Neural Basis of Recovery of Inhibitory Control After Pediatric TBI

儿童 TBI 后抑制控制恢复的神经基础

• 批准号: 7927087
• 负责人: Stacy Jennifer Marcus Suskauer
• 金额: $ 13.38万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-10 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7927087
• 关键词: Acute; Adult; Affect; Anatomy; Anisotropy; Behavior; Behavioral; Brain Injuries; Child; Childhood; Chronic; Communities; Community Integration; Complex; Data; Data Analyses; Development Plans; Diffusion Magnetic Resonance Imaging; Environment; Evaluation; Future; Goals; Home environment; Image; Impairment; Injury; Institutes; Laboratories; Longitudinal Studies; Measures; Memory; Methods; Natural History; Parents; Pattern; Physicians; Principal Investigator; Process; Questionnaires; Recovery; Rehabilitation therapy; Reporting; Research Design; Research Personnel; Resolution; Risk; Scanning; Schools; Self-control as a personality trait; Social Functioning; Therapeutic Intervention; Thick; Time; Training; Traumatic Brain Injury; Treatment Efficacy; Universities; Work; base; behavior measurement; brain behavior; career development; frontal lobe; high risk; improved; magnetic resonance spectroscopic imaging; neurobehavioral; neuroimaging; neuromechanism; outcome forecast; prognostic indicator; public health relevance; relating to nervous system; showing emotion; social; therapy design; white matter

DESCRIPTION (provided by applicant): Inhibitory control is frequently impaired following pediatric traumatic brain injury (TBI), and deficits in inhibitory control impact a child's function in school and at home and ultimately their likelihood for successful community integration as an adult. The long-term goal is to understand the neural mechanisms underlying the recovery of inhibitory control, including that involved in self-control of emotional expression and in social situations, in order to identify children at high risk for ongoing problems in these domains and to evaluate the efficacy of interventions designed to optimize inhibitory control. The focus of this proposal is to understand the recovery of inhibitory control over 18 months following pediatric TBI using laboratory assessments and parent-report measures of behavior in the home and community and to identify neuroimaging predictors and correlates of chronic inhibitory control. The specific aims are to 1) describe the pattern of recovery of varying aspects of inhibitory control over 18 months following moderate to severe pediatric TBI, 2) identify imaging measures which, after moderate to severe TBI in childhood, a) correlate with current inhibitory control, b) predict inhibitory control at one year following injury, and c) predict future imaging findings, and 3) identify, in children with moderate to severe TBI, changes in imaging measures between 2 months and 1 year following injury which are associated with improved inhibitory control over the same time period. Neuroimaging methods will include diffusion tensor imaging (DTI), magnetic resonance spectroscopic imaging (MRSI), and morphometric analyses, with primary analyses consisting of the relationship of frontal lobe integrity with measures of inhibitory control. This project is proposed as part of a career development plan for the PI, a pediatric rehabilitation physician, to obtain training in longitudinal study design and data analysis, neurobehavioral evaluation after pediatric TBI including assessment of inhibitory control and social function, and processing and analysis of DTI, MRSI, and structural imaging data from children with TBI. The Kennedy Krieger Institute and Johns Hopkins University provide an exceptional environment to enable the PI to become an independent investigator studying brain-behavior relationships after pediatric TBI. Public Health Relevance: After brain injury, many children have difficulty with controlling their behavior, which leads to problems in school and at home. The goal of this study is to develop ways to better understand which children are at risk to have this problem long-term after brain injury. This information will help children receive treatment to optimize their behavior as soon as possible and will allow studies of the efficacy of these treatments.

描述（由申请人提供）：儿童创伤性脑损伤（TBI）后，抑制性控制经常受损，抑制性控制的缺陷会影响儿童在学校和家中的功能，最终影响他们成年后成功融入社区的可能性。长期目标是了解抑制控制恢复的神经机制，包括参与情绪表达的自我控制和社交情境，以识别这些领域中持续存在问题的高风险儿童，并评估旨在优化抑制控制的干预措施的有效性。本提案的重点是了解儿童TBI后18个月内抑制控制的恢复情况，使用实验室评估和家长报告的家庭和社区行为测量，并确定神经影像学预测因子和慢性抑制控制的相关性。具体目的是：1）描述中度至重度小儿TBI后18个月内抑制性控制的不同方面的恢复模式，2）鉴定成像测量，在儿童期中度至重度TBI后，a）与当前抑制性控制相关，B）预测损伤后一年的抑制性控制，和c）预测未来的成像发现，和3）鉴定，在中度至重度TBI儿童中，损伤后2个月至1年的影像学测量变化与同一时期抑制控制的改善相关。神经影像学方法包括弥散张量成像（DTI）、磁共振波谱成像（MRSI）和形态测量分析，主要分析包括额叶完整性与抑制控制措施的关系。该项目被提议作为PI（儿科康复医生）职业发展计划的一部分，以获得纵向研究设计和数据分析、儿科TBI后神经行为评估（包括抑制控制和社会功能评估）以及DTI、MRSI和TBI儿童结构成像数据的处理和分析方面的培训。肯尼迪克里格研究所和约翰霍普金斯大学提供了一个特殊的环境，使PI成为一个独立的研究人员研究儿童TBI后的大脑行为关系。 公共卫生相关性：脑损伤后，许多儿童难以控制自己的行为，这导致了学校和家庭的问题。这项研究的目的是开发更好地了解哪些儿童在脑损伤后长期存在这种问题的风险的方法。这些信息将帮助儿童接受治疗，以尽快优化他们的行为，并将允许研究这些治疗的疗效。