Neuropsychological Profile and Neurocognitive Biomarkers of Attention and Memory in Trauma-Exposed Responders at Risk of Premature Cognitive Decline

摘要 直接创伤暴露与负面的身心健康后果有关，包括 认知功能快速下降的风险增加，这可能在中年早期开始。此外，额外的寿命 COVID-19等创伤以及慢性疾病也被证明会加速认知老化。 在世界贸易中心恐怖袭击及其后果期间，成千上万的传统急救人员 和其他清理和恢复工作人员暴露在情感创伤和环境 有毒物质，他们有很高的比例，随后的身体和精神疾病。检测时间 认知能力下降是发病前较明显的症状，使潜在的神经退行性变 可能会延迟或减少。为了评估认知能力下降的风险，我们将使用远程基于网络的 评估最年轻的第一反应者核心认知功能的神经心理学任务（N= 1，200） 分两波相隔40个月不同程度的创伤暴露，以及随之而来的身体和精神 结果，这已被充分记录，可能意味着不同程度的过早认知能力下降的风险， 在我们的实验设计和分析模型中将考虑的响应者之间。我们计划 招募通过世贸中心健康计划获得健康服务的第一反应者，其中大多数人 是警察和非传统的救援，恢复和清理工作者，并比较认知的风险， 这些群体之间的差距。此外，一个响应者小组和额外的社区控制 （N=120）将参与使用EEG和MRI的神经认知研究，以阐明神经生物学 与过早认知衰退有关的机制。具体来说，我们将包括核心认知任务 （注意力和情景记忆），以确定早期认知变化和意志的神经基础 获取大脑形态和连通性的测量结果。这项研究将产生科学可靠的信息， 指导临床和公共卫生行动，重点关注最年轻人过早认知能力下降的问题 响应者。更好地了解过早认知衰退和最重要的途径 导致这种下降有可能改善干预措施，可以减少过早的认知下降， 这个和其他的同伙。

ABSTRACT Direct trauma exposure is associated with negative physical and mental health consequences, including an increased risk of rapid decline of cognitive function, which may start early in midlife. Moreover, additional life traumas such as COVID-19, as well as chronic illnesses, have also been shown to accelerate cognitive aging. During the World Trade Center terror attack and its aftermath, tens of thousands of traditional first responders and other cleanup and recovery workers were exposed to the emotional trauma and to environmental toxicants, and they had high rates of subsequent physical and psychiatric disorders. The time to detect cognitive decline is before the onset of more obvious symptoms, so that the underlying neurodegeneration may be delayed or lessened. To evaluate the risk of cognitive decline, we will use remote web-based neuropsychological tasks to assess core cognitive functioning among the youngest first responders (N=1,200) in two waves, 40 months apart. The different levels of trauma exposure, and consequent physical and mental outcomes, which have been well documented, may imply different levels of premature cognitive decline risk among the responders which will be considered in our experimental design and analytical models. We plan to recruit first responders who received health services through the WTC Health Program, a majority of whom were police and non-traditional rescue, recovery and cleanup workers, and compare the risk of cognitive decline between these groups. In addition, a sub-group of responders and additional community controls (N=120) will participate in a neurocognitive study using EEG and MRI to elucidate the neurobiological mechanisms associate with premature cognitive decline. Specifically, we will include core cognitive tasks (attention and episodic memory) to determine the neuronal underpinnings of early cognitive changes and will obtain measures of brain morphology and connectivity. This study will generate scientifically robust information to guide clinical and public health actions focused on premature cognitive decline among the youngest responders. A better understanding of premature cognitive decline and of the most important pathways causing such decline has the potential to improve interventions that can reduce premature cognitive decline in this and other cohorts.