Advanced Morphological Analysis of Cerebral Blood Flow for Acute Concussion Diagnosis

 描述(申请人提供)：仅在美国，每年就有160至380万人遭受轻度创伤性脑损伤(TBI)。目前的诊断和重返参与指南是基于患者症状、神经认知评估和/或体能测试。由于人们在这些测试中的内在能力差异很大，许多这些诊断方法都存在主观、不准确或要求(受伤前)基线的问题。因此，不能及时诊断 绝大多数患有轻度脑外伤的患者。本项目旨在开发一种基于患者受伤后生理变化的轻型创伤性脑损伤(轻度TBI)的客观诊断。该方法基于对脑震荡后众所周知的生理变化的量化，即自主神经功能受损和脑血流改变(CBF)。该方法的创新之处在于使用了最近开发的分析框架来分析CBF速度(CBFV)波形。与以前使用的方法不同，该方法利用复杂CBFV波形的整个形状，从而获得在其他分析方法中丢失的血流变化的细微变化。在该项目的第一阶段，将在洛杉矶地区的高中运动员中进行一项小型研究，以证明所提出的方法的可行性。第一阶段的目标是开发能够在准确率达到90%或更高的研究中诊断脑外伤的指标。第二阶段的工作将侧重于开发一种精确度更高的便携式诊断设备，适用于现场应用(医院外)。拟议工作的成功完成将导致便携式、客观的轻微脑损伤诊断的开发，该诊断可以用于非临床环境，具有极大地改善各行各业脑损伤患者护理的潜力。

 DESCRIPTION (provided by applicant): Each year, between 1.6 and 3.8 million people each year suffer a mild traumatic brain injury (TBI) in the US alone. Current diagnosis and return-to-participation guidelines are based on patient symptoms, neurocognitive evaluations, and / or physical performance testing. Many of these diagnostic methods suffer from the problem of being subjective, inaccurate, or requiring baseline (before injury) due to large variations in people's inherent ability to perform in these tests. Thus the timely diagnosis is unavailable for a vast number of patients who suffer mild TBI. This project is aimed at developing an objective diagnosis of mild traumatic brain injury (mild TBI) based on physiologic changes in a patient after injury. The method is based on quantification of well-known physiologic changes after a concussion, i.e. the impairment of autonomic function and altered cerebral blood flow (CBF). The novelty of the proposed approach is the use of a recently-developed analytical framework for the analysis of the CBF velocity (CBFV) waveforms. In contrast to previous methods used before, the proposed approach utilizes the entire shape of the complex CBFV waveform, thus obtaining subtle changes in blood flow changes that are lost in other analysis methods. In Phase I of this project, feasibility of the proposed method will be demonstrated using a small study among high school athletes in the Los Angeles region. The objective of Phase I is to develop metrics that can diagnose TBI among studies with an accuracy of 90% or better. Phase II work will focus on developing a portable diagnostic device with improved accuracy, suitable for use in field applications (outside of hospitals). Successful completion of the proposed work will lead to the development of a portable, objective mild TBI diagnostic that can be used in non-clinical settings, that has the potential to vastly improve TBI patient care in all walks of life.