Physiologically Based Markers of Idiopathic Intracranial Hypertension

特发性颅内高压的生理标志物

• 批准号: 8679930
• 负责人: Heather Elspeth Moss
• 金额: $ 21.13万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8679930
• 关键词: Affect; Aftercare; Age; Analysis of Variance; Area; Award; Biological Markers; Blindness; Blood Pressure; Blood Vessels; Brain; Caliber; Caring; Cell physiology; Cerebrovascular Disorders; Clinical; Clinical Management; Clinical Research; Clinical Trials; Commit; Control Groups; Development; Diagnosis; Disease; Disease Outcome; Electrophysiology (science); Ensure; Environment; Equation; Eye; Foundations; Functional disorder; Glaucoma; Goals; Height; Image; Impairment; Incidence; Injury; Institution; Intracranial Hypertension; Intracranial Pressure; K-Series Research Career Programs; Knowledge; Lasers; Leadership; Light; Measures; Mechanics; Mentors; Mentorship; Modeling; Monitor; Morbidity - disease rate; Nerve; Neurology; Obesity; Ophthalmologist; Ophthalmology; Optic Disk; Optic Nerve; Optical Coherence Tomography; Outcome; Outcome Measure; Papilledema; Patients; Perimetry; Peripheral; Physicians; Physiological; Physiology; Pilot Projects; Plant Roots; Population; Principal Investigator; Productivity; Pseudotumor Cerebri; Pupil; Recruitment Activity; Request for Applications; Research; Research Personnel; Research Project Grants; Retinal; Retinal Ganglion Cells; Risk; Scanning; Scientific Advances and Accomplishments; Scientist; Spinal Puncture; Spinal Tap; Structure; Swelling; Techniques; Testing; Therapeutic; Thick; Time; Training; Translational Research; Uncertainty; Veins; Vision; Vision research; Visual; Visual Pathways; Visual Psychophysics; Work; base; career; career development; clinical care; clinical epidemiology; experience; hypertension treatment; improved; interest; medical schools; non-invasive imaging; ophthalmic artery; optic nerve disorder; patient oriented; pressure; programs; public health relevance; response; retina blood vessel structure; retinal nerve fiber layer; success; tool; vision science; visual information; young woman

Project Summary/Abstract This application requests a career development award for an academic neuro-ophthalmologist with a scientific interest in idiopathic intracranial hypertension (IIH), a potentially blinding condition that most commonly affects young women. This award will provide the candidate with the necessary mentorship, training and experience to propel her to the level of independent patient oriented researcher focused on advancing diagnosis, clinical care and outcomes of IIH. The candidate is an accomplished early career physician-scientist. In the short term she seeks research career development in the areas of clinical research & epidemiology, visual psychophysics & electrophysiology and neuro-ophthalmic imaging. She will develop her knowledge and capabilities in these areas through coursework, guided study, practical experience and mentored research. This will form the foundation upon which she will build an independent research program in IIH. From this vantage point she will pursue her long term goal of improving clinical care for IIH and other neuro-ophthalmic conditions both as an independent researcher with a strong translational research program and as an expert clinician caring directly for patients. The environment created by the Department, Medical School and Institution is characterized by clinical and research expertise and productivity. There is a proven track record of effectively nurturing early career physician scientists in the fields of ophthalmology and vision research. Departmental and Medical School leadership are committed to providing material, financial and intellectual support to ensure the candidate's development and success. There is a significant clinical need for non-invasive biomarkers that will improve diagnosis and management of IIH. The objective of the research project is to establish physiologically based markers of retinal ganglion cell (RGC) function and retinal vasculature as markers of IIH that detect abnormalities, monitor treatment and distinguish peripheral vision outcomes. This objective will be accomplished with two specific aims: 1. To test the hypothesis that RGC function is impaired and retinal vascular diameters are enlarged in IIH subjects as compared to visually normal control subjects: Electrophysiological and pupil light response based measures of RGC function and image based measures of retinal blood vessel diameter will be compared between IIH subjects with elevated intracranial pressure and control subjects. This will establish that these markers are abnormal in the IIH population. 2. To test the hypothesis that RGC function impairment and retinal vascular dilation recover in IIH subjects with short and long term treatment: Electrophysiological and pupil light response based measures of RGC function and image based measures of retinal blood vessel diameter will be compared within IIH subjects when intracranial pressure is elevated, immediately following short term intracranial pressure lowering by lumbar puncture and following long term intracranial pressure lowering by standard clinical therapy. This will establish that these markers change with treatment of IIH. The results of the proposed study will lay the scientific and technical foundation for the development of these markers as clinical tools and clinical trial outcome measures of IIH. Furthermore, the results will advance scientific understanding of the pathophysiology underlying optic nerve dysfunction and injury in IIH. The project has broader significance because the knowledge gained and technical capabilities developed will have applications to other diseases at the intersection of neurology and ophthalmology such as glaucoma and cerebrovascular disease. The research career development and mentoring plan will transform the candidate into an independent researcher who will make long-lasting contributions to vision science.

项目摘要/摘要 本申请要求获得职业发展奖，获奖对象为具有科学技能的学术神经眼科医生。 对特发性颅内高压(IIH)感兴趣，这是一种潜在的致盲情况，最常见的影响 年轻女性。该奖项将为候选人提供必要的指导、培训和经验。 为了推动她达到以患者为中心的独立研究人员的水平，专注于推进诊断、临床 IIH的护理和结局。 应聘者是一位有成就的早期职业内科医生兼科学家。在短期内，她寻求研究 在临床研究和流行病学、视觉心理物理学和电生理学领域的职业发展 以及神经眼科成像。她将通过以下途径发展她在这些领域的知识和能力 课程、指导学习、实践经验和指导性研究。这将为 她将在IIH建立一个独立的研究项目。从这一有利位置开始，她将长期追求 改善IIH和其他神经眼科疾病的临床护理的长期目标 具有强大的翻译研究计划的研究人员，并作为直接照顾患者的专家临床医生。 科室、医学院和机构创造的环境以临床和 研究专业知识和工作效率。有一个被证明有效地培养早期职业生涯的记录 眼科和视力研究领域的内科科学家。科室和医学院 领导层致力于提供物质、财政和智力支持，以确保候选人 发展和成功。 临床上对改进诊断和管理的非侵入性生物标志物有很大的需求。 当然了。本研究的目的是建立基于生理的视网膜神经节标记物 细胞(RGC)功能和视网膜血管构筑作为IIH的标志物，检测异常，监测治疗和 辨别周边视力结果。实现这一目标将有两个具体目标： 1.检验RGC功能受损和视网膜血管内径增大的假说 IIH受试者与视觉正常对照组受试者的比较：电生理和瞳孔光 基于响应的RGC功能测量和基于图像的视网膜血管直径测量将是 高颅内压的IIH患者与对照组的比较。这将确立 这些标记在IIH人群中是异常的。 2.验证IIH视网膜皮质功能损害和视网膜血管扩张恢复的假说 短期和长期治疗的受试者：基于电生理和瞳孔光反应的测量 RGC功能和基于图像的视网膜血管直径测量将在IIH内进行比较 受试者在短期内颅内压降低后立即出现颅内压升高 通过腰椎穿刺术，并根据标准的临床治疗进行长期的颅内压降低。这 将确定这些标志物随着IIH的治疗而改变。 拟议的研究结果将为这些项目的发展奠定科学和技术基础 标记物作为IIH的临床工具和临床试验结果指标。此外，结果还将向前推进 对IIH视神经功能障碍和损伤的病理生理学的科学认识。这个 项目具有更广泛的意义，因为获得的知识和发展的技术能力将具有 在神经学和眼科学交叉的其他疾病中的应用，如青光眼和 脑血管疾病。研究、职业发展和指导计划将使应聘者转变 成为一名将为视觉科学做出长期贡献的独立研究人员。