Regional Cerebral Metabolism in Blast-Induced Mild Traumatic Brain Injury

爆炸引起的轻度创伤性脑损伤中的局部脑代谢

• 批准号: 8246098
• 负责人: Gholam R Berenji
• 金额: --
• 依托单位: VA GREATER LOS ANGELES HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8246098
• 关键词: Acute; Address; Affect; Afghanistan; Biochemical; Blast Cell; Brain; Brain Concussion; Brain Injuries; Brain region; Cerebrum; Chronic; Clinical; Clinical Data; Cognitive; Cognitive deficits; Comorbidity; Conflict (Psychology); Control Groups; Controlled Study; Data Analyses; Data Correlations; Detection; Diagnosis; Distress; Evaluation; Freedom; Health; Human Resources; Image; Imaging Device; Impaired cognition; Individual; Injury; Interview; Investigation; Iraq; Magnetic Resonance Imaging; Measurement; Measures; Metabolic; Metabolism; Military Personnel; Mood Disorders; Multiple Trauma; Neuropsychological Tests; Patient Self-Report; Patients; Pattern; Performance; Physical Examination; Physicians; Positron-Emission Tomography; Post-Concussion Syndrome; Post-Traumatic Stress Disorders; Publishing; Readiness; Recording of previous events; Recruitment Activity; Role; Safety; Services; Severities; Symptoms; Traumatic Brain Injury; Veterans; base; chronic pain; clinical application; cognitive function; evaluation/testing; fluorodeoxyglucose positron emission tomography; functional disability; instrument; member; neurobehavior; neurobehavioral; neuropsychological; operation; outcome forecast; research clinical testing; tool

DESCRIPTION (provided by applicant): Blast-induced traumatic brain injury (TBI) is the leading injury among military personnel who were serving in recent conflicts in Afghanistan and Iraq. Post-concussive syndrome with persistent long term cognitive impairment frequently occurs even after mild TBI, which directly impacts the health and safety of service members. Accurate diagnosis, assessment, and prognosis of structural and/or functional brain injury are extremely important and urgently needed. Unfortunately, current diagnosis and assessment for mild TBI are mainly based on self reported history, subjective measures and clinical findings. Conventional structural imaging studies such as CT or MRI have a very limited role in evaluation of mild TBI. Recently, several studies have demonstrated that Positron Emission Tomography (PET) is a reliable tool for detection of regional cerebral metabolic (RCM) changes in mild-TBI and have potential to objectively assess the functional impairment of mild TBI. PET, due to its biochemical sensitivity and quantitative measurability, has been found being able to detect subtle changes in RCM even without apparent structural changes. Despite the promising potential of PET in mild TBI evaluation, conclusion from prior studies has been limited due to variability in pattern of abnormal findings, partly due to other comorbidities such as Post Traumatic Stress Disorder (PTSD) which introduce confounding findings in clinical, neurobehavioral, and imaging presentation. In this project we will evaluate the regional cerebral metabolism changes in patients who had sustained post-concussion syndrome due to blast-induced mild TBI. PTSD patients will be included to understand the confounding findings. A total number of 210 individuals will be recruited in this study with 70 in each group (TBI; PTSD; healthy control). We will measure RCM and conduct standard neuropsychological assessments for all individuals. Appropriate statistical analyses will be applied to compare RCM and cognitive function/neurobehavioral findings among different groups. We will determine whether there is any correlation between RCM and neurobehavioral findings. The result of this study will help us understand the pathophysiological changes, especially the metabolic changes of TBI. The severity and extent of abnormal RCM findings will serve as an objective measurement for clinical evaluation, and possibly prognosis of mild TBI.

描述（由申请人提供）： 爆炸引起的创伤性脑损伤（TBI）是最近在阿富汗和伊拉克冲突中服役的军事人员中最主要的伤害。即使在轻度创伤性脑损伤后，也经常发生伴有持续性长期认知障碍的脑震荡后综合症，这直接影响服役人员的健康和安全。结构性和/或功能性脑损伤的准确诊断、评估和预后极其重要且迫切需要。不幸的是，目前对轻度 TBI 的诊断和评估主要基于自我报告的病史、主观测量和临床发现。 CT 或 MRI 等传统结构成像研究在评估轻度 TBI 方面的作用非常有限。最近，多项研究表明，正电子发射断层扫描（PET）是检测轻度TBI局部脑代谢（RCM）变化的可靠工具，并有潜力客观评估轻度TBI的功能损伤。 PET 由于其生化敏感性和定量可测量性，即使没有明显的结构变化，也能够检测 RCM 的细微变化。尽管 PET 在轻度 TBI 评估中具有广阔的潜力，但由于异常结果模式的可变性，先前研究的结论受到限制，部分原因是其他合并症，如创伤后应激障碍 (PTSD)，它在临床、神经行为和影像学表现方面引入了混杂的发现。在这个项目中，我们将评估因爆炸引起的轻度脑外伤而持续脑震荡后综合征的患者的局部脑代谢变化。创伤后应激障碍（PTSD）患者将被纳入其中，以了解令人困惑的发现。本研究总共招募 210 人，每组 70 人（TBI；PTSD；健康对照）。我们将为所有个体测量 RCM 并进行标准的神经心理学评估。将应用适当的统计分析来比较不同组之间的 RCM 和认知功能/神经行为结果。我们将确定 RCM 和神经行为发现之间是否存在任何相关性。本研究结果将有助于我们了解TBI的病理生理变化，特别是代谢变化。异常 RCM 结果的严重性和范围将作为临床评估的客观测量，并可能作为轻度 TBI 的预后。