Pediatric Mild Traumatic Brain Injury and the ABCD Study: A Prospective Behavioral, Psychiatric, Neurocognitive, Imaging, and Genetic Investigation

儿科轻度创伤性脑损伤和 ABCD 研究：前瞻性行为、精神病学、神经认知、影像学和遗传研究

• 批准号: 10646161
• 负责人: JEFFREY Edwin MAX
• 金额: $ 44.81万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10646161
• 关键词: 10 year old; Accidents; Adolescent; Age; Behavior Disorders; Behavioral; Behavioral Mechanisms; Birth; Brain; Candidate Disease Gene; Child; Childhood; Childhood Injury; Cognition Disorders; Data; Development; Diagnostic; Diffuse Axonal Injury; Early identification; Enrollment; Event; Exposure to; Family; Fostering; Fracture; Functional Magnetic Resonance Imaging; Gene Structure; Genetic; Image; Individual; Injury; Investigation; Lesion; Life; Measures; Mediating; Mediation; Mental disorders; Methodology; Neurocognitive; Orthopedics; Outcome; Pattern; Phenotype; Predictive Factor; Predisposing Factor; Public Health; Recording of previous events; Reporting; Research Design; Risk Factors; Severities; Site; Socioeconomic Status; Structure; Systems Biology; Time; Trauma; United States; behavior measurement; biopsychosocial; cognitive development; cognitive function; cohort; improved; insight; longitudinal, prospective study; mild traumatic brain injury; neurobehavioral; neuroimaging; novel; phenomenological models; prospective; psychological trauma; sex; stressor; therapeutic development

Mild traumatic brain injury (mTBI) is a major public health problem in the United States. Data from the Adolescent Brain Cognitive Development (ABCD) study afford our team an opportunity to significantly advance the study of mTBI-associated behavioral, psychiatric, and neurocognitive problems which are very controversial. We shall analyze biopsychosocial data generated since 2016 from this ten-year prospective longitudinal 21-site national study of an enrolled cohort of over 11,000 nine/ten-year old children who have been subsequently evaluated annually. The study design permits a rare analysis of predictive factors and mechanisms of post-injury behavioral, psychiatric, and neurocognitive outcomes by examining child and family variables collected pre-injury and post-injury in the 237 children who have so far suffered a mTBI in the years subsequent to enrollment. The mTBI group will be compared with two groups of children 1) with a post-enrollment accidental bone fracture (orthopedic injury; OI); and 2) a lifetime “no injury” (NI) group. Additional children who have had a mTBI will be identified and will be compared with OI and NI controls in the first month of the study, and at the end of year 2 and middle of year 4 of the five-year study. There are three unique aspects of the proposed study. 1) Pre-injury and post-injury sequential structural and functional neuroimaging data facilitate predictive and mediation analyses of behavioral, psychiatric, and neurocognitive outcomes using individual pre- versus post-injury changes and group differences in brain maturation trajectories. 2) Genetic data permit predictive and moderation analyses of outcomes using a novel systems biology approach not based on candidate genes. 3) The proposed study evaluates multiple neurocognitive domains before and after mTBI. The study will examine 3 major hypotheses: (1) Change in behavioral measures and changes in neurocognitive function will be of greater magnitude, and new-onset psychiatric disorders will occur at a significantly higher rate, in children with mTBI compared with children with OI and NI. (2) Behavioral changes, new-onset psychiatric disorders, and neurocognitive function changes in children will be predicted by pre-injury child variables (sex, adaptive function, academic and cognitive function, lifetime psychiatric disorders, behavioral ratings, brain structure and functional MRI measures, and genetic factors), and pre-injury family variables (socioeconomic status, family function, family psychiatric history) in children with mTBI, OI, and NI. (3) The occurrence and pattern of behavioral changes, new-onset psychiatric disorders, and neurocognitive function changes will be mediated by child brain variables (trajectory of brain maturation), post-injury family variables (functioning and stressors), and injury variables (age at injury, time-since-injury, severity, presence of a brain lesion, and extent of diffuse axonal injury) and moderated by child gene structure (genetic factors), in children with mTBI, OI, and NI.

轻度创伤性脑损伤(MTBI)在美国是一个主要的公共卫生问题。数据来自 青少年大脑认知发展(ABCD)研究为我们的团队提供了一个显著 推进与mTBI相关的行为、精神和神经认知问题的研究 非常有争议。我们将分析自2016年以来从这个十年展望中产生的生物心理社会数据 对11,000多名9/10岁儿童进行了21个地点的纵向全国性研究 随后每年进行一次评估。研究设计允许罕见地分析预测因素和 通过检查儿童和儿童的行为、精神和神经认知结果来研究损伤后行为、精神和神经认知结果的机制 收集了237名受伤前和受伤后的儿童的家庭变量，这些儿童到目前为止已经遭受了mTBI 注册后的几年。MTBI组将与两组儿童进行比较1) 入选后意外骨折(骨科损伤；OI)；2)终生“无损伤”(NI)组。 将确定其他患有mTBI的儿童，并将其与OI和NI对照进行比较 研究的第一个月，以及五年研究的第二年末和第四年年中。 这项拟议的研究有三个独特的方面。1)受伤前和受伤后的顺序 结构和功能神经成像数据有助于预测和调节行为分析， 使用个体受伤前和受伤后的变化和群体的精神和神经认知结果 大脑成熟轨迹的差异。2)遗传数据允许进行预测性和适度性分析 结果使用一种新的系统生物学方法，而不是基于候选基因。3)建议的研究 评估mTBI前后的多个神经认知域。 这项研究将检验三个主要假设：(1)行为测量的变化和 神经认知功能将具有更大的规模，新发的精神障碍将在 与OI和NI儿童相比，mTBI儿童的发病率明显更高。(2)行为改变； 新发的精神障碍和儿童神经认知功能的变化将通过损伤前进行预测 儿童变量(性别、适应功能、学习和认知功能、终生精神障碍、 行为分级、脑结构和功能核磁共振测量，以及遗传因素)，以及受伤前家庭 患有mTBI、OI和NI的儿童的变量(社会经济地位、家庭功能、家庭精神病史)。 (3)行为改变、新发精神障碍和神经认知障碍的发生和模式 功能变化将由儿童大脑变量(大脑成熟轨迹)、损伤后家庭进行调节 变量(功能和应激源)和损伤变量(受伤时的年龄、受伤后的时间、严重程度、是否存在 脑损伤和弥漫性轴索损伤的程度)，并受儿童基因结构(遗传因素)的调节 患有mTBI、OI和NI的儿童。