Volumetric MRSI Evaluation of Traumatic Brain Injury

创伤性脑损伤的体积 MRSI 评估

• 批准号: 8013887
• 负责人: Andrew A. Maudsley
• 金额: $ 33.52万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8013887
• 关键词: Accounting; Affect; Age; Anisotropy; Blast Injuries; Brain; Brain Concussion; Brain Injuries; Brain region; Choline; Clinic; Clinical assessments; Closed head injuries; Cognitive; Craniocerebral Trauma; Development; Diffusion Magnetic Resonance Imaging; Evaluation; Exhibits; Functional disorder; Gray unit of radiation dose; Head; Headache; Health; Image; Image Analysis; Individual; Injury; Lobar; Location; Magnetic Resonance Imaging; Maps; Measurement; Measures; Membrane; Metabolic; Metabolic Marker; Metabolism; Methods; Minor; N-acetylaspartate; Neuronal Dysfunction; Neurons; Normal Range; Outcome; Outcome Measure; Patients; Pattern; Performance; Post-Concussion Syndrome; Post-Traumatic Headaches; Protons; Public Health; Reaction; Recovery of Function; Relaxation; Reporting; Severities; Signal Transduction; Sports; Symptoms; Testing; Time; Tissues; Traumatic Brain Injury; Water; base; cognitive function; expectation; follow-up; functional outcomes; improved; magnetic resonance spectroscopic imaging; neuroimaging; neuropsychological; outcome forecast; restoration; spectroscopic imaging; white matter

DESCRIPTION (provided by applicant): The primary aim of this project is to develop objective measures for evaluation of mild and moderate Traumatic Brain Injury (MTBI) using advanced MR neuroimaging methods. MTBI represents a major public health problem for which the current assessment measures are limited in their ability to quantify the severity of injury or to indicate possible outcomes. The pilot period of this project has demonstrated that Volumetric Magnetic Resonance Spectroscopic Imaging (MRSI) at 3 Tesla can detect widespread metabolic changes in the brain that correlate with the degree of injury, even for mild injury and in the absence of significant structural MRI findings. It is now proposed to extend this study to improve characterization of these changes and to evaluate the use MRSI and diffusion-weighted MRI measures for prognosis of functional outcomes following mild and moderate closed-head injury. Measurements will include N-Acetylaspartate and choline, metabolic markers known to be sensitive to neuronal dysfunction and membrane turnover, and Fractional Anisotropy, which reflects the degree of neuronal organization. Results will be correlated with findings from structural MRI, initial clinical assessments, and neuropsychological evaluation of functional outcomes at multiple time points after injury. A secondary aim of this study is to examine possible associations between post- concussive symptoms, which are debilitating and persistent consequences in a fraction of this patient group, and neuroimaging measures. A third aim is to optimize the quantitative and multiparametric neuroimaging measures to improve characterization of the spatial extent and the degree of metabolic consequences of the injury, and their associations with functional outcome measures. It is hypothesized that the improved sensitivity and spatial coverage of the proposed neuroimaging measures will improve characterization of mild and moderate injury. PUBLIC HEALTH RELEVANCE: This project will evaluate improved quantitative MR neuroimaging methods for assessment of the metabolic and micro-structural changes associated with mild brain injury. These objective measures will guide treatment and patient management decisions following mild head trauma, as well as providing expectations for long-term consequences of the injury. Patient groups affected by this common injury include sports-related injuries and blast-related concussion.

描述(由申请人提供)：本项目的主要目标是开发使用先进的磁共振神经成像方法评估轻、中度创伤性脑损伤(MTBI)的客观指标。MTBI是一个重大的公共卫生问题，目前的评估措施在量化伤害的严重程度或表明可能的结果方面的能力有限。该项目的试行期已经证明，在3特斯拉的体积磁共振光谱成像(MRSI)可以检测到大脑中与损伤程度相关的广泛代谢变化，即使是轻微损伤，在没有显著结构MRI表现的情况下也是如此。现在建议扩展这项研究，以改善这些变化的特征，并评估使用MRSI和弥散加权MRI测量方法预测轻、中度闭合性颅脑损伤后功能预后的价值。测量将包括N-乙酰天冬氨酸和胆碱，已知的对神经元功能障碍和膜翻转敏感的代谢标志物，以及反映神经元组织程度的分数各向异性。结果将与损伤后多个时间点的结构磁共振结果、初步临床评估和神经心理学评估结果相关联。这项研究的第二个目的是研究脑震荡后症状和神经影像指标之间的可能联系。脑震荡后症状在这组患者中有一小部分人会导致虚弱和持续性后果。第三个目标是优化定量和多参数神经成像措施，以改善对损伤的空间范围和代谢后果程度的表征，以及它们与功能结果指标的关系。据推测，拟议的神经成像措施的灵敏度和空间覆盖率的提高将改善轻、中度损伤的特征。公共卫生相关性：该项目将评估改进的定量磁共振神经成像方法，以评估与轻度脑损伤相关的代谢和微结构变化。这些客观措施将指导轻微头部创伤后的治疗和患者管理决策，并提供对伤害的长期后果的预期。受这种常见损伤影响的患者群体包括与运动相关的损伤和与爆炸相关的脑震荡。