An fMRI Study of TBI Associated with Blast Injury

描述(由申请人提供)： 6.项目摘要/摘要创伤性脑损伤是部署在伊拉克和阿富汗的服役人员致病和致残的主要原因，占医疗后送的四分之一。在三年的时间里，78%的临床医生确认的美国军人受伤与爆炸机制有关，其中30%的受伤涉及头部和颈部。为了阐明爆炸相关脑损伤后认知障碍的神经机制，我们建议对在伊拉克或阿富汗部署时因爆炸而持续脑损伤的退伍军人和服役人员进行多模式脑成像、认知、行为和健康相关的生活质量结果测量。共有84名退伍军人和服役人员将在伤后4至60个月内入选，其中28人遭受中到重度冲击伤相关的脑损伤，28人患有轻度冲击伤相关的脑损伤，以及对照组遭受的非脑部损伤。功能磁共振成像(FMRI)将在认知控制和工作记忆任务中进行，并分析与磁化传递成像和扩散张量成像测量的大脑灰质和白质的完整性以及磁共振成像(MRI)测量的脑区体积的关系。我们还将分析调整创伤后应激障碍和抑郁症状的fMRI数据。通过这项设计，我们建议评估与冲击波相关的脑损伤对脑功能的影响，并与脑结构完整性和损伤并存的指标相关。 公共卫生相关性： 项目简介这个更新项目使用多模式脑成像来表征退伍军人和服役人员爆炸相关创伤性脑损伤(TBI)后的脑功能。使用功能磁共振成像(FMRI)，当患有中重度(n=28)或轻度(n=28)BLAST相关脑损伤的退伍军人和服役人员执行认知控制和工作记忆任务时，我们建议分析与脑区体积、扩散张量成像和磁化转移成像测量的结构脑完整性相关的结果。功能磁共振成像的分析还将调整创伤后应激障碍和抑郁症的共病。一组28名遭受非脑部损伤的退伍军人和服役人员也将被研究，以与脑外伤组进行比较。

DESCRIPTION (provided by applicant): 6. Project Summary/Abstract Traumatic brain injury (TBI) is a leading cause of morbidity and disability in service members deployed in Iraq and Afghanistan, accounting for one-fourth of medical evacuations. An explosive mechanism was linked to 78% of the clinician-confirmed injuries sustained by U.S. service members over a three-year period, and the head and neck were involved in 30% of these injuries. To elucidate the neural mechanisms mediating cognitive deficit after blast related TBI, we propose to perform multimodality brain imaging, cognitive, behavioral and health related quality of life outcome measures in veterans and service members who sustained TBI due to blast while deployed in Iraq or Afghanistan. A total of 84 veterans and service members will be enrolled between 4 and 60 months post-injury, including 28 who sustained moderate to severe blast related TBI, 28 with mild blast related TBI, and a comparison group who sustained injury not involving the brain. Functional magnetic resonance imaging (fMRI) will be performed during cognitive control and working memory tasks and analyzed in relation to the integrity of brain gray matter and white matter measured by magnetization transfer imaging and diffusion tensor imaging and brain region volumes measured by magnetic resonance imaging (MRI). We will also analyze fMRI data adjusting for co-morbid posttraumatic stress disorder and depression symptoms. With this design we propose to evaluate the effects of blast related TBI on brain function in relation to indices of brain structural integrity and co-morbidities of injury. PUBLIC HEALTH RELEVANCE: Project Narrative This renewal project uses multimodality brain imaging to characterize brain function following blast related traumatic brain injury (TBI) in veterans and service members. Using functional magnetic resonance imaging (fMRI) while veterans and service members with moderate to severe (n=28) or mild (n=28) blast related TBI perform cognitive control and working memory tasks, we propose to analyze the results in relation to structural brain integrity as measured by brain region volumes, diffusion tensor imaging, and magnetization transfer imaging. Analysis of fMRI will also adjust for co-morbid posttraumatic stress disorder and depression. A group of 28 veterans and service members who sustained injury not involving the brain will also be studied for comparison with the TBI groups.