An fMRI Study of TBI Associated with Blast Injury

描述（由申请人提供）： 6.创伤性脑损伤（TBI）是部署在伊拉克和阿富汗的服务人员发病和残疾的主要原因，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装置有关，其中30%的受伤涉及头部和颈部。为了阐明爆炸相关TBI后介导认知缺陷的神经机制，我们建议在部署在伊拉克或阿富汗的退伍军人和服役人员中进行多模态脑成像，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受伤后4至60个月内入组，其中28人持续中度至重度爆炸相关TBI，28人轻度爆炸相关TBI，以及一个对照组，他们持续受伤，不涉及大脑。将在认知控制和工作记忆任务期间进行功能性磁共振成像（fMRI），并分析通过磁化传递成像和扩散张量成像测量的脑灰质和白色物质的完整性以及通过磁共振成像（MRI）测量的脑区域体积。我们还将分析功能磁共振成像数据调整共病创伤后应激障碍和抑郁症状。通过这种设计，我们建议评估冲击波相关TBI对脑功能的影响，与脑结构完整性和损伤并发症的指数有关。

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.