Cortical GABA in pediatric sports concussion

描述（由申请人提供）：儿童脑震荡仍然没有可靠的扫描工具来成像损伤或指导治疗。以往的MRI研究使用的方法，如弥散张量成像、功能MRI和功能连通性MRI，还不够敏感或特异性，无法用于临床扫描。磁共振光谱可以测量大脑部分区域的化学成分。磁共振光谱的最新进展允许检测神经递质的水平，包括γ -氨基丁酸（GABA），这是一种广泛的抑制性递质。GABA功能对认知至关重要，可能在创伤中出现异常。异常的GABA水平可能会损害损伤动物模型的恢复。我们的团队结合了一个专门的运动脑震荡项目，一个与西门子医学成像集团合作的正在进行的工作，一个先进的成像系统（3T磁铁和32通道头线圈）以及一个具有儿科神经成像专业知识的放射学研究小组。我们将通过在严格定义的儿童运动脑震荡人群中开发和研究GABA的MR光谱来解决几个研究领域的兴趣，并进行适当的控制。我们的第一个目标是通过将研究方案应用于最先进的临床扫描仪，在临床相关的时间范围内（30分钟）检测GABA水平。第二个目的是证明青少年脑震荡和非脑震荡之间GABA的差异。基于脑震荡后常见的工作记忆缺陷，我们将使用工作记忆的功能性MRI来定位测量区域，以确保我们对脑震荡中有风险的大脑区域敏感。在第三个目标中，GABA水平将与脑震荡后的记忆评估和其他MRI大脑结构和功能测量相关联。这些结果将构成未来临床试验的基础，显示GABA光谱在儿童脑震荡治疗中的效用。

DESCRIPTION (provided by applicant): Pediatric concussion remains without a reliable scanning tool to image injury or guide therapies. Previous studies with MRI use methods, such as diffusion tensor imaging, functional MRI and functional connectivity MRI, that have not yet been sensitive or specific enough to be used as clinical scans. MR spectroscopy allows measures of the chemical composition in parts of the brain. Recent advances in MR spectroscopy allow for the detection of levels of neurotransmitters, including gamma-amino butyric acid (GABA) which is a widespread inhibitory transmitter. GABA function is critical for cognition and may be abnormal in trauma. Abnormal GABA levels may impair recovery in animal models of injury. Our group combines a dedicated sports concussion program, a work-in-progress collaboration with Siemens Medical Imaging group, and an advanced imaging system (3T magnet with 32 channel head coil) along with a radiology research group with expertise in pediatric neuroimaging. We will address several areas of research interest by developing and studying MR spectroscopy of GABA in a tightly defined pediatric sports concussion population, with appropriate controls. Our first aim will detect GABA levels in a clinically relevant time fram (30 min) by applying research protocols to state-of-the art clinical scanners. The second aim will be to demonstrate the difference in GABA between adolescents with concussion and those without. We will use functional MRI of working memory to target the measurement areas to make sure we are sensitive to brain areas at risk in concussion, based on the common deficits in working memory seen after concussion. In the third aim, the GABA levels will be correlated with post-concussion memory assessments and other MRI brain measures of structure and function. These results will form the basis for future clinical trials showing the utility of GABA spectroscopy in the management of pediatric concussion.