Neuroimaging Methods for Diagnosis of Mild Traumatic Brain Injury

描述（由申请人提供）： 摘要/项目摘要轻度创伤性脑损伤（mTBI）是最近在伊拉克和阿富汗服役的退伍军人的主要发病率的来源。人们对使用弥散张量成像（DTI）评估与mTBI相关的白色物质损伤非常感兴趣。本提案的目的是提供定量评估和可视化的白色物质损伤的一个单一的主题，是基于比较一个大的参考组的非创伤性脑损伤的退伍军人。我们的方法包括进行全脑分析，以创建FA（各向异性分数）图，通过与100名受试者的参考组的平均FA进行比较，提示单个受试者的白色损伤。我们提出了显著性检验的主要和验证性分析方法：（i）使用一种称为排列检验的非参数统计方法，然后是一种新的“无阈值”校正多重比较检验，以及（ii）使用基于人口的推理统计来计算全脑Z统计图，然后是更典型的基于聚类的校正多重比较。 我们的初步数据表明，白色物质损害可以有效地评估在单一的主题。因此，我们的建议超越了传统的应用DTI的mTBI研究进行组比较。如果成功，然后在更大规模的研究中得到证实，我们提出的方法将提供客观的证据，在临床环境中诊断个别患者与mTBI的损伤。 公共卫生相关性： 轻度创伤性脑损伤（TBI）对"持久自由行动"/"伊拉克自由行动"退伍军人的健康和福祉产生了不利影响。然而，轻度TBI的诊断和治疗一直具有挑战性，因为与PTSD和抑郁症有显著的重叠。人们对使用称为扩散张量成像（DTI）的先进MRI方法来评估轻度TBI的脑组织损伤非常感兴趣。传统上，DTI仅用于研究中，以得出关于轻度TBI患者的一般结论，但并不专注于对个体患者的评估。拟议的研究计划将调查使用DTI可视化个别退伍军人的脑损伤，以帮助诊断轻度TBI。如果我们的方法是成功的，DTI可以用于评估轻度TBI在临床上。

DESCRIPTION (provided by applicant): Abstract / Project Summary Mild traumatic brain injury (mTBI) is a source of major morbidity in recent veterans who served in Iraq and Afghanistan. There has been keen interest in using diffusion tensor imaging (DTI) to assess white matter damage associated with mTBI. The goal of this proposal is to provide quantitative assessment and visualization of white matter damage in a single subject that is based on comparison to a large reference group of non-TBI veterans. Our approach involves performing a whole-brain analysis to create an FA (fractional anisotropy) map that is suggestive of white matter injury in a single subject by comparison to mean FA from a reference group of 100 subjects. We propose primary and confirmatory analytic methods for significance testing: (i) using a method of non-parametric statistics known as permutation testing followed by a novel "threshold-free" correction for multiple comparison testing, and (ii) using population based inferential statistics to compute whole brain Z-statistic map followed by more typical cluster-based correction for multiple comparisons. Our preliminary data suggests that white matter damage can be effectively assessed in single subjects. Thus, our proposal moves beyond the conventional application of DTI to mTBI research for making group comparisons. If successful and then confirmed in a larger scale study, the approach we propose would provide objective evidence of injury for diagnosing individual patients with mTBI in the clinical setting. PUBLIC HEALTH RELEVANCE: Project Narrative Mild traumatic brain injury (TBI) has had detrimental impact on the health and well-being of OEF/OIF veterans. However, the diagnosis and treatment of mild TBI has been challenging because of significant overlap with PTSD and depression. There has been keen interest in using advanced MRI methods called diffusion tensor imaging (DTI) to assess damage to brain tissue in mild TBI. Traditionally, DTI has only been used in research to draw general conclusions about patients with mild TBI but has not focused on assessment of individual patients. The proposed research program will investigate the use of DTI to visualize brain injury in individual veterans to aid in the diagnosis of mild TBI. If our approach is successful, DTI could be used for evaluation of mild TBI in the clinic.