Predicting Response to Memory Training in TBI with fMRI

描述（由申请人提供）：这是R21的第二次修订申请，标题为：用fMRI预测TBI中记忆训练的反应。创伤性脑损伤（TBI）是年轻健康成人致残的主要原因。创伤性脑损伤的后果是高度可变的，一些人表现出良好的恢复，而另一些人则患有慢性残疾，并对认知和社会产生深远的影响。创伤性脑损伤的长期预后很难用损伤严重程度、认知障碍和常规神经影像学的标准方法来预测。使用功能磁共振成像的认知激活研究可能为TBI的预后预测提供改进的方法。功能磁共振成像范式能够量化认知挑战期间的神经网络功能，提供功能完整性的活体测量。我们预测，这些数据将有助于量化功能性神经损伤的程度，了解脑外伤患者认知障碍的神经机制，并最终预测长期预后。本项目旨在通过使用功能磁共振成像（fMRI）检查在非线索和线索语言学习期间支持语义策略使用的大脑系统，以确定创伤性脑损伤的恢复机制。该研究有两个具体目标：1。评估TBI患者和匹配健康对照（HC）参与者在无提示和有提示条件下使用语义策略的能力，并定义大脑激活模式如何改变以支持这一过程。2. 在TBI组和HC组中，用fMRI检查预定感兴趣区域（ROI）的特定大脑激活模式，并确定大脑激活的个体差异如何与自然环境下的认知功能和行为相关。这项工作是创新的，处于发展的早期阶段，因此适合R21机制。

DESCRIPTION (provided by applicant): This is the second revised application for an R21 entitled: Predicting Response to Memory Training in TBI with fMRI. Traumatic brain injury (TBI) is a leading cause of disability in young otherwise healthy adults. The consequences of TBI are highly variable, with some individuals showing good recovery and others suffering chronic disability with profound cognitive and social impacts. Long-term outcome from TBI is difficult to predict using standard measures of injury severity, cognitive impairment, and conventional neuroimaging. Cognitive activation studies using fMRI may offer improved methods for outcome prediction in TBI. fMRI paradigms enable quantification of neural network function during cognitive challenges, providing in vivo measures of functional integrity. We predict that these data will be useful in quantifying the degree of functional neural impairment, understanding neural mechanisms underlying cognitive impairment in individuals with TBI, and ultimately predicting long-term outcome. This project aims to identify mechanisms of recovery from TBI by examining brain systems supporting the use of semantic strategies during non-cued and cued verbal learning using functional magnetic resonance imaging (fMRI). The study addresses two Specific Aims: 1. Assess the ability of TBI patients and matched healthy control (HC) participants to utilize semantic strategies under both non-cued and cued conditions and define how patterns of brain activation change to support this process. 2. Examine specific patterns of brain activation with fMRI in predefined regions of interest (ROI) in TBI and HC groups and determine how individual differences in brain activation relate to cognitive functioning and behavior in natural settings. This work is innovative and at an early stage of development, and thus appropriate for the R21 mechanism.