Translational Research Center for TBI and Stress Disorders (TRACTS)

TBI 和应激障碍转化研究中心 (TRACTS)

• 批准号: 10664963
• 负责人: Catherine Brawn Fortier
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10664963
• 关键词: Address; Anxiety Disorders; Area; Back; Behavior; Biological; Biology; Boston; Brain Injuries; Center for Translational Science Activities; Clinical; Clinical Research; Communities; Complex; Development; Diagnostic; Education; Elderly; Ensure; Environment; Epidemiology; Exposure to; Family; Fostering; Freedom; Funding; Glean; Goals; Health; Healthcare Systems; Home; Individual; Infrastructure; Injury; Internships; Knowledge; Life; Long-Term Effects; Longitudinal Studies; Longitudinal cohort study; Medical; Medical center; Mental Health; Mentors; Minority; Mission; Mood Disorders; Multiple Trauma; Nature; Neurobiology; Neuropsychology; Neurosciences Research; Phenotype; Population; Post-Traumatic Stress Disorders; Postdoctoral Fellow; Rehabilitation therapy; Research; Research Personnel; Resources; Risk; Severities; Site; Societies; Substance Use Disorder; Symptoms; Therapeutic; Training; Training and Education; Trauma; Traumatic Brain Injury; Universities; Veterans; War; Work; chronic pain; clinical training; cohort; data repository; effective therapy; endophenotype; experience; functional decline; graduate student; innovation; loved ones; mild traumatic brain injury; multidisciplinary; neuropsychiatry; next generation; operation; outreach; physical conditioning; post 9/11; programs; prospective; psychoeducation; psychoeducational; psychologic; rehabilitation research; rehabilitation strategy; sleep syndrome; stress disorder; stress related disorder; training opportunity; undergraduate student

The VA RR&D TBI National Network Research Center based at VA Boston Healthcare System, with a network site at the Michael E. DeBakey VA Medical Center, called the Translational Research Center for TBI and Stress Disorders (TRACTS) (funded initially in 2009) proposes to continue its mission of conducting multidisciplinary, clinical research aimed at providing a psychological, biological and neurobiological characterization of the effects of traumatic brain injury (TBI) and related stress disorders, and to use this understanding to create effective treatment opportunities for Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND). Over the last funding period, TRACTS has made remarkable progress in understanding the synergistic effect of mild traumatic brain injury (mTBI) and exposure to blast munitions on the mental and physical health of Veterans. This foundational work, which holistically has integrated psychological, biological, and epidemiological approaches to the study of the long- term effects of brain injury incurred during war, has led to the emerging concept of “Deployment Trauma” (DT) and helped create a roadmap toward the treatment and rehabilitation of the complex and interacting issues that define the civilian experience of Veterans in the post 9/11 era. It is our overarching goal and unifying mission to identify, understand, and treat the long-term effects of deployment trauma in our post 9/11 Veterans. Over the next funding period, the TRACTS infrastructure will be used to continue to grow and maintain the TRACTS cohort and the TRACTS prospective longitudinal cohort study, as well as the resultant TRACTS Data Repository. In the current application, we propose to investigate three interlocking Focus Areas (FA) that speak to critical gaps in our knowledge that must be addressed if we are to be successful in reaching our goals. These focus areas build upon our foundational observations over the last 8+ years and use this evolving wealth of information regarding the clinical presentation and endophenotypes of deployment trauma in OEF/OIF/OND Veterans to develop rehabilitative treatments that will foster civilian reintegration and reduce psychological and medical symptom severity. The three focus areas are: FA1: Deep phenotyping of DT and its functional consequences; FA 2: Understanding the dynamic interplay between biology and behavior that determines the biological and functional consequences of DT; FA 3: Rehabilitation and treatment of the functional and neurobiological consequences of DT. TRACTS will continue in its mission to provide the next generation of VA researchers with an innovative and outstanding mentoring environment at both the VA Boston and Houston Medical Centers through training in assessment, and rehabilitation and clinical neuroscience research. Our affiliations with other programs within VA, such as the National Centers for PTSD, MAVERIC, PTSD/TBI Brain Bank, as well as our affiliated universities, ensure that we have rich resources for excellence in training opportunities for undergraduates, graduate students, neuropsychology interns and post docs, and geriatric, neuropsychiatry and polytrauma fellows. Finally, TRACTS has initiated a wide-ranging education, outreach and dissemination effort intended to reach a broad audience of researchers, clinicians, Veterans and their families. This effort has included the provision of clinical training/education on the clinical complexities and idiosyncrasies of the OEF/OIF/OND population to researchers and clinicians, development of collaborative relationships within the greater Boston and Houston communities, and provide psychoeducation and resources to returning Veterans and their loved ones. In sum, TRACTS is well poised to continue its cutting-edge work over the next five years. The knowledge gleaned from the neuroscience and rehabilitation research conducted at TRACTS will continue to fill current gaps in diagnostics and therapeutics for Veterans with mTBI, blast, and stress-related disorders.

VA RR&D TBI 国家网络研究中心位于 VA 波士顿医疗保健系统，拥有一个网络 位于迈克尔·E·德贝基退伍军人医疗中心 (Michael E. DeBakey VA Medical Center) 的站点，称为 TBI 转化研究中心 应激障碍 (TRACTS)（最初于 2009 年资助）提议继续其开展 多学科的临床研究旨在提供心理、生物学和神经生物学的研究 描述创伤性脑损伤（TBI）和相关应激障碍的影响，并利用它 了解为持久自由行动退伍军人创造有效的治疗机会， 伊拉克自由行动和新黎明行动（OEF/OIF/OND）。在上一个资助期内，TRACTS 在理解轻度创伤性脑损伤（mTBI）和 暴露于爆炸弹药对退伍军人的身心健康的影响。这项基础性工作， 整体上综合了心理学、生物学和流行病学的方法来研究长期流行病 战争期间发生的脑损伤的长期影响导致了“部署创伤”（DT）概念的出现 并帮助制定了治疗和康复复杂且相互作用的问题的路线图 定义了 9/11 后时代退伍军人的平民经历。这是我们的总体目标并统一 任务是识别、理解和治疗 9/11 事件后部署创伤的长期影响 退伍军人。在下一个资助期内，TRACTS 基础设施将用于继续发展和 维持TRACTS队列和TRACTS前瞻性纵向队列研究，以及由此产生的结果 TRACTS 数据存储库。在当前的申请中，我们建议研究三个相互关联的重点领域 （FA）指出了我们知识中的关键差距，如果我们要成功实现这一目标，就必须解决这些差距 我们的目标。这些重点领域建立在我们过去 8 年多的基础观察之上，并利用了这一点 关于部署创伤的临床表现和内表型的不断变化的丰富信息 OEF/OIF/OND 退伍军人开发康复治疗，以促进平民重返社会并减少 心理和医学症状的严重程度。三个重点领域是： FA1：DT 及其相关的深层表型分析 功能性后果； FA 2：理解生物学和行为之间的动态相互作用 确定 DT 的生物学和功能后果； FA 3：康复和治疗 DT 的功能和神经生物学后果。 TRACTS 将继续履行其使命，为下一代 VA 研究人员提供创新和 VA 波士顿和休斯顿医疗中心通过培训提供出色的指导环境 评估、康复和临床神经科学研究。我们与其他项目的联系 VA，例如国家 PTSD 中心、MAVERIC、PTSD/TBI 脑库，以及我们的附属机构 大学，确保我们拥有丰富的资源，为本科生提供卓越的培训机会， 研究生、神经心理学实习生和博士后，以及老年病学、神经精神病学和多发伤 各位。 最后，TRACTS 发起了广泛的教育、外展和传播工作，旨在实现 研究人员、临床医生、退伍军人及其家人的广泛受众。这项努力包括提供 针对 OEF/OIF/OND 人群的临床复杂性和特质进行临床培训/教育 研究人员和临床医生，在大波士顿和休斯顿地区发展合作关系 社区，并为返回的退伍军人及其亲人提供心理教育和资源。 总之，TRACTS 已做好准备，在未来五年内继续开展前沿工作。知识点 从 TRACTS 进行的神经科学和康复研究中收集到的信息将继续填补当前的空白 患有 mTBI、爆炸和压力相关疾病的退伍军人的诊断和治疗方面存在差距。

项目成果

Childhood trauma differentially impacts depression and stress associations with reintegration challenges among post-9/11 U.S. veterans.

童年创伤对 9/11 事件后美国退伍军人的抑郁和压力与重返社会挑战的影响存在差异。

• DOI: 10.1016/j.outlook.2021.10.008
• 发表时间: 2022
• 期刊: Nursing outlook
• 影响因子: 4.3
• 作者: Etchin,AnnaG;Fonda,JenniferR;Howard,ElizabethP;Fortier,CatherineB;Milberg,WilliamP;Pounds,Karen;McGlinchey,ReginaE
• 通讯作者: McGlinchey,ReginaE

Reporting of symptoms associated with concussion by OEF/OIF/OND Veterans: Comparison between research and clinical contexts.

OEF/OIF/OND 退伍军人报告与脑震荡相关的症状：研究与临床背景之间的比较。

• DOI: 10.1080/02699052.2017.1280740
• 发表时间: 2017
• 期刊: Brain injury
• 影响因子: 1.9
• 作者: Jackson,ColleenE;Nordstrom,Leslie;Fonda,JenniferR;Fortier,CatherineB;Milberg,WilliamP;McGlinchey,ReginaE
• 通讯作者: McGlinchey,ReginaE

Associations between Post-Traumatic stress disorder symptoms and automobile driving behaviors: A review of the literature.

创伤后应激障碍症状与汽车驾驶行为之间的关联：文献综述。

• DOI: 10.1016/j.aap.2022.106648
• 发表时间: 2022-06
• 期刊: ACCIDENT ANALYSIS AND PREVENTION
• 影响因子: 5.9
• 作者: Bernstein, John P. K.;Milberg, William P.;McGlinchey, Regina E.;Fortier, Catherine B.
• 通讯作者: Fortier, Catherine B.

Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder.

患有创伤后应激障碍的军人和退伍军人的记忆障碍率升高。

• DOI: 10.1080/13803395.2016.1264575
• 发表时间: 2017
• 期刊: Journal of clinical and experimental neuropsychology
• 影响因子: 2.2
• 作者: Stricker,NikkiH;Lippa,SaraM;Green,DeborahL;McGlynn,SusanM;Grande,LauraJ;Milberg,WilliamP;McGlinchey,ReginaE
• 通讯作者: McGlinchey,ReginaE

Intimate Partner Violence Predicts Posttraumatic Stress Disorder Severity Independent of Early Life and Deployment-Related Trauma in Deployed Men and Women Veterans.

亲密伴侣暴力可以预测退役男女退伍军人的创伤后应激障碍严重程度，与早年生活和服役相关创伤无关。

• DOI: 10.1177/0886260520938514
• 发表时间: 2022
• 期刊: Journal of interpersonal violence
• 影响因子: 2.5
• 作者: Pierce,MeghanE;Fortier,Catherine;Fonda,JenniferR;Milberg,William;McGlinchey,Regina
• 通讯作者: McGlinchey,Regina