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

虽然轻度创伤性脑损伤（mTBI）已成为许多神经影像学研究的焦点， 理解mTBI，特别是在没有放射学证据显示损伤的患者中， 经历临床和认知症状，仍然是一个复杂的挑战。先进的成像工具 需要描绘出这些患者中存在的那种微妙的脑损伤，因为现有的工具是 通常不适合诊断mTBI。例如，常规磁共振成像（MRI） 研究集中于使用统计分析来寻找异常信号的空间一致模式 比较组间的平均差异，即，将mTBI与健康对照分开。虽然这些 虽然这些方法在许多疾病中是成功的，但它们在mTBI中不那么有用，其中脑损伤在空间上是 异质的 这项提案的目标是开发一个强大的框架来执行特定主题的神经成像 弥散MRI（dMRI）分析，因为这种方式对脑损伤表现出极好的敏感性， 定位常规临床神经放射学读数无法检测到的细微脑部异常。新 将开发算法来创建个性化脑异常（IBA）图， 临床和研究应用。在这项提案中，这项技术将被用来分析一个以前 从INTRuST临床联盟获得的数据集，该联盟是一个多中心研究受试者的研究项目， 创伤性应激障碍（PTSD）和mTBI。神经影像学异常测量将与临床 和神经心理学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，并建立神经影像学标志物之间的基线关系， 临床和认知测量。 该项目完成后，将提供一套工具，这些工具有可能建立放射性证据， mTBI中的脑损伤，将被设计和评估，从而提高诊断和 监测损伤的进展/恢复，以及评估治疗对受伤大脑的功效。 相关性（参见说明）： 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并不 灵敏度足以检测轻度创伤性脑损伤（mTBI）的细微病理。总体 该提案的目标是设计工具，从弥散MRI创建个性化的脑损伤图， 检测这些细微的异常，并帮助建立mTBI的成像和影像学之间的联系。

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.