Longitudinal Assessment of Driving After Mild TBI in Teens

青少年轻度 TBI 后驾驶的纵向评估

• 批准号: 10680410
• 负责人: Despina Stavrinos
• 金额: $ 58.36万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-11 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10680410
• 关键词: Acute; Affect; Age; Australia; Automobile Driving; Canada; Clinical; Clinical Practice Guideline; Cognitive; Enrollment; Geography; Goals; Guidelines; Health Personnel; Hour; Impaired cognition; Individual; Injury; Longitudinal Studies; Mediating; Neurocognitive; Neurocognitive Deficit; Outcome; Participant; Patient Self-Report; Patients; Performance; Physicians; Pilot Projects; Protocols documentation; Psyche structure; Race; Reaction Time; Recommendation; Recording of previous events; Recovery; Research; Resolution; Resources; Rest; Risk; Site; Speed; Surveys; Symptoms; Teenagers; Testing; Time; Vehicle crash; age group; clinical development; cognitive load; distraction; driving behavior; evidence base; experience; experimental study; functional disability; improved; innovation; mild traumatic brain injury; recruit; sex; socioeconomic diversity; teen drivers; teen driving; therapeutic target

PROJECT SUMMARY Returning to drive after an mild traumatic brain injury (mTBI) is an immediate goal for many individuals as they return to their daily activities. However, evidence-based guidance about when those with mTBI can safely return to drive is lacking. While an mTBI can lead to significant cognitive and functional impairments, little is known about how mTBI affects driving, especially among teen drivers who are at an increased risk of both mTBI and motor vehicle collisions compared to other age groups. The long-term goal of this research is to evaluate the effects of mTBI on teen's driving performance and inform clinical practice guidelines on when teens can safely return to drive post-mTBI and under what conditions. We will test the following specific aims: Aim1: Characterize the trajectory of driving from acutely post-injury to symptom resolution among teen drivers with mTBI compared to healthy controls. Aim 2: Examine the effect of cognitive load on driving performance from acutely post-injury to symptom resolution in teen drivers with mTBI compared to healthy controls. Aim 3: Examine the extent to which differences in driving performance between teen drivers with and without mTBI, especially under increased cognitive load, are mediated by acute post-injury neurocognitive function. We will enroll 200 teen drivers ages 16-19 years from two study sites to increase racial, geographic, and socioeconomic diversity. Participants will include 100 teen drivers (50 per site) with a physician-confirmed isolated mTBI and 100 (50 per site) healthy controls with no history of TBI matched for age, sex, driving experience, and athlete status. Primary driving outcomes will be assessed using two innovative, complementary approaches: 1) high-fidelity driving simulators will be used to assess driving performance under 4 experimental study conditions at up to 9 time points: acutely post-injury (≤ 96 hours of injury) and then weekly until symptom resolution or 8 weeks post-injury, whichever occurs first; 2) self-report surveys of real- world driving behaviors will be completed by all participants daily. This is the first study to longitudinally evaluate teen driving after mTBI from acutely post-injury to symptom resolution. The study will fill critical gaps by providing evidence on how increased cognitive load and underlying neurocognitive function post-injury may impact driving performance. Our results will have a significant impact on clinical practice and guidelines by providing evidence to inform the development of clinical return to drive guidelines, and to help healthcare providers make informed clinical recommendations regarding when a teen can safely return to drive after mTBI.

项目摘要 轻度创伤性脑损伤（mTBI）后恢复驾驶是许多人的直接目标，因为他们 回到他们的日常活动。然而，关于mTBI患者何时可以安全地 返回驱动器是缺乏的。虽然mTBI可能导致严重的认知和功能障碍，但很少有 了解mTBI如何影响驾驶，特别是在青少年驾驶员中， 与其他年龄组相比，mTBI和机动车碰撞。这项研究的长期目标是 评估mTBI对青少年驾驶表现的影响，并告知临床实践指南， 青少年可以安全地返回驾驶后mTBI和在什么条件下。我们将测试以下具体目标： 目标1：描述青少年驾驶员从急性损伤后到症状消退的轨迹 与健康对照组相比。目的2：研究认知负荷对驾驶表现的影响 与健康对照组相比，患有mTBI的青少年驾驶员从急性损伤后到症状消退。目标3： 检查有和没有mTBI的青少年司机之间驾驶性能的差异程度， 特别是在认知负荷增加的情况下，是由急性损伤后神经认知功能介导的。 我们将从两个研究中心招募200名16-19岁的青少年司机，以增加种族，地理， 社会经济多样性。参与者将包括100名青少年司机（每个站点50名）， 孤立的mTBI和100例（每个研究中心50例）年龄、性别、驾驶情况匹配的无TBI病史的健康对照 经验和运动员身份。主要驾驶结果将使用两个创新的， 补充方法：1）高保真驾驶模拟器将用于评估驾驶性能 在4种实验研究条件下，在多达9个时间点：急性损伤后（损伤≤ 96小时），然后 每周一次，直至症状消退或损伤后8周，以先发生者为准; 2）自我报告调查真实的- 世界驾驶行为将由所有参与者每天完成。这是第一个纵向研究 评估青少年mTBI后从急性损伤后到症状缓解的驾驶情况。这项研究将填补关键空白 通过提供证据，说明损伤后认知负荷和潜在神经认知功能的增加如何 影响驾驶性能。我们的研究结果将对临床实践和指南产生重大影响， 提供证据，为制定临床恢复驾驶指南提供信息，并帮助医疗保健 提供者就青少年何时可以安全地恢复驾驶提出明智的临床建议 mTBI。