Clinical Phenotyping of Mild Traumatic Brain Injury (mTBI)

轻度创伤性脑损伤 (mTBI) 的临床表型

• 批准号: 9281411
• 负责人: Lindsay Nelson
• 金额: $ 8.41万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9281411
• 关键词: Affective; Area; Attention; Categories; Classification; Clinical; Clinical Research; Cognitive; Collaborations; Communities; Data Set; Development; Diagnosis; Diagnostic; Diffuse; Dimensions; Elements; Emotional; Female; Future; Goals; Head; Heterogeneity; High Prevalence; Individual; Injury; Interest Group; Measures; Mental Health; Mental disorders; Methodology; Methods; Modeling; Modernization; Neurobiology; Occupational; Outcomes Research; Patients; Pattern; Phase; Phenotype; Population; Population Control; Psychometrics; Psychopathology; Public Health; Recovery; Research; Research Personnel; Sampling; Sex Characteristics; Signs and Symptoms; Source; Sports; Structure; Symptoms; System; Techniques; Testing; Therapeutic Intervention; Work; base; brain research; clinical phenotype; cost; effective therapy; evidence base; improved; improved outcome; innovation; longitudinal dataset; male; mild traumatic brain injury; neurobiological mechanism; novel; personalized intervention; precision medicine; prospective; response; response to injury; secondary analysis; sex; statistics; stem; success; symposium; targeted treatment

Abstract Mild traumatic brain injury (mTBI) is a costly injury due to its high prevalence and effects on patients' emotional, cognitive, and occupational functioning. Efforts to identify the neurobiological effects of mTBI and develop effective treatments are hampered by limitations in current operational definitions of the injury. This problem stems from heterogeneity in patients' responses to mTBI and conventions to aggregate diffuse, nonspecific symptoms into a single diagnostic category. Although current clinical and research practices treat mTBI as unitary, emerging evidence indicates that clinical presentation following injury is multidimensional, with distinct elements that may be more informative when measured separately. The proposed R03 project will apply modern quantitative methods to establish distinct clinical phenotypes of mTBI with higher potential to inform translational mTBI research. The aims of the study are to (1) identify the optimal phenotypic model of clinical presentation in both athlete and civilian mTBI patients and (2) test hypotheses regarding sex differences in mTBI phenotypes. The project will be innovative in its application of diverse, advanced quantitative modeling approaches to identify mTBI phenotypes and to compare multiple groups of interest (males and females, athlete and civilians). The proposed work is made possible by the recent availability of sufficiently large, longitudinal datasets of athletes and civilians with mTBI and the collaboration of our team of investigators with diverse clinical, empirical, and methodological expertise relevant to the proposed project. The findings will be significant in yielding novel phenotypic models that (a) could change how the field diagnoses and classifies mTBI and (b) could yield novel clinical targets with tighter or more consistent linkages to neurobiological systems. The long-term goal of this research is to use the findings derived from this project to accelerate efforts to identify the neurobiological mechanisms underlying mTBI and to develop personalized interventions to maximize patients' recoveries from mTBI.

摘要 轻度创伤性脑损伤（mTBI）是一种昂贵的损伤，因为其高患病率和对患者健康的影响。 情感认知和职业功能努力确定mTBI的神经生物学效应， 由于当前伤害操作定义的局限性，开发有效的治疗方法受到阻碍。这 问题源于患者对mTBI的反应的异质性和聚集扩散的惯例， 将非特异性症状归入单一诊断类别。虽然目前的临床和研究实践治疗 mTBI作为单一的新兴证据表明，损伤后的临床表现是多方面的， 其具有不同的元素，当单独测量时，这些元素可以提供更多信息。R03项目将 应用现代定量方法建立不同的mTBI临床表型， 为翻译mTBI研究提供信息。本研究的目的是（1）确定最佳的表型模型， 运动员和平民mTBI患者的临床表现和（2）关于性别的测试假设 mTBI表型的差异。该项目将在其应用多样化，先进的创新， 确定mTBI表型并比较多个感兴趣组的定量建模方法 （男性和女性，运动员和平民）。拟议的工作是可能的，最近可用的 足够大的，纵向数据集的运动员和平民与mTBI和我们的团队的合作， 具有与拟议项目相关的各种临床、经验和方法学专业知识的研究人员。 这些发现将在产生新的表型模型方面具有重要意义，这些模型（a）可以改变该领域的 诊断和分类mTBI和（B）可以产生具有更紧密或更一致的联系的新的临床靶点 神经生物学系统。这项研究的长期目标是利用从这个项目中得出的发现 加快努力，以确定mTBI的神经生物学机制，并制定个性化的 干预措施，以最大限度地提高患者从mTBI的恢复。