CRCNS:Subject-Specific Difusion MRI Profiles of Injury in TBI and PTSD

虽然轻度创伤性脑损伤(MTBI)已成为许多神经成像研究的重点，但 对创伤性脑损伤的了解，特别是在没有表现出损伤的放射学证据的患者中 经历临床和认知症状，仍然是一个复杂的挑战。复杂的成像工具 就像现有的工具一样，需要描述在这些患者中存在的那种轻微的脑损伤 通常不适合诊断脊髓损伤。例如，常规磁共振成像(MRI) 研究的重点是使用统计分析来寻找异常信号的空间一致模式 这比较了不同组之间的平均差异，即从健康对照组中分离出mTBI。而这些 这种方法在许多疾病中都是成功的，但在脑损伤是空间上的脑损伤的mTBI中就不那么有用了 异质的。 这项提议的目标是开发一个强大的框架来执行特定于对象的神经成像 弥散磁共振成像(DMRI)分析，因为这种方式对脑损伤表现出极好的敏感性，并且可以 定位常规临床神经放射学读数未发现的细微脑部异常。新的 将开发算法来创建个性化脑异常(IBA)地图，该地图将具有 临床和研究应用。在这份提案中，这项技术将用于分析以前的 从InTrust临床联盟获得的数据集，这是一个多中心的努力，研究对象后- 创伤应激障碍(PTSD)和mTBI。神经影像异常测量将与临床挂钩 和神经心理评估。这项技术将使我们能够梳理出神经成像的差异 PTSD和mTBI之间的关系，并建立神经影像标志物之间的基线关系，以及 临床和认知测量。 在该项目完成后，一套工具有可能建立 将设计和评估mTBI中的脑损伤，从而提高诊断和 监测损伤的进展/恢复，以及评估对受伤大脑的治疗效果。 相关性(请参阅说明)： 标准临床护理的一个主要限制是常规用于诊断的成像方法不是 灵敏到足以检测轻微创伤性脑损伤(MTBI)的细微病理。最重要的是 这项提议的目标是设计工具，从扩散磁共振成像创建个性化的脑损伤地图，可以 检测这些细微的异常，并帮助在mTBI的影像和症状之间建立联系。

While mild traumatic brain injury (mTBI) has become the focus of many neuroimaging studies, the understanding of mTBI, particularly in patients who evince no radiological evidence of injury and yet experience clinical and cognitive symptoms, has remained a complex challenge. Sophisticated imaging tools are needed to delineate the kind of subtle brain injury that is extant in these patients, as existing tools are often ill-suited for the diagnosis of mTBI. For example, conventional magnetic resonance imaging (MRI) studies have focused on seeking a spatially consistent pattern of abnormal signal using statistical analyses that compare average differences between groups, i.e., separating mTBI from healthy controls. While these methods are successful in many diseases, they are not as useful in mTBI, where brain injuries are spatially heterogeneous. The goal of this proposal is to develop a robust framework to perform subject-specific neuroimaging analyses of Diffusion MRI (dMRI), as this modality has shown excellent sensitivity to brain injuries and can locate subtle brain abnormalities that are not detected using routine clinical neuroradiological readings. New algorithms will be developed to create Individualized Brain Abnormality (IBA) maps that will have a number of clinical and research applications. In this proposal, this technology will be used to analyze a previously acquired dataset from the INTRuST Clinical Consortium, a multi-center effort to study subjects with Post- Traumatic Stress Disorder (PTSD) and mTBI. Neuroimaging abnormality measures will be linked to clinical and neuropsychological assessments. This technique will allow us to tease apart neuroimaging differences between PTSD and mTBI and to establish baseline relationships between neuroimaging markers, and clinical and cognitive measures. Upon completion of this project, a set of tools, which have the potential to establish radiological evidence of brain injury in mTBI, will have been designed and evaluated, thereby enhancing both the diagnosis and monitoring of progression/recovery of injury, as well assessing the efficacy of therapies on the injured brain. RELEVANCE (See instructions): One major limitation to standard clinical care is that imaging methods used routinely for diagnosis are not sensitive enough to detect the subtle pathologies of mild Traumatic Brain Injury (mTBI). The overarching goal of this proposal is to design tools to create individualized brain injury maps from diffusion MRI that can detect these subtle abnormalities, and help establish a link between imaging and symptomatology in mTBI.