EEG and MRI Biomarkers to Predict Post-traumatic Epilepsy

项目摘要 詹妮弗·A·金博士是耶鲁-纽黑文医院的重症神经病学家和神经学家。她的长期工作 职业目标是成为一名独立资助的翻译调查员，拥有信号处理方面的专业知识 应用神经生理学和神经影像资料确定危重患者继发性脑损伤的早期生物标志物 患者，特别是与创伤后癫痫有关的患者。创伤后癫痫是一种致残性并发症 创伤性脑损伤(TBI)。迫切需要寻找创伤后癫痫的生物标志物来识别 患者发生这种并发症的风险很高。这是一个早期生物标记物识别的群体 可以改善患者监测，并最终开发治疗方法，以避免癫痫的发生。邮寄- 创伤性癫痫导致本已很高的脑损伤发病率、致残率和成本进一步恶化 护理，从而强调预防这一并发症的重要性。我们需要找到最好的生物标记物 确定哪些最有可能从潜在的治疗中受益，并使此类治疗发现试验更多 可行。在拟议的培训期间，应聘者将扩展她对脑电信号的知识 处理和机器学习技术，并获得利用磁学进行神经成像分析的新技能 共振技术和生物统计学。为了实现这一目标，金博士召集了一支强大的 Hal Blumenfeld博士(主要导师)和共同导师Todd Conable博士的导师团队，Brandon Westover和Brian Edlow在研究癫痫的多模式方法方面拥有专业知识，功能磁共振 分析、计算脑电分析和结构脑损伤成像。在他们的指导下，金博士 建议：1)量化癫痫样异常(EA)频率并识别EA波形特征 最佳预测PTE，2)根据皮质厚度和挫伤评估是否直接海马区损伤 体积，分层PTE风险3)评估基于结构和功能的间接海马区损伤 磁共振连通性分析，预示PTE。总体目标是确定高危患者的早期生物标志物。 为创伤后癫痫的靶向开发抗癫痫的治疗方法。汇聚在一起 先进的神经生理学和神经成像分析以及这种强有力的指导支持，这个项目开始了 优化后续护理和推进所有创伤潜在治疗发展的新途径 脑损伤患者有患创伤后癫痫的风险。这项定义明确、以患者为中心的研究建议，在 配合导师指导和结构化的教学课程，将为Kim博士提供以下技能 对于在神经生理学和神经成像研究领域发展独立的职业生涯至关重要，这将转化为 改善患者的预后。

Project Summary Dr. Jennifer A. Kim is a critical care neurologist and neuroscientist at Yale-New Haven Hospital. Her long-term career goal is to become an independently funded translational investigator with expertise in signal processing of neurophysiologic and neuroimaging data to identify early biomarkers of secondary brain injury in critically ill patients, particularly related to post-traumatic epilepsy. Post-traumatic epilepsy is a disabling complication of traumatic brain injury (TBI). There is an urgent need to find biomarkers of post-traumatic epilepsy to identify patients at high risk for developing this complication. It is a population in which early biomarker identification could improve patient monitoring and ultimately treatment development to circumvent epileptogenesis. Post- traumatic epilepsy contributes to worsening of the already high rates of TBI morbidity, disability and cost of care, thus emphasizing the importance of preventing this complication. We need to find biomarkers to best define those most likely to benefit from potential treatments and make such treatment discovery trials more feasible. During the proposed training period, the candidate will expand upon her knowledge of EEG signal processing and machine learning techniques and acquire new skills in neuroimaging analysis using Magnetic Resonance technologies and biostatistics. To accomplish this, Dr. Kim has brought together a strong mentorship team of Dr. Hal Blumenfeld (primary mentor) and co-mentors Drs. Todd Constable, Brandon Westover and Brian Edlow who have expertise in multi-modal approaches to studying epilepsy, functional MRI analysis, computational EEG analysis and structural TBI imaging, respectively. Under their mentorship, Dr. Kim proposes to: 1) quantify epileptiform abnormality (EA) frequency and identify EA waveform features that optimally predict PTE, 2) determine if direct hippocampal injury, assessed by cortical thickness and contusion volume, stratifies PTE risk 3) assess whether indirect hippocampal injury, based on structural and functional MRI connectivity analyses, portend PTE. The overall goal is to identify early biomarkers of patients at high risk for post-traumatic epilepsy to target development of anti-epileptogenesis treatments. Bringing together advanced neurophysiologic and neuroimaging analysis and this strong mentorship support, this project opens new avenues for optimizing follow-up care and advancing potential treatment development for all traumatic brain injury patients at risk for post-traumatic epilepsy. This well-defined patient-oriented research proposal, in concert with the mentorship and structured didactic curriculum, will provide Dr. Kim with the skills that are essential to develop an independent career in neurophysiological and neuroimaging research that translates to improving patient outcomes.