Identifying the Cognitive, Psychological, and Neuroimaging Signatures of Head Trauma in Female Survivors of Intimate Partner Violence

识别亲密伴侣暴力女性幸存者头部创伤的认知、心理和神经影像特征

• 批准号: 10666681
• 负责人: Carrie Lynn Esopenko
• 金额: $ 68.66万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666681
• 关键词: Acceleration; Affect; Aggressive behavior; Aging; Anoxia; Anterior; Anxiety; Attention; Autopsy; Behavioral; Blunt Trauma; Brain; Brain Concussion; Brain Injuries; Case Study; Choline; Chronic; Clinical; Cognitive; Cohort Studies; Collaborations; Contusions; Coupled; Craniocerebral Trauma; Data; Deceleration; Dementia; Development; Exposure to; Face; Female; Frequencies; Genetic; Glutamates; Glutathione; Goals; Grant; Head; Health; Height; Hypoxia; Image; Impaired cognition; Impairment; Injury; Interview; Life; Link; Literature; Longevity; Magnetic Resonance Spectroscopy; Memory; Mental Depression; Mental disorders; Meta-Analysis; Military Personnel; Moods; Neck; Nervous System Trauma; Neurologic; Neuropsychology; Outcome; Pathology; Pathway interactions; Patient-Centered Care; Persons; Phenotype; Population; Post-Traumatic Stress Disorders; Prefrontal Cortex; Prevalence; Process; Public Health; Recording of previous events; Recreation; Reporting; Research; Rest; Risk; Role; Sample Size; Sampling; Short-Term Memory; Site; Sports; Structure; Subgroup; Substance Use Disorder; Survivors; Symptoms; Syndrome; Techniques; Trauma; Traumatic Brain Injury; United States; Verbal Learning; Violence; Woman; Work; behavioral phenotyping; brain volume; chronic traumatic encephalopathy; cingulate gyrus; cognitive function; cognitive process; cohort; comorbidity; early onset; executive function; experience; head impact; high risk; intimate partner violence; member; myoinositol; neural; neuroimaging; psychiatric comorbidity; psychologic; psychological outcomes; resilience; response; sexual violence; symptom cluster; symptomatology; trauma exposure; virtual; white matter; working group

Intimate partner violence (IPV), the physical violence, sexual violence, psychological aggression, or stalking by a current or former intimate partner, is a significant public health concern affecting approximately 10 million people in the United States annually. Approximately 33% of women exposed to IPV report physical trauma resulting in heighted risk of head injury in this population. Recent work suggests that anywhere from 40-90% of women experience head trauma due to IPV. IPV-related head trauma is caused by blunt force trauma, being pushed or violently shaken, and/or strangulation, which can result in focal trauma or contusions, acceleration and deceleration injuries, as well as hypoxia and anoxia due to strangulation, respectively. Limited research has shown that women exposed to IPV with head trauma report higher depression, anxiety, and post-traumatic stress disorder symptomatology, as well as impaired cognitive function relative to women with IPV and no exposure to head trauma. Although the clinical features of repeated exposure to head trauma identified in IPV are similar to the effects observed in military traumatic brain injury (TBI) and sports-related concussion, limited work has been done to understand IPV-related head trauma, in particular its chronic cognitive and psychological effects as well as associated brain changes. Through a multi-site research collaboration consisting of members of the Enhancing NeuroImaging and Genetics through Meta-Analysis (ENIGMA) IPV Working Group, the proposed study will characterize the cognitive, psychological, and neural profiles of IPV- related head trauma, as well as determine whether specific symptoms clusters are associated with discernable IPV subgroups. Furthermore, this proposal initiates the process of creating an IPV study cohort that will be re- assessed every 5 years to chronically assess brain and behavioral changes associated with IPV-related head trauma over the lifespan. Semi-structured interviews will be used to obtain IPV specific information such as abuse and head trauma history and frequency. A comprehensive neuropsychological battery will be used to determine cognitive and psychological status, while sophisticated neuroimaging techniques will be used to characterize neural structure, function, and brain metabolites in IPV with exposure to head trauma relative to IPV without exposure to head trauma. Finally, we will use a data-driven approach to determine whether symptom clusters differentiate subgroups of IPV. In aim 1, we will identify the cognitive and psychological profiles of subgroups of IPV. Aim 2 will examine the neuroimaging signatures in subgroups of IPV. In aim 3, we will determine whether symptom clusters are associated with discernible subgroups of IPV. The results from this study will provide critical information about the role of IPV-related head trauma in cognitive and psychological outcomes, as well as the underlying neural changes. This is important not only for understanding the chronic effects of repetitive brain trauma, but also the identification of distinct subgroups of IPV has direct implications for development of patient-centered care approaches for IPV.

亲密伴侣暴力（IPV），身体暴力，性暴力，心理攻击，或跟踪 目前或以前的亲密伴侣，是一个重大的公共卫生问题，影响约1000万人 美国人每年。大约33%暴露于IPV的女性报告身体创伤 导致该人群头部受伤的风险增加。最近的研究表明，在任何地方， 女性因IPV而遭受头部创伤。IPV相关的头部创伤是由钝力创伤引起的， 推或猛烈摇晃，和/或勒颈，这可能导致局灶性创伤或挫伤，加速 和减速损伤，以及缺氧和缺氧，由于窒息，分别。有限的研究 研究表明，暴露于IPV的头部创伤妇女报告抑郁，焦虑和创伤后 与有IPV和无IPV的女性相比， 头部创伤虽然IPV中确定的反复暴露于头部创伤的临床特征 与军事创伤性脑损伤（TBI）和运动相关脑震荡中观察到的效果相似， 已经做了工作，以了解IPV相关的头部创伤，特别是其慢性认知和 心理影响以及相关的大脑变化。通过多站点研究协作 由通过荟萃分析增强神经影像学和遗传学（ENIGMA）IPV的成员组成 工作组，拟议的研究将表征IPV的认知，心理和神经概况- 相关的头部创伤，以及确定特定的症状群是否与可辨别的 IPV亚组。此外，该提案启动了创建IPV研究队列的过程， 每5年评估一次，以长期评估与IPV相关头部相关的大脑和行为变化 在生命周期中的创伤。半结构化访谈将用于获取IPV特定信息，例如 虐待和头部创伤史及频率一个全面的神经心理电池将被用来 确定认知和心理状态，而复杂的神经成像技术将用于 描述IPV中暴露于头部创伤的神经结构、功能和脑代谢物， IPV不暴露于头部创伤。最后，我们将使用数据驱动的方法来确定是否 症状群区分IPV的亚组。在目标1中，我们将确定认知和心理 IPV亚组的特征。目的2将检查IPV亚组的神经影像学特征。在目标3中，我们 将确定症状群是否与可辨别的IPV亚组相关。的结果 这项研究将提供关于IPV相关头部创伤在认知和 心理结果，以及潜在的神经变化。这不仅对理解 重复性脑外伤的慢性效应，而且IPV的不同亚组的识别具有直接的 对发展以病人为中心的IPV护理方法的影响。