MINDS Imaging Ancillary Study

MINDS 影像辅助研究

• 批准号: 10001823
• 负责人: Michelle Gurvitz
• 金额: $ 52.69万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10001823
• 关键词: Address; Adolescent; Adult; Alzheimer' s Disease; Ancillary Study; Behavioral; Biological; Blood Vessels; Brain; Brain Diseases; Brain Injuries; Caring; Cerebrovascular Circulation; Cerebrovascular Disorders; Cerebrovascular Trauma; Child; Childhood; Clinical; Clinical Data; Cognitive deficits; Common Ventricle; Complex; Cross-Sectional Studies; Crystallization; Data; Dementia; Development; Educational Background; Executive Dysfunction; Exhibits; Fostering; Funding; Future; Habits; Heart; Hemosiderin; Hypoxia; Image; Impaired cognition; Impairment; Infarction; Knowledge; Lesion; Life Style; Longevity; Machine Learning; Magnetic Resonance Imaging; Measures; Modeling; Molecular Abnormality; Multicenter Studies; National Heart, Lung, and Blood Institute; Network Infrastructure; Neurocognitive; Neurocognitive Deficit; Neuropsychology; Outcome; Parents; Patients; Physiological; Physiology; Population; Prevention strategy; Protocols documentation; Proxy; Quality of life; Research; Rest; Risk; Risk Factors; Role; Sampling; Shapes; Site; Social Interaction; Statistical Models; Structure; Techniques; Thick; Translational trial; United States National Institutes of Health; Vision; White Matter Hyperintensity; aged; brain abnormalities; cerebrovascular; cognitive reserve; cohesion; cohort; congenital heart disorder; connectome; cost effective; environmental enrichment for laboratory animals; executive function; imaging study; improved; insight; ischemic injury; multimodality; neuroimaging; neuroimaging marker; prevent; protective factors; randomized trial; reconstruction; recruit; response; social; translational study; white matter; young adult

Dramatic advances in management of congenital heart disease (CHD) have improved survival to adulthood from <10% in the 1960's to nearly 90% in the current era. With this shifting demographic, adult CHD (ACHD) patients now outnumber pediatric CHD patients.1 ACHD patients demonstrate domain-specific neurocognitive deficits such as impairment in executive function, associated with reduced quality of life that includes deficits in educational attainment and social interaction.2-7 These deficits are related to risk factors that can occur across the lifespan, including genetic abnormalities, cumulative hypoxic/ischemic injury, and, adult-onset atherosclerotic cerebrovascular disease. Our overarching hypothesis is that ACHD patients exhibit vascular brain injury and structural/physiological brain alterations that are predictive of specific neurocognitive deficits, including executive dysfunction, which are modified by behavioral and environmental enrichment proxies of CR (e.g., level of education and lifestyle/social habits). We propose an ancillary study to the NHLBI-funded Pediatric Heart Network (PHN) “Multi-Institutional Neurocognitive Discovery Study (MINDS) in Adult Congenital Heart Disease (ACHD).” We will leverage the MINDS-ACHD parent study data (i.e., NIH Toolbox neuropsychological battery/clinical data/biological samples) and our established neuroimaging harmonization, which we currently use for the PHN Single Ventricle Reconstruction (SVRIII) multi-center brain connectome study (R01-HL128818; PI-Panigrahy), to measure neuroimaging biomarkers in ACHD patients at the same PHN sites. Our specific aims are: Specific Aim #1 (brain injury): To determine if vascular-related brain injury (cortical infarcts, hemosiderin lesions, and white matter hyperintensity) is associated with specific neurocognitive deficits (e.g. NIH Toolbox total composite score) in ACHD patients. Specific Aim #2 (brain structure): To determine if reduced fronto-temporal cortical thickness and white matter connectivity are associated with specific neurocognitive deficits (e.g. NIH Toolbox frontal executive sub-score) in ACHD patients. Specific Aim #3 (brain physiology): To determine if reduced cerebrovascular reserve (regional cerebral blood flow/ resting BOLD imaging) is associated with specific neurocognitive deficits (e.g. NIH Toolbox crystallized composite score) in ACHD patients. Specific Aim #4 (cognitive reserve): To determine if the associations between neuroimaging biomarkers and neurocognitive outcomes in ACHD patients are modified by behavioral and environmental enrichment proxies of CR, using traditional statistical models and machine learning techniques. Given the paucity of multi-modal neuroimaging studies in ACHD, our proposed study addresses a major knowledge gap in the ACHD population by providing insight into the mechanism underlying impaired neurocognitive outcomes. Our study will provide structural-physiological correlates of neurocognitive outcomes, representing the first multi-center neuroimaging study to be performed in ACHD. Importantly, other behavioral and environmental enrichment data will be integrated with these neuroimaging and neurocognitive outcome data to model cognitive reserve. Results from this research will help shape the care of ACHD patients, and further our understanding of the interplay between brain injury and cognitive reserve. The proposed ancillary study is thus both feasible and cost-effective by leveraging the NHLBI-PHN infrastructure As such, the proposed research is well aligned with the NHLBI's Strategic Vision.

先天性心脏病 (CHD) 治疗的巨大进步提高了患者的生存率 成年期的比例从 1960 年代的 <10% 上升到当今时代的近 90%。随着人口结构的变化，成人冠心病 (ACHD) 患者数量现已超过儿科 CHD 患者。1 ACHD 患者表现出领域特异性 神经认知缺陷，例如执行功能受损，与生活质量下降相关 包括教育程度和社交互动方面的缺陷。2-7 这些缺陷与风险因素有关 可能在整个生命周期中发生，包括遗传异常、累积性缺氧/缺血性损伤，以及 成人发病的动脉粥样硬化性脑血管疾病。我们的首要假设是 ACHD 患者 表现出血管性脑损伤和结构/生理性脑改变，这些改变可预测特定的 神经认知缺陷，包括执行功能障碍，可通过行为和环境改变 CR 的丰富代理（例如，教育水平和生活方式/社会习惯）。我们建议进行一项辅助研究 NHLBI 资助的儿科心脏网络 (PHN)“多机构神经认知发现研究 (MINDS) 成人先天性心脏病（ACHD）。”我们将利用 MINDS-ACHD 家长研究数据（即 NIH 工具箱神经心理学电池/临床数据/生物样本）和我们建立的神经影像学 协调，我们目前用于 PHN 单心室重建 (SVRIII) 多中心大脑 连接组研究（R01-HL128818；PI-Panigrahy），测量 ACHD 患者的神经影像生物标志物 相同的 PHN 站点。我们的具体目标是： 具体目标#1（脑损伤）：确定是否与血管相关 脑损伤（皮质梗塞、含铁血黄素损伤和白质高信号）与特定的 ACHD 患者的神经认知缺陷（例如 NIH Toolbox 综合总分）。具体目标#2（大脑 结构）：确定额颞叶皮层厚度和白质连接性是否减少 与 ACHD 中特定的神经认知缺陷（例如 NIH Toolbox 额叶执行子评分）相关 患者。具体目标#3（脑生理学）：确定脑血管储备是否减少（区域 脑血流量/静息 BOLD 成像）与特定的神经认知缺陷相关（例如 NIH Toolbox ACHD 患者的结晶综合评分）。具体目标#4（认知储备）：确定是否 ACHD 患者神经影像生物标志物与神经认知结果之间的关联被修改 通过 CR 的行为和环境富集代理，使用传统的统计模型和机器 学习技巧。鉴于 ACHD 多模式神经影像学研究的缺乏，我们提出的研究 通过提供对潜在机制的深入了解，解决了 ACHD 人群的主要知识差距 神经认知结果受损。我们的研究将提供神经认知的结构生理相关性 结果，代表了在 ACHD 中进行的第一个多中心神经影像研究。重要的是，其他 行为和环境丰富数据将与这些神经影像和神经认知相整合 用于建模认知储备的结果数据。这项研究的结果将有助于塑造 ACHD 的护理 患者，并进一步了解脑损伤和认知储备之间的相互作用。这 因此，通过利用 NHLBI-PHN 基础设施，拟议的辅助研究既可行又具有成本效益 因此，拟议的研究与 NHLBI 的战略愿景非常一致。