批准号: 7503339
• 负责人: Semyon Slobounov
• 金额: $ 32.05万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7503339
• 关键词: Acute; Affect; Algorithms; Area; Behavioral; Brain; Brain Concussion; Brain Diseases; Brain Injuries; Brain imaging; Caring; Cause of Death; Classification; Clinical; Cognition; Cognitive; Cognitive deficits; Computer Graphics; Conflict (Psychology); Data; Databases; Disruption; Electroencephalography; Environment; Epidemic; Equilibrium; Event; Functional Magnetic Resonance Imaging; Functional disorder; Fuzzy Logic; Goals; Health; Human; Impairment; Incidence; Individual; Injury; Laboratories; Lead; Link; Longitudinal Studies; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measures; Motion; Motor; Movement; Multiple Trauma; Musculoskeletal Equilibrium; Neurocognitive; Neurocognitive Deficit; Neurologic; Organism; Pattern; Pattern Recognition; Perception; Postural response; Posture; Price; Probability; Procedures; Protocols documentation; Rate; Recovery; Regression Analysis; Rehabilitation therapy; Research; Research Methodology; Residual state; Resolution; Risk; Sensory; Source; Sports; Staging; Students; Symptoms; Techniques; Technology; Testing; Traumatic Brain Injury; United States; Visual Fields; Work; base; brain electrical activity; cell injury; design; disability; frontal lobe; neuromechanism; neuropsychological; prevent; relating to nervous system; tool; virtual reality; white matter

DESCRIPTION (provided by applicant): Multiple traumas to the brain are the most common type of catastrophic injury and a leading cause of death in athletes. Multiple brain injuries may occur as the long-term disabilities resulting from a single mild traumatic brain injury (MTBI) are often overlooked and the most obvious clinical symptoms appear to resolve rapidly. Most previous research has: a) failed to provide pure pre-injury status of MBTI subjects which may lead to misdiagnosis of the persistent or new neurological and behavioral deficits following a single brain injury; b) focused primarily on transient deficits after single MTBI, and failed to examine long-term deficits and symptoms of multiple MTBI; c) focused primarily on pathophysiology, neurocognitive or behavioral sequelae of MTBI in isolation; and d) failed to identify and predict athletes at risk for traumatic brain injury. We will build on our previous work and plan to identify and examine both transient and long-term behavioral, sensory-motor, neuropsychological, and neural mechanisms that are interactively affected by MTBI. We aim to provide direct evidence that there are long-lasting residual disabilities in subjects suffering from MTBI. We hypothesize that the rate of brain injury symptom resolution predicts the probability of multiple brain injuries in athletes at risk. Our specific aims are: 1) to identify neural mechanisms associated with transient and long-term residual postural abnormalities as a result of single and multiple MTBI; 2) to identify abnormal mechanisms associated with neurocognitive deficits, including those specifically involved in postural control in subjects suffering from MTBI; 3) to examine destabilizing neural mechanisms in MTBI subjects via manipulations of visual field motion; and, 4) to develop and test unsupervised pattern recognition algorithms for predicting athletes at risk for a single and multiple MTBI. The behavioral, neurocognitive and neural dysfunctions will be tested in student-athletes at risk prior to and after a single and multiple brain injuries using a longitudinal design. A set of tools for assessment of mild traumatic brain injury will be developed based on computer graphics and virtual reality (VR) technologies incorporated with modern human movement analysis and brain imaging (EEG and MRI) techniques. Preliminary research in our laboratory has provided strong evidence for the feasibility of the proposed approach to examine the functional changes in the brain, cognition and balance and to identify athletes at risk for a single and multiple MTBI. Brain damage has been referred to as the "silent epidemic," primarily due to its high level of incidence and the lack of acknowledgement when compared to many other large-scale health issues. In sport and recreational activities alone, there are approximately 300,000 concussions in the United States annually, carrying a $9 to $10-billion price tag for acute care and rehabilitation. In this context, single and multiple concussions are relevant to the study of brain injury in general and in traumatic brain injury in those at risk, such as athletes, as a prototypical example of both short and long-term brain disorders. This project seeks to develop new comprehensive concussion assessment procedures aimed at predicting subjects at risk for concussion and ultimately preventing multiple traumatic brain injuries.

描述（由申请人提供）：脑部多发性创伤是最常见的灾难性损伤类型，也是运动员死亡的主要原因。多发性脑损伤可能会发生，因为单一轻度创伤性脑损伤（MTBI）导致的长期残疾往往被忽视，最明显的临床症状似乎很快就会消失。大多数以前的研究有：a）未能提供MBTI受试者的纯粹的损伤前状态，这可能导致误诊为单一脑损伤后的持续性或新的神经和行为缺陷; B）主要集中在单一MTBI后的短暂缺陷上，并且未能检查多个MTBI的长期缺陷和症状; c）主要集中在孤立的MTBI的病理生理学、神经认知或行为后遗症上;以及d）未能识别和预测有创伤性脑损伤风险的运动员。我们将建立在我们以前的工作和计划，以确定和检查瞬时和长期的行为，感觉运动，神经心理和神经机制，是相互影响的MTBI。我们的目标是提供直接证据，证明患有MTBI的受试者存在长期残留残疾。我们假设脑损伤症状的缓解率可以预测高危运动员多发性脑损伤的概率。我们的具体目标是：1）鉴定与作为单次和多次MTBI的结果的短暂和长期残留姿势异常相关的神经机制; 2）鉴定与神经认知缺陷相关的异常机制，包括在患有MTBI的受试者中特别涉及姿势控制的那些机制; 3）通过操纵视野运动来检查MTBI受试者中的不稳定神经机制;以及，4）开发和测试用于预测运动员处于单个和多个MTBI风险中的无监督模式识别算法。行为，神经认知和神经功能障碍将在学生运动员在风险之前和之后，一个单一的和多个脑损伤使用纵向设计进行测试。将根据计算机图形和虚拟现实（VR）技术，结合现代人体运动分析和脑成像（EEG和MRI）技术，开发一套评估轻度创伤性脑损伤的工具。我们实验室的初步研究为所提出的方法的可行性提供了强有力的证据，以检查大脑，认知和平衡的功能变化，并确定运动员有单次和多次MTBI的风险。脑损伤被称为“沉默的流行病”，主要是因为与许多其他大规模的健康问题相比，它的发病率很高，而且缺乏认识。仅在体育和娱乐活动中，美国每年就有大约30万例脑震荡，急性护理和康复费用高达90亿至100亿美元。在这种情况下，单次和多次脑震荡与一般脑损伤的研究以及处于风险中的创伤性脑损伤（如运动员）的研究相关，作为短期和长期脑功能障碍的典型例子。该项目旨在开发新的综合脑震荡评估程序，旨在预测受试者有脑震荡风险，并最终预防多发性创伤性脑损伤。