Using Resting State Functional MRI to Predict Cognitive Decline among World Trade Center Responders

使用静息态功能 MRI 预测世贸中心急救人员的认知能力下降

• 批准号: 10458727
• 负责人: SEAN CLOUSTON
• 金额: $ 24.98万
• 依托单位: STATE UNIVERSITY NEW YORK STONY BROOK
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10458727
• 关键词: Age; Alzheimer' s Disease; Atrophic; Biological Markers; Brain; Caring; Cause of Death; Cessation of life; Chronic; Cognition; Cognitive; Communities; Cost of Illness; Coupling; Data; Dementia; Diagnostic; Dorsal; Early identification; Etiology; Functional Magnetic Resonance Imaging; Future; Goals; Health; Hippocampus (Brain); Impaired cognition; Major Depressive Disorder; Measures; Memory; Mental Depression; Modeling; Monitor; Nerve Degeneration; Neurophysiology - biologic function; Participant; Pattern; Performance; Plasma; Population; Post-Traumatic Stress Disorders; Prefrontal Cortex; Prevention; Process; Reporting; Research; Rest; Sampling; Scanning; Severities; Source; Suggestion; Surveillance Program; Survivors; Symptoms; Temporal Lobe; Thick; Time; Trauma; Visit; Wellness Program; World Health; cingulate cortex; cognitive change; cognitive control; cognitive performance; disability; disorder risk; experience; follow up assessment; functional MRI scan; imaging study; improved; lifetime risk; member; memory process; middle age; neural network; neuroimaging; neuropathology; peer; processing speed; programs; prospective

Dementia is the fifth most common cause of disability and death with a lifetime risk of 40% in the U.S. population. It is a costly disease, with estimates exceeding $236 billion annually, and is the only top cause of death for which neither a prevention nor cure is available. Dementia is typically preceded by milder forms of cognitive impairment (CI). Previous research by members of this investigative team have found that CI is more common among World Trade Center responders, relative to age-matched normative samples, approximating 12-14% in two separate studies. Further, among a different sample of 99 WTC responders in the Stony Brook health monitoring program (half of whom had CI) also studied by this team, reduced global mean cortical thickness and thickness across 21/34 subregions was found among those with CI. While the etiology of CI among WTC responders is unknown, preliminary data suggests that Alzheimer’s neuropathology may be one major source, as reflected in specific cognitive domains impacted (e.g., memory), as well as plasma biomarkers and atrophy of enthorhinal and temporal cortices. In addition to structural neuroimaging data, resting state functional MRI (RS-fMRI) data have been acquired among a sample of 99 WTC responders, approximately half of whom had CI at the time of scanning (Time Ascan). Given recent findings on the significance of RS data as a stable set of biomarkers for understanding disease risk, this proposal seeks first to leverage these existing data for determining RS connectivity differences among those with and without CI, as well as relationships with memory and processing speed. As a second aim, it will identify relationships among metrics of RS-fMRI network connectivity and cognition four years following the initial scan among 80 participants (Time Ascan®Time Bcog ). As an exploratory aim, it will characterize changes in RS network connectivity among 25 participants with progressing cognitive decline over four years and 25 with continued unimpaired cognition over four years by adding a RS-fMRI scan four years following the initial scan (Time Bscan) during the two-year study period. These results will inform a study that will aim to identify (with a larger sample) how and to what extent RS fMRI metrics can be used for predicting cognitive change in WTC responders.

痴呆症是残疾和死亡的第五大最常见原因，终生风险为40％ 美国人口。这是一种昂贵的疾病，估计每年超过2360亿美元，是 仅预防和治愈的最大死亡原因。痴呆通常是 在米勒的认知障碍（CI）之前。成员的先前研究 调查小组发现，CI在世界贸易中心响应者中更为普遍， 相对于年龄匹配的正常样品，在两项单独的研究中近似于12-14％。 此外，在Stony Brook Health监测中的99个WTC响应者的不同样本中 该团队还研究了计划（其中一半患有CI），减少了全球平均皮质厚度 在CI的患者中发现了21/34个子区域的厚度。而CI的病因 在WTC响应者中，尚不清楚，初步数据表明阿尔茨海默氏症的神经病理学 可能是一个主要来源，如受影响的特定认知领域（例如，内存）， 以及血浆生物标志物和临时皮质的萎缩。此外 结构性神经成像数据，静止状态功能MRI（RS-FMRI）数据已获取 在99个WTC响应者的样本中，大约一半的CI在 扫描（时代Ascan）。鉴于最新的发现RS数据作为稳定的一组 该建议首先寻求了解疾病风险的生物标志物，以利用这些现有 确定有或没有CI的人之间的RS连通性差异的数据以及 与内存和处理速度的关系。作为第二个目标，它将确定关系 在初次扫描后四年的RS-FMRI网络连接性和认知的指标中 在80名参与者中（TimeAscan®TimeBCOG）。作为探索目的，它将表征 25名参与者的RS网络连接变化，认知能力下降 在四年中，四年来持续不断受损的认知，增加了RS-FMRI，持续了25年 在两年研究期间进行初次扫描（时间BSCAN）后四年扫描。这些 结果将告知一项研究，该研究旨在识别（使用更大的样本）如何以及在多大程度上 RS fMRI指标可用于预测WTC响应者的认知变化。