Precursors and Prognosis of Traumatic Brain Injury in Young to Middle Aged Adults

描述（由申请人提供）：拟议的申请，题为青年至中年成人创伤性脑损伤的前兆和预后，旨在确定单一或重复创伤性脑损伤（TBI）是否会增加认知情绪，行为和日常功能的晚年衰退风险。该项目利用已有的健康、生活方式、生物标志物、遗传、认知和神经成像数据，并将其与美国国家神经疾病和中风研究所（NINDS）推荐作为通用数据元素（CDE）的新TBI数据的拟议采集相结合。这项研究标志着在以社区为基础的样本中系统收集TBI特定NINDS CDE的初步努力。此外，虽然开发风险特征评分的概念起源于心脏病研究并已被广泛使用，但风险特征评分尚未用于记录可能导致以下情况的活动： 影响暴露和TBI，以确定这些暴露是否会导致以后的生活后果。拟议的研究将获得详细的兵役，体育参与和就业历史，以回顾性地评估暴露于影响，并将确定在Fractionary Heart研究第3代（Gen 3; n=4095）及其较小的多种族Omni Generation 2（n=410; Omni Gen 2）队列中诊断的TBI的患病率。然后，我们将这些风险因素与现有的和新的计算机化认知测量方法相关联，以确定撞击暴露史和/或诊断的TBI是否与认知障碍和加速衰退相关。我们还将研究是否历史的影响暴露和/或诊断TBI与较小的脑容量和受损的白色物质的完整性，特别是在与记忆和执行功能的大脑区域。此外，我们还将探讨这些风险因素是否与情绪、行为和日常功能的变化有关。最后，我们将寻求确定与撞击暴露史和/或诊断的TBI相关的代谢和炎症生物标志物，以及特定的遗传标志物是否会改变TBI和慢性健康结果之间的关系。我们关注的是从事可能导致普通人群中的影响暴露和TBI的活动的潜在长期后果，这对公共卫生具有重大影响。

DESCRIPTION (provided by applicant): The proposed application, entitled Precursors and Prognosis of Traumatic Brain Injury in Young to Middle Aged Adults seeks to determine whether single or repeated traumatic brain injuries (TBI) increase risk for later life decline in cognition mood, behavior and daily function. This project leverages already available health, lifestyle, biomarker, genetic, cognitive and neuroimaging data and combines it with proposed acquisition of new TBI data recommended as Common Data Elements (CDE) by the National Institute of Neurological Disorders and Stroke (NINDS). This study marks an initial effort to systematically collect specific NINDS CDE on TBI in a community-based sample. Further, while the concept of developing risk profile scores originated within the Framingham Heart Study and have been widely used, risk profile scores have not been utilized for documenting activities that can lead to impact exposures and TBIs in order to characterize whether those exposures lead to later life consequences. The proposed study will obtain detailed histories of military service, sports participation, and employment to retrospectively assess exposure to impacts, and will also determine prevalence of diagnosed TBI in the Framingham Heart Study Generation 3 (Gen 3; n=4095) and its smaller multi-ethnic Omni Generation 2 (n=410; Omni Gen 2) cohorts. We will then relate these risk factors to available and new computerized measures of cognition to determine whether history of impact exposures and/or diagnosed TBI is associated with cognitive impairment and accelerated decline. We will also examine whether history of impact exposures and/or diagnosed TBI is associated with smaller brain volumes and compromised white matter integrity, particularly in the regions of the brain linked to memory and executive function. Further we will address the question of whether these risk factors are associated with changes in mood, behavior and daily functioning. Finally, we will seek to identify metabolic and inflammatory biomarkers associated with history of impact exposures and/or diagnosed TBI and whether specific genetic markers modify the relationship between TBI and chronic health outcomes. Our focus on the potential long-term consequences of engaging in activities that can lead to impact exposures and TBIs in the general population has significant implications for public health.