Somatosensory Processing-Assessing Youth Sport-Related Concussion and Recovery

描述（由申请人提供）：青少年运动相关脑震荡（SRC）是美国的一个公共卫生问题，目前在40多个州生效的青少年脑震荡法的公共卫生方法证明了这一点。由于对受伤的生理反应不同，年轻人被认为特别容易受到脑震荡的伤害。对患有SRC的青少年进行护理的一个关键方面是确定青少年何时可以安全返回体育活动；与患有SRC的老年运动员相比，这对年轻人来说是一个特别重要的决定，因为如果在SRC康复期间发生第二次损伤，年轻人发生灾难性后果的风险会增加。青少年SRC的循证管理受到限制，因为缺乏与年龄相适应的有效评估脑生理恢复的评估方法。该项目的总体目标是评估一种新的、与临床相关的体感信息处理（SSIP）测量方法作为青年SRC和SRC恢复的生物标志物的效用，并与评估SRC的神经基础和SRC恢复相关。SSIP测试电池使用廉价、便携的技术向指尖传递振动触觉刺激，不需要基线数据，因此可以广泛应用于学校和场边。本项目的目的是：1)评估SSIP对青少年SRC的敏感性和SRC的恢复情况；2)通过磁共振波谱（MRS）评估感觉运动皮层中GABA和谷氨酸的含量，评估患有SRC的青少年SSIP的神经学基础。我们将在伤后1周内评估25名13-17岁的青年SRC，并在伤后2-3周内再次评估；在第二次访视时仍有SRC症状的青少年将在临床康复后进行第三次访视。我们将比较受伤后1周内患有SRC的青年运动员的SSIP、MRS GABA和谷氨酸与年龄和性别匹配的无脑震荡史的同龄运动员的SSIP和MRS GABA和谷氨酸，并评估SSIP与MRS GABA和谷氨酸的相关性。我们将评估SSIP和MRS变化与SRC临床恢复和SRC持续症状的关系。最后，我们将评估即使在SRC临床恢复后，SSIP或MRS GABA或谷氨酸的改变是否仍然存在，因为这可能是预测随后SRC和/或晚期脑震荡相关缺陷（如慢性创伤性脑病）出现的短期结果的标志。该项目将确定在青少年SRC中使用这种新方法的进一步工作的实用性。

DESCRIPTION (provided by applicant): Youth sports-related concussion (SRC) is a public health problem in the United States, as evidenced by the public health approach of youth concussion laws which are now in effect in more than 40 states. Youth are felt to be particularly vulnerable to concussion, due to differences in physiological response to injury. One of the critical aspects of care for youth with SRC is determining when it is safe for youth to return to their sports activities; this is a particularly important decision in youth, compared to older athletes with SRC, because youth are at increased risk for catastrophic outcomes if a second injury is incurred during recovery from SRC. Evidence-based management of youth SRC is limited by the lack of age-appropriate evaluation methods with validity for assessing recovery of brain physiology. The overall goal of this project is to evaluate the utility of a novel, clinicall-relevant measure of somatosensory information processing (SSIP) as a biomarker for youth SRC and recovery from SRC with relevance for evaluating the neurologic basis of SRC and recovery from SRC. The SSIP testing battery makes use of inexpensive, portable technology to deliver vibrotactile stimuli to the fingertips and does not require baseline data, making it readil applicable for widespread use in schools and on sidelines. The aims of this project are to 1) evaluate the sensitivity of SSIP to youth SRC and recovery from SRC and 2) to assess the neurological basis of SSIP in youth with SRC through magnetic resonance spectroscopy (MRS) evaluation of GABA and glutamate in sensorimotor cortex. We will evaluate 25 youth aged 13-17 years with SRC within 1 week post-injury and again 2-3 weeks post-injury; youth who remain symptomatic from SRC at the second visit will return for a third visit after they have achieved clinically recovery. We will compare SSIP and MRS GABA and glutamate in youth with SRC within 1 week post-injury to that of age- and gender-matched peer athletes with no history of concussion and will evaluate for correlation of SSIP with MRS GABA and glutamate. We will evaluate changes in SSIP and MRS in association with clinical recovery from SRC versus persisting symptoms from SRC. Lastly, we will evaluate whether alterations in SSIP or MRS GABA or glutamate persist even after clinical recovery from SRC, as this may represent a marker for predicting short-term outcome from subsequent SRC and/or emergence of late concussion-related deficits (such as chronic traumatic encephalopathy). This project will determine the utility of further work using this novel methodology in youth SRC.