Understanding the Cognitive and Neural Consequences of Repetitive Head Impacts

项目摘要 头部受伤是一个重大的公共卫生问题。仅在美国，创伤性脑损伤（TBI） 每年有235，000人次到医院就诊。这些TBI中的大部分被归类为轻度（脑震荡; mTBI）。是 假设几个月后，患者逐渐恢复到发病前的状态，包括假设 认知完全恢复然而，关于人们是否会回到 损伤后表现的神经典型水平，或者mTBI是否存在持久的认知后果。在 在当前的环境下，没有长时间的监测，也没有干预来跟踪认知表现 经过几周的恢复期。这项提案调查了有mTBI病史的人是否 返回到工作记忆任务的神经典型水平，并评估神经连接以测试 表现是否与神经差异有关。工作记忆被选为一个实用的选择 因为它是一种重要的执行功能，可能会受到异质性损伤（如mTBI）的影响。 换句话说，大脑许多部位的损伤可能会导致工作记忆障碍，因此， 对不同个体的mTBI敏感。这里测试的人群包括慢性mTBI和那些 在mTBI恢复的亚急性阶段。在培训补助金的F99和K 00阶段，我建议 我使用各种方法来研究这两个mTBI人群，以促进我的培训，包括 行为、HD-EEG、静息状态EEG、fMRI、DTI和神经心理学测试。在F99阶段， 建议（目标2），我将获得高级分析技能的培训，并与 校外同事我将开发与编码实验相关的技术技能，并将主题数据 超出我目前理解的统计方法。这些技能将使我更好地了解 在亚急性mTBI的认知恢复过程中出现的时间变化。我还将研究认知和 慢性mTBI人群中与损伤持续时间较长相关的神经缺陷。在K 00- 在本建议的第三阶段（目标3），我计划继续研究持久认知变化的程度 与轻度和中度TBI相关。扩展将使用不同的神经措施，如休息 状态fMRI和DTI，以评估神经网络在损伤后如何受到影响，以及哪些类型的变化 更能预测行为表现。拟议工作的短期目标是了解 与轻度和中度TBI相关的认知和神经后果。这一长期目标 作为一名未来的独立研究人员，我将开发和完善干预措施，以解决认知问题， 在mTBI和TBI人群中的表现。这笔资金将使我能够取得重大进展， 我的长期目标。

Project Summary Head injury is a major public health issue. In the United States alone, traumatic brain injury (TBI) causes 235,000 hospital visits, each year. The bulk of these TBI are categorized as mild (concussion; mTBI). It is assumed that after a few months patients gradually return to their premorbid states including the assumption of full cognitive recovery. However, there is a fundamental gap in knowledge as to whether people return to neurotypical levels of performance post-injury, or whether there are lasting cognitive consequences of mTBI. In the current environment, there is no prolonged monitoring and no intervention to track cognitive performance beyond the several week recovery period. This proposal investigates whether people with a history of mTBI return to neurotypical levels of performance on working memory tasks and evaluates neural connectivity to test whether performance is related to neural differences. Working memory is selected as a practical selection because it is an important executive function that could be impacted by a heterogeneous injury such as mTBI. In other words, damage to many parts of the brain could contribute to working memory impairment, thus it would be sensitive to different individual’s mTBI. The populations tested here include chronic mTBI and those in the subacute stage of mTBI recovery. Over both the F99 and K00 phases of the training grant I propose to study both of these mTBI populations using a variety of methodologies to advance my training, including behavioral, HD-EEG, resting state EEG, fMRI, DTI, and neuropsychological tests. In the F99-phase of this proposal (Aim 2), I will gain training in advanced analysis skills and develop additional collaborations with extramural colleagues. I will develop technical skills associated with coding experiments and I will subject data to statistical approaches beyond my current understanding. These skills will allow me to better understand the temporal changes that unfold during cognitive recovery in subacute mTBI. I will also study the cognitive and neural deficits associated with a longer duration since injury in the chronic mTBI population. During the K00- phase of this proposal (Aim 3), I plan on continuing to investigate the extent of enduring cognitive changes associated with mild and moderate TBI. The extension will be to use different neural measures such as resting state fMRI and DTI to assess how neural networks are impacted following injury and which types of changes are more predictive of behavioral performance. The short-term goal of the proposed work is to understand the cognitive and neural consequences associated with mild and moderate forms of TBI. This long-term goal of mine, as a future independent researcher, will be to develop and refine interventions to address cognitive performance in the mTBI and TBI populations. This grant would allow me to make significant progress toward my long-term goal.