Using Resting State Functional MRI to Predict Cognitive Decline among World Trade Center Responders

痴呆症是残疾和死亡的第五大常见原因，其终生风险为40%。 美国人口这是一种代价高昂的疾病，估计每年超过2360亿美元，是世界上 唯一的头号死因，既没有预防也没有治愈。痴呆症通常是 在此之前有轻度的认知障碍（CI）。该组织成员此前的研究表明， 调查小组发现，CI在世贸中心应急人员中更为常见， 相对于年龄匹配的标准样本，在两项独立的研究中约为12-14%。 此外，在斯托尼布鲁克健康监测的99名WTC应答者的不同样本中， 该团队还研究了一个程序（其中一半患有CI），降低了整体平均皮质厚度 脑梗死组21/34个亚区有增厚。虽然脑梗死的病因 在WTC反应者中，初步数据表明，阿尔茨海默氏症的神经病理学 可能是一个主要来源，反映在特定的认知领域的影响（例如，存储器）， 以及血浆生物标志物和内嗅和颞叶皮质萎缩。除了 结构神经成像数据，静息状态功能MRI（RS-fMRI）数据已获得 在99名WTC应答者的样本中，大约一半的人在 扫描（时间扫描）。鉴于最近关于遥感数据作为一组稳定的 为了了解疾病风险的生物标志物，这项提案首先寻求利用这些现有的生物标志物， 用于确定具有CI和不具有CI的RS连接性差异的数据，以及 与记忆和处理速度的关系。作为第二个目标，它将确定关系 在初次扫描后四年的RS-fMRI网络连接和认知指标中， 80名参与者（Time Ascan®Time Bcog）。作为一个探索性的目标，它将描述 25名认知能力不断下降的参与者的RS网络连接变化 25名认知能力持续未受损的患者在4年内接受了RS-fMRI检查 在两年的研究期间，在初次扫描（时间B扫描）后四年进行扫描。这些 结果将为一项研究提供信息，该研究旨在（用更大的样本）确定如何以及在多大程度上 RS fMRI指标可用于预测WTC应答者的认知变化。

Dementia is the fifth most common cause of disability and death with a lifetime risk of 40% in the U.S. population. It is a costly disease, with estimates exceeding $236 billion annually, and is the only top cause of death for which neither a prevention nor cure is available. Dementia is typically preceded by milder forms of cognitive impairment (CI). Previous research by members of this investigative team have found that CI is more common among World Trade Center responders, relative to age-matched normative samples, approximating 12-14% in two separate studies. Further, among a different sample of 99 WTC responders in the Stony Brook health monitoring program (half of whom had CI) also studied by this team, reduced global mean cortical thickness and thickness across 21/34 subregions was found among those with CI. While the etiology of CI among WTC responders is unknown, preliminary data suggests that Alzheimer’s neuropathology may be one major source, as reflected in specific cognitive domains impacted (e.g., memory), as well as plasma biomarkers and atrophy of enthorhinal and temporal cortices. In addition to structural neuroimaging data, resting state functional MRI (RS-fMRI) data have been acquired among a sample of 99 WTC responders, approximately half of whom had CI at the time of scanning (Time Ascan). Given recent findings on the significance of RS data as a stable set of biomarkers for understanding disease risk, this proposal seeks first to leverage these existing data for determining RS connectivity differences among those with and without CI, as well as relationships with memory and processing speed. As a second aim, it will identify relationships among metrics of RS-fMRI network connectivity and cognition four years following the initial scan among 80 participants (Time Ascan®Time Bcog ). As an exploratory aim, it will characterize changes in RS network connectivity among 25 participants with progressing cognitive decline over four years and 25 with continued unimpaired cognition over four years by adding a RS-fMRI scan four years following the initial scan (Time Bscan) during the two-year study period. These results will inform a study that will aim to identify (with a larger sample) how and to what extent RS fMRI metrics can be used for predicting cognitive change in WTC responders.