Developing and validating blood and imaging BIOmarkers of AXonal injury following Traumatic Brain Injury

创伤性脑损伤（TBI）发生在大脑受到物理损伤时，例如车祸后。这是常见的，幸存者往往有严重的持续问题。很难预测病人在脑外伤后的情况。其中一个原因是我们无法测量创伤性脑损伤的所有影响。一个重要的因素是神经细胞之间的连接受到脑损伤（轴索损伤）的影响而受损。这种损伤在过去很难测量，但扫描大脑的新方法和更敏感的血液损伤检测方法可能会改变这种情况。在医学的其他部分，这种类型的测试对我们如何治疗病人产生了巨大的影响。例如，泄漏到血液中的心肌损伤产物可以用来识别心脏病发作并指导治疗。我们需要在TBI中使用类似的测试。这应该是可能的，因为轴突损伤的产物也会渗漏到血液中，我们有一种灵敏的方法来检测它。对轴索损伤的准确检测将指导治疗选择，并使我们能够预测患者将如何恢复。我们汇集了一个国际团队，他们多年来一直在研究这个问题的不同方面。我们将共同进行一项大型研究，以确定轴索损伤的最佳措施。我们将仔细测试这些措施是否有助于我们预测结果，并将研究血液标记物的来源，使用一种安全的方法来测量直接来自大脑的轴突损伤的影响。这项工作与一些已经开始的大型项目相关联，并将使用一种标准的方法来评估受伤后的患者。这很重要，因为它将使我们能够在不同的研究中分享结果。我们希望这项工作将使我们能够确定TBI的血液标记物，该标记物可以广泛用于快速识别轴索损伤的存在。我们还将展示哪种脑成像方法最能发现轴突损伤，以及如何最好地结合这些方法来预测患者的康复情况。这将使医生能够更准确地诊断创伤性脑损伤后的问题，选择正确的治疗方法，并就出院后的情况向患者及其家属提供准确的建议。

Traumatic brain injury (TBI) occurs when the brain is physically damaged, for example after a car crash. It is common and survivors often have major on-going problems. It is very difficult to predict how patients will do after TBI. One reason for this is that we are unable to measure all the effects of TBI. An important factor is that the connections between nerve cells are damaged by the impact on the brain of an injury (axonal injury). This damage has been difficult to measure in the past, but new ways to scan the brain and more sensitive ways of picking up the effects of this injury in the blood could change this. In other parts of medicine tests of this type have had a dramatic effect on how we treat patients. For example, the products of heart muscle damage that have leaked into the blood can be used identify a heart attack and guide treatment. We need similar tests to be available in TBI. This should be possible as the products of axonal injury also leak into the blood and we have a sensitive way to pick this up. An accurate test for axonal injury would guide treatment choices and allow us to predict how patients will recover. We have brought together an international team who have been working on different aspects of this problem for many years. Together we will conduct a large study to identify the best measures of axonal injury. We will carefully test whether these measures help us predict outcomes and will study where the blood markers come from using a safe method to measure the effects of axonal injury directly from the brain. The work links into some large projects that have already started and will use a standard way to assess patients after their injury. This is important because it will allow us to share results across studies. We hope the work will allow us to identify a blood marker for TBI that could be widely used to quickly identify the presence of axonal injury. We will also show what brain imaging measure is best at picking up axonal injury and how best to combine the measures to best predict how patients recover. This will allow doctors to diagnose problems after TBI more accurately, choose the right treatments and give patients and their families accurate advice about what will happen after discharge from hospital.