Understanding the Cognitive and Neural Consequences of Repetitive Head Impacts

项目摘要 头部损伤是一个重大的公共卫生问题。仅在美国，创伤性脑损伤(TBI)导致 每年有23.5万人次去医院就诊。这些颅脑损伤大部分被归类为轻度(脑震荡；mTBI)。它是 假设患者在几个月后逐渐恢复到发病前的状态，包括假设 认知完全恢复。然而，关于人们是否会重返地球，在知识上存在一个根本性的差距 损伤后的神经典型表现水平，或者mTBI是否有持久的认知后果。在……里面 在目前的环境下，没有长期的监测和干预来跟踪认知表现 超过了几周的恢复期。这项提案调查了有mTBI病史的人 恢复到工作记忆任务的神经典型水平，并评估神经连通性以进行测试 表现是否与神经差异有关。工作记忆被选为一种实用的选择 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受损，因此 会对不同个体的mTBI敏感。这里测试的人群包括慢性mTBI和那些 亚急性期mTBI恢复期。在F99和K00两个阶段的培训补助金上，我建议 使用各种方法研究这两个mTBI人群，以推进我的培训，包括 行为、HD-EEG、静息状态EEG、功能磁共振成像、DTI和神经心理测试。在此的F99阶段 提议(目标2)，我将接受高级分析技能培训，并与 校外同事。我将发展与编码实验相关的技术技能，我将研究数据 统计方法超出了我目前的理解。这些技能将使我更好地理解 亚急性颅脑损伤患者认知恢复过程中的时间变化。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K00期间- 在本提案阶段(目标3)，我计划继续调查持久认知变化的程度 与轻度和中度创伤性脑损伤相关。扩展将是使用不同的神经测量方法，如休息 说明功能磁共振成像和DTI，以评估损伤后神经网络受到的影响以及哪些类型的变化 对行为表现的预测性更强。拟议工作的短期目标是了解 与轻度和中度脑损伤相关的认知和神经后果。这一长期目标是 作为一名未来的独立研究人员，我将开发和改进干预措施，以解决认知 在mTBI和TBI人群中的表现。这笔赠款将使我在以下方面取得重大进展 这是我的长期目标。

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.