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)在美国是一个公共卫生问题，目前在40多个州生效的青少年脑震荡法律的公共卫生方法证明了这一点。由于对损伤的生理反应不同，年轻人被认为特别容易受到脑震荡的影响。对患有SRC的青年进行护理的一个关键方面是确定青年何时可以安全地重返他们的体育活动；与患有SRC的老年运动员相比，这在青年中是一个特别重要的决定，因为如果青年在SRC康复期间发生二次受伤，则发生灾难性后果的风险增加。青年SRC的循证管理受到缺乏适合年龄的评估方法的限制，这些评估方法对评估脑生理恢复具有有效性。本项目的总体目标是评估一种新的、与临床相关的躯体感觉信息处理(SSIP)指标作为青年SRC和SRC恢复的生物标志物的实用性，并与评估SRC的神经学基础和SRC恢复相关。SSIP测试电池利用廉价、便携的技术将振动触觉刺激传递到指尖，并且不需要基线数据，使其易于在学校和边远地区广泛使用。本研究的目的是：1)评价SSIP对青年SRC的敏感性和SRC的恢复情况；2)通过磁共振波谱(MRS)检测感觉运动皮质中GABA和谷氨酸的含量，探讨SSIP在青年SRC中的神经学基础。我们将在受伤后1周内和受伤后2-3周内对25名13-17岁的青少年进行SRC评估；第二次就诊时SRC仍有症状的青少年将在临床恢复后再次进行第三次就诊。我们将比较伤后1周内患有SRC的青少年与年龄和性别匹配的无脑震史的同行运动员的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的变化与SRC临床恢复和SRC持续症状的关系。最后，我们将评估SSIP或MRS GABA或谷氨酸的变化是否在SRC临床恢复后仍然存在，因为这可能是预测后续SRC的短期结果和/或出现晚期脑震荡相关缺陷(如慢性创伤性脑病)的标志。该项目将确定在青年SRC中使用这一新方法的进一步工作的效用。

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.