Somatosensory Processing-Assessing Youth Sport-Related Concussion and Recovery

体感处理-评估青少年运动相关脑震荡和恢复

• 批准号: 8661564
• 负责人: Stacy Jennifer Marcus Suskauer
• 金额: $ 20.21万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-01 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8661564
• 关键词: 17 year old; Adult; Age; Behavior; Biological Markers; Brain; Brain Concussion; Caring; Child; Chronic; Clinical; Cognitive; Data; Evaluation; Functional Imaging; Future; Gender; Glutamates; Goals; Gold; Image; Image Analysis; Impairment; Injury; Laws; Lead; Magnetic Resonance Spectroscopy; Measures; Mediating; Methodology; Methods; Neurologic; Neurotransmitters; Outcome; Pattern; Phase; Physiological; Physiology; Play; Post-Concussion Syndrome; Process; Protocols documentation; Public Health; Recording of previous events; Recovery; Reporting; Risk; Safety; Schools; Sensory; Severities; Sports; Stimulus; Symptoms; Tactile Illusions; Technology; Testing; Traumatic Brain Injury; United States; Visit; Work; Youth; aged; balance testing; base; candidate marker; college; conditioning; cost effective; evidence base; experience; gamma-Aminobutyric Acid; information processing; injured; innovation; nonhuman primate; novel; peer; public health relevance; research clinical testing; response to injury; somatosensory; student athlete

DESCRIPTION (provided by applicant): Youth sports-related concussion (SRC) is a public health problem in the United States, as evidenced by the public health approach of youth concussion laws which are now in effect in more than 40 states. Youth are felt to be particularly vulnerable to concussion, due to differences in physiological response to injury. One of the critical aspects of care for youth with SRC is determining when it is safe for youth to return to their sports activities; this is a particularly important decision in youth, compared to older athletes with SRC, because youth are at increased risk for catastrophic outcomes if a second injury is incurred during recovery from SRC. Evidence-based management of youth SRC is limited by the lack of age-appropriate evaluation methods with validity for assessing recovery of brain physiology. The overall goal of this project is to evaluate the utility of a novel, clinicall-relevant measure of somatosensory information processing (SSIP) as a biomarker for youth SRC and recovery from SRC with relevance for evaluating the neurologic basis of SRC and recovery from SRC. The SSIP testing battery makes use of inexpensive, portable technology to deliver vibrotactile stimuli to the fingertips and does not require baseline data, making it readil applicable for widespread use in schools and on sidelines. The aims of this project are to 1) evaluate the sensitivity of SSIP to youth SRC and recovery from SRC and 2) to assess the neurological basis of SSIP in youth with SRC through magnetic resonance spectroscopy (MRS) evaluation of GABA and glutamate in sensorimotor cortex. We will evaluate 25 youth aged 13-17 years with SRC within 1 week post-injury and again 2-3 weeks post-injury; youth who remain symptomatic from SRC at the second visit will return for a third visit after they have achieved clinically recovery. We will compare SSIP and MRS GABA and glutamate in youth with SRC within 1 week post-injury to that of age- and gender-matched peer athletes with no history of concussion and will evaluate for correlation of SSIP with MRS GABA and glutamate. We will evaluate changes in SSIP and MRS in association with clinical recovery from SRC versus persisting symptoms from SRC. Lastly, we will evaluate whether alterations in SSIP or MRS GABA or glutamate persist even after clinical recovery from SRC, as this may represent a marker for predicting short-term outcome from subsequent SRC and/or emergence of late concussion-related deficits (such as chronic traumatic encephalopathy). This project will determine the utility of further work using this novel methodology in youth SRC.

描述（由申请人提供）：青少年运动相关脑震荡（SRC）是美国的一个公共卫生问题，正如目前在40多个州生效的青少年脑震荡法律的公共卫生方法所证明的那样。由于对伤害的生理反应不同，青年人特别容易受到脑震荡的伤害。护理患有SRC的青少年的关键方面之一是确定青少年何时可以安全地重返体育活动;与患有SRC的老年运动员相比，这对青少年来说是一个特别重要的决定，因为如果在SRC恢复期间发生第二次受伤，青少年遭受灾难性后果的风险会增加。青少年SRC的循证管理受到缺乏适合年龄的评估方法的限制，这些方法可有效评估脑生理学的恢复。本项目的总体目标是评估一种新的、临床相关的体感信息处理（SSIP）测量方法作为青年SRC和SRC恢复的生物标志物的实用性，该生物标志物与评估SRC的神经学基础和SRC恢复相关。SSIP测试电池利用廉价的便携式技术向指尖提供振动触觉刺激，并且不需要基线数据，使其易于在学校和场外广泛使用。本项目的目的是：1）评估SSIP对青年SRC的敏感性和SRC的恢复情况; 2）通过磁共振波谱（MRS）评估感觉运动皮层中GABA和谷氨酸，评估青年SRC患者SSIP的神经学基础。我们将在伤后1周内和伤后2-3周内对25名13-17岁的SRC青少年进行评估;在第二次访视时仍有SRC症状的青少年将在临床恢复后返回进行第三次访视。我们将比较受伤后1周内患有SRC的年轻人的SSIP和MRS GABA和谷氨酸与年龄和性别匹配的无脑震荡史的同龄运动员的SSIP和MRS GABA和谷氨酸的相关性，并将评估SSIP与MRS GABA和谷氨酸的相关性。我们将评估与SRC临床恢复和SRC持续症状相关的SSIP和MRS变化。最后，我们将评估SSIP或MRS GABA或谷氨酸的改变是否即使在SRC临床恢复后仍持续存在，因为这可能代表预测后续SRC的短期结果和/或出现晚期脑震荡相关缺陷（如慢性创伤性脑病）的标志物。该项目将确定进一步的工作，使用这种新的方法在青年SRC的效用。