Effect of Biomechanical Force Exposure on Cognition and Brain Activation in TBI

描述（由申请人提供）：美国每年有30万人遭受运动性脑震荡，运动性脑震荡和亚震荡影响的短期和长期影响尚不清楚，反复损伤的累积影响也不清楚。显而易见的是，结果存在巨大的可变性，尽管这种可变性的原因尚不清楚。该提案的首要主题是个体暴露于生物力学力是影响结果的关键因素。这有两个广泛的组成部分：单次撞击的特征（如线性加速度、旋转加速度、方向等），以及暴露于生物力学力的历史（如在前几天和几周内撞击的频率和强度的测量）。我们建议利用现场头部撞击监测、认知测试和功能性脑成像方面的技术进步，首次了解哪种类型的头部撞击，在什么情况下，在哪些个体中，会对大脑功能产生什么影响。急性（脑震荡后）和累积（赛季前到赛季后一个月）的生物力学力监测都是值得关注的，并将进行评估。三组学生运动员（有脑震荡的足球/曲棍球运动员，没有脑震荡的队友，匹配的非冲击运动运动员）将在三个时间点（季前赛，季后赛和脑震荡一周内）使用标准化的认知电池和功能磁共振成像（fMRI）进行研究。撞击参数将使用基于头盔的加速度计单元直接测量。这项研究的结果将在运动相关创伤性脑损伤的生物力学和遗传学方面提供重要信息，导致更明智的恢复比赛指南，并提供关于累积性轻微头部损伤影响的客观信息。

DESCRIPTION (provided by applicant): 300,000 individuals sustain sports concussions each year in the U.S. The short and long-term effects of sports concussions and sub-concussive impacts are not known, nor are the cumulative effects of repeated injuries understood. What is clear is that there is enormous variability in outcome, although the reasons for this variability are not understood. The overarching theme of this proposal is that an individual's exposure to biomechanical forces is a critical factor influencing outcome. This has two broad components: the characteristics of a single impact (e.g. linear acceleration, rotational acceleration, direction etc.), and the history of exposure to biomechanical forces (e.g. measures of frequency and intensity of impacts over the preceding days and weeks). We propose to use technological advances in on-field head impact monitoring, cognitive testing, and functional brain imaging to learn for the first time what types of head impacts, under what circumstances, in which individuals, cause what effects in brain function. Both acute (post-concussive) and cumulative (pre to one-month post season) monitoring of biomechanical forces are of interest and will be assessed. Three groups of student athletes (football/hockey players with concussion, teammates without concussion, matched non-impact sport athletes) will be studied at three time points (preseason, postseason, and within one week of a concussion) using a standardized cognitive battery and functional MRI (fMRI). Impact parameters will be directly measured using helmet-based accelerometer units. Results of this study should yield important information on the biomechanics and genetics of sports-related traumatic brain injury, lead to more informed return-to-play guidelines, and provide objective information regarding the effects of cumulative minor head injuries.