Advanced Morphological Analysis of Cerebral Blood Flow for Acute Concussion Diagnosis

 描述（由申请人提供）： 仅在美国，每年就有160万至380万人遭受轻度创伤性脑损伤（TBI）。目前的诊断和重返参与指南是基于患者症状，神经认知评估和/或身体性能测试。这些诊断方法中的许多存在主观、不准确或需要基线（受伤前）的问题，这是由于人们在这些测试中的固有能力存在很大差异。因此，无法及时诊断， 大量患有轻度TBI的患者。该项目的目的是根据患者受伤后的生理变化，对轻度创伤性脑损伤（轻度TBI）进行客观诊断。该方法基于脑震荡后众所周知的生理变化的量化，即自主神经功能的损害和脑血流（CBF）的改变。所提出的方法的新奇是使用最近开发的分析框架的CBF速度（CBFV）波形的分析。与以前使用的方法相比，所提出的方法利用复杂CBFV波形的整个形状，从而获得在其他分析方法中丢失的血流变化的细微变化。在本项目的第一阶段，将使用洛杉矶地区高中运动员的小型研究来证明所提出的方法的可行性。第一阶段的目标是开发可以在研究中诊断TBI的指标，准确率为90%或更高。第二阶段的工作将集中在开发一种便携式诊断设备，具有更高的准确性，适用于现场应用（医院外）。成功完成拟议的工作将导致开发一种便携式，客观的轻度TBI诊断，可用于非临床环境，有可能大大改善各行各业的TBI患者护理。

 DESCRIPTION (provided by applicant): Each year, between 1.6 and 3.8 million people each year suffer a mild traumatic brain injury (TBI) in the US alone. Current diagnosis and return-to-participation guidelines are based on patient symptoms, neurocognitive evaluations, and / or physical performance testing. Many of these diagnostic methods suffer from the problem of being subjective, inaccurate, or requiring baseline (before injury) due to large variations in people's inherent ability to perform in these tests. Thus the timely diagnosis is unavailable for a vast number of patients who suffer mild TBI. This project is aimed at developing an objective diagnosis of mild traumatic brain injury (mild TBI) based on physiologic changes in a patient after injury. The method is based on quantification of well-known physiologic changes after a concussion, i.e. the impairment of autonomic function and altered cerebral blood flow (CBF). The novelty of the proposed approach is the use of a recently-developed analytical framework for the analysis of the CBF velocity (CBFV) waveforms. In contrast to previous methods used before, the proposed approach utilizes the entire shape of the complex CBFV waveform, thus obtaining subtle changes in blood flow changes that are lost in other analysis methods. In Phase I of this project, feasibility of the proposed method will be demonstrated using a small study among high school athletes in the Los Angeles region. The objective of Phase I is to develop metrics that can diagnose TBI among studies with an accuracy of 90% or better. Phase II work will focus on developing a portable diagnostic device with improved accuracy, suitable for use in field applications (outside of hospitals). Successful completion of the proposed work will lead to the development of a portable, objective mild TBI diagnostic that can be used in non-clinical settings, that has the potential to vastly improve TBI patient care in all walks of life.