Linking Injury Severity to Brainstem White Matter Integrity: A Tractography Study
将损伤严重程度与脑干白质完整性联系起来:纤维束成像研究
基本信息
- 批准号:8634881
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2014
- 资助国家:美国
- 起止时间:2014-04-01 至 2018-03-31
- 项目状态:已结题
- 来源:
- 关键词:AccelerationAddressAmnesiaAnatomyAnimalsAnisotropyAnxietyAreaAttentionAwarenessBiological MarkersBlast CellBlast InjuriesBrainBrain StemBrain regionCardiovascular systemCase MixesCharacteristicsChronicChronic PhaseClinicalClinical ResearchCognitionCognitiveComaCorticospinal TractsCoupledCraniocerebral TraumaDataDecelerationDiagnosisDiffuseDiffusionDiffusion Magnetic Resonance ImagingDizzinessEquilibriumEvaluationExhibitsFrequenciesFunctional disorderHumanImageImaging TechniquesInferiorInjuryKnowledgeLinkMaintenanceMeasurementMedialMedial lemniscusMental DepressionMethodologyMethodsMetricMilitary PersonnelMotorMyelinNauseaOutcomeParticipantPathologic ProcessesPathologyPatientsPontine structurePopulationPost-Concussion SyndromePost-Traumatic Stress DisordersPostureProxyRadialRecording of previous eventsReportingResearchResolutionRespiratory physiologySecondary toSensorySeveritiesSleepSleep disturbancesSleeplessnessSliceStructureSubgroupSymptomsSyndromeTBI PatientsTechniquesTegmentum MesencephaliTimeTinnitusTissuesTraumatic Brain InjuryUnconscious StateVeteransVulnerable Populationsalertnesscombatexecutive functionexperienceindexinginterestmultidisciplinarynegative moodneurobehavioralneuroimagingneuropathologyneuropsychiatrynovelpsychosocialpublic health relevancesleep regulationwhite matterwhite matter changewhite matter injury
项目摘要
Although the vast majority of all head injuries are classified as mild to moderate, many patients report
persistent neuropsychiatric symptoms, despite normal clinical neuroimaging. Generally, traumatic brain injury
(TBI) is difficult to detect and diagnose, and the scope of the problem is compounded significantly given that we
know very little about the neuropathology and sequelae of neurotrauma. Historically, the brainstem has been
implicated as a particularly vulnerable structure in the context of TBI. However, unfortunately, to our knowledge,
there are no existing data relating injury severity variables (e.g., loss of consciousness [LOC]~ post-traumatic
amnesia [PTA]~ number and frequency of blasts) as well as commonly experienced post-concussive
symptoms (PCS~ e.g., sleep difficulties, balance/coordination problems, dizziness, tinnitus) to actual pathology
in the human brain, and this could be directly related to the inability to visualize small, critical white matter tracts
within the brainstem, a vital structure that is critically important for respiratory function, cardiovascular
regulation, and sleep and alertness. Although it is thought that diffusion tensor imaging (DTI) can help address
the shortcomings of conventional imaging techniques in the evaluation of patients with TBI, there is a lack of
comprehensive, multidisciplinary TBI studies focusing on brainstem white matter integrity and injury severity
markers, and research examining this population has been extremely limited. For example, to date, whole-brain
DTI data in humans have been collected using multislice acquisition techniques that have limited imaging
resolution to perform measurements with very thin slices, prohibiting the study of small white matter tracts and
deep intracranial structures (i.e., brainstem). Indeed, there are very few brainstem DTI studies in TBI, and none
have assessed associations to important injury severity variables and enduring neuropsychiatric symptoms
comprising the posttraumatic syndrome.
Despite a paucity of DTI studies in TBI, promising findings from animal and clinical studies-as well as
our own pilot data in support of this proposal-provide preliminary support for the potential use of DTI as a
biomarker of TBI-related white matter injury. We thus propose to use a newly developed methodology (HARDI~
described in the Methods section of the proposal) coupled with high spatial-resolution anatomic images in order
to help identify and visualize important brainstem tracts that may represent the anatomical substrates of TBI.
Using this approach, millimetric slices and probabilistic tractography allow thinner brainstem tracts to be
identified, especially within low anisotropic areas. Thus, in 190 veterans and combat controls (mild to moderate
TBI: 120~ combat and non-combat exposed NC: 70), we will employ DTI tractography in the context of a novel,
cutting edge imaging sequence and analytic approach in order to fully segment and properly visualize critical
brainstem white matter tracts and relate white matter integrity to important injury severity variables and PCS
symptoms across mechanism of injury (blast versus blunt force TBI). Primary aims will also examine whether
and how other important injury variables (e.g., number and proximity of blasts) modify the relationship between
white matter integrity and PCS symptoms in this vulnerable population. To our knowledge, our proposal
represents the first to fully segment and properly visualize critical brainstem white matter tracts, examine
brainstem white matter integrity by mechanism of neurotrauma, and relate DTI indices to important injury
severity and PCS variables. We expect that findings will advance our knowledge of the clinical utility of DTI in
identifying specific brainstem white matter changes in mild to moderate TBI, and they will provide novel
information about the effects of differing mechanisms of injury on brain regions that have been shown in tissue
studies to be particularly vulnerable to the effects of TBI. Clearly, linkages of injury severity characteristics and
enduring PCS symptoms typically associated with vegetative signs of psychiatric origin to a neuroanatomic
substrate would have very important implications for this relatively new field.
尽管绝大多数头部损伤被归类为轻度至中度,但许多患者报告说
项目成果
期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Lisa Marie Delano-Wood其他文献
Lisa Marie Delano-Wood的其他文献
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{{ truncateString('Lisa Marie Delano-Wood', 18)}}的其他基金
Use of Novel Neuroimaging, Neuropsychological Methods, and Retrograde Memory Test to Detect Cognitive and Cerebral Disruption in Veterans with Mild Traumatic Brain Injury
使用新的神经影像学、神经心理学方法和逆行记忆测试来检测患有轻度创伤性脑损伤的退伍军人的认知和大脑障碍
- 批准号:
10696693 - 财政年份:2023
- 资助金额:
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