EVALUATION OF MILD TRAUMATIC BRAIN INJURY PATIENTS

轻度创伤性脑损伤患者的评估

• 批准号: 8356711
• 负责人: HARVEY LEVIN
• 金额: $ 0.24万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356711
• 关键词: Address; Adolescent; Age; Biological Markers; Blood; Brain; Brain Concussion; Brain imaging; Brain region; Cause of Death; Cerebrospinal Fluid; Cerebrum; Clinical Research; Cognition; Cognitive; Conscious; Data Analyses; Diffusion Magnetic Resonance Imaging; Emotional; Episodic memory; Evaluation; Funding; Grant; Hand; Health; Hour; Image; Impairment; Injury; Lesion; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Mediation; Modeling; Morbidity - disease rate; National Center for Research Resources; Orthopedics; Outcome; Patients; Persons; Post-Concussion Syndrome; Predisposition; Principal Investigator; Relative (related person); Research; Research Infrastructure; Resources; Selection Criteria; Serum; Short-Term Memory; Source; Stress; Symptoms; TBI Patients; Traumatic Brain Injury; United States National Institutes of Health; Weight; X-Ray Computed Tomography; cost; disability; executive function; functional outcomes; functional status; gray matter; health related quality of life; information processing; neurobehavioral; neurobehavioral test; processing speed; prospective; statistics; white matter; young adult

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. ABSTRACT Traumatic brain injury (TBI) is a leading cause of death and disability in adolescents and young adults and therefore represents a major health problem. Although mild traumatic brain injury (MTBI) is generally nonfatal in this age range, the neurobehavioral effects can persist for months and their mediation by changes in the brain is poorly understood. To gain understanding of changes in brain imaging and neurobehavioral function over three months post-MTBI relative to orthopedic injury (OI), Aim 1 addresses changes in the integrity of cerebral white matter as measured by diffusion tensor imaging (DTI), hemorrhagic lesions seen on susceptibility weighted imaging, and the magnetization transfer ratio on magnetization transfer imaging. Aim 1 also addresses changes in brain region volumes of white matter, gray matter, and cerebrospinal fluid by analysis of magnetic resonance imaging. Aim 1 also investigates the relation of serum biomarkers of MTBI obtained from a blood draw at baseline to the brain imaging variables and whether the concentrations of these biomarkers differentiate MTBI and OI groups. Aim 2 measures change over three months post-injury in MTBI patients relative to the OI group in information processing speed, working memory, episodic memory, and executive functions and the relation of changes in these cognitive domains to brain imaging findings and to functional outcome. Aim 3 measures change over three months in post-concussion symptoms, posttraumatic stress symptoms, emotional status, functional status, and health-related quality of life (HRQL). Aim 3 also studies change in cognitive post-concussion symptoms in relation to brain imaging variables and the relation of change in cognitive, emotional, and somatic post-concussion symptoms to functional outcome and HRQL. We propose a prospective, longitudinal study of 220 right-handed patients, age 14-30 years old, including 88 with MTBI, 44 patients with TBI associated with moderate impairment of consciousness, and 88 patients with OI without brain insult. Selection criteria for the two TBI groups include computed tomography within 24 hours post-injury that shows no brain lesions. All groups would undergo a baseline assessment within 96 hours post-injury, including assessment of pre-injury status, brain imaging, blood draw for surrogate biomarkers, and neurobehavioral testing including cognition, post-concussion and posttraumatic stress symptoms, emotional status, functional status, and HRQL. Brain imaging would be repeated at three months post-injury, and neurobehavioral assessment would be repeated at both one and three months post-injury. Multivariate statistics and the general linear mixed model would be used to analyze the data. By helping to understand the relation of changes in brain imaging to neurobehavioral changes after MTBI in young persons, this studys findings may suggest ways to reduce morbidity and enhance outcomes.

这个子项目是许多利用资源的研究子项目之一 由NIH/NCRR资助的中心拨款提供。子项目的主要支持 子项目的主要研究者可能是由其他来源提供的， 包括其它NIH来源。 列出的子项目总成本可能 代表子项目使用的中心基础设施的估计数量， 而不是由NCRR赠款提供给子项目或子项目工作人员的直接资金。 摘要 创伤性脑损伤（TBI）是青少年和年轻人死亡和残疾的主要原因，因此是一个主要的健康问题。虽然轻度创伤性脑损伤（MTBI）在这个年龄范围内通常是非致命的，但神经行为的影响可以持续数月，并且对大脑变化的介导知之甚少。为了了解MTBI后3个月内相对于骨科损伤（OI）的脑成像和神经行为功能变化，目标1阐述了通过扩散张量成像（DTI）测量的脑白色物质完整性的变化、磁敏感加权成像上观察到的出血性病变以及磁化传递成像上的磁化传递率。目的1还通过磁共振成像分析讨论了脑区白色物质、灰质和脑脊液体积的变化。目的1还研究了从基线抽血中获得的MTBI血清生物标志物与脑成像变量的关系，以及这些生物标志物的浓度是否区分MTBI和OI组。目的2测量MTBI患者相对于OI组在信息处理速度、工作记忆、情景记忆和执行功能方面的损伤后三个月的变化，以及这些认知领域的变化与脑成像结果和功能结果的关系。目的3测量三个月内脑震荡后症状、创伤后应激症状、情绪状态、功能状态和健康相关生活质量（HRQL）的变化。目标3还研究脑震荡后认知症状的变化与脑成像变量的关系，以及脑震荡后认知、情感和躯体症状的变化与功能结果和HRQL的关系。我们对220例右利手患者进行了前瞻性纵向研究，年龄在14-30岁之间，包括88例MTBI患者，44例TBI伴中度意识障碍患者和88例无脑损伤的OI患者。两个TBI组的选择标准包括损伤后24小时内的计算机断层扫描显示无脑损伤。所有组将在受伤后96小时内进行基线评估，包括损伤前状态评估，脑成像，替代生物标志物抽血，以及神经行为测试，包括认知，脑震荡后和创伤后应激症状，情绪状态，功能状态和HRQL。脑成像将在伤后三个月重复，神经行为评估将在伤后一个月和三个月重复。采用多元统计和一般线性混合模型对数据进行分析。通过帮助了解年轻人MTBI后脑成像变化与神经行为变化的关系，这项研究的发现可能会提出降低发病率和提高预后的方法。