Comprehensive White-matter Microstructure-informed Analytical Methods to Elucidate Neurobiological Mechanisms of Sports-related Concussion (SRC)

项目摘要 运动相关脑震荡（SRC），虽然通常被认为是创伤性脑损伤（TBI）的最温和形式， 然而，这是一个重大的公共卫生问题。根据疾病控制中心的估计，1.6 每年在高中和大学运动员中发生380万次SRCs。运动员持续急性 脑震荡具有广泛的临床体征和症状，包括心理困扰、认知障碍、 损伤和躯体症状。在某些情况下，这些症状持续存在，轻度TBI的人可能 神经退行性疾病，未来TBI的风险较高，在重复性损伤的情况下，慢性 创伤性脑病虽然标准化的评估工具在临床管理中是有用的， 急性脑震荡，SRC的潜在病理生理学和生理恢复后的时间过程， 受伤情况尚不清楚。迫切需要解决长期的异质性问题 SRC的后果，以促进脑震荡管理。这项拟议中的研究旨在了解为什么 一些脑震荡的运动员有延长的恢复时间，更重要的是，如何检测这种极端 例 弥漫性轴索损伤通常被认为是与轻度脑梗死相关的初始白色神经病理学。 创伤性脑损伤然而，这种微观损伤在人类轻度TBI中更难以检测。现代弥散磁共振成像 技术提供了用于描述白质改变的增加的生物特异性。因此， 拟议的研究是确定这些新的轴突指标是否：（1）提供间接证据， 人类SRC中弥漫性轴索损伤;（2）有助于解释个体恢复轨迹的异质性;（3） 了解SRC轴索损伤与临床表现的关系。

Project Abstract Sports-related concussion (SRC), while often regarded as the mildest form of traumatic brain injury (TBI), is nevertheless a significant public health issue. Based on the estimates by the Centers for Disease Control, 1.6 to 3.8 million SRCs occur annually among high school and collegiate athletes. Athletes sustaining acute concussion have a wide spectrum of clinical signs and symptoms including psychological distress, cognitive impairment, and somatic symptoms. In some cases, these symptoms persist, and people with mild TBI may be at higher risk for neurodegenerative diseases, future TBI, and, in cases of repetitive injuries, chronic traumatic encephalopathy. While standardized assessment tools are useful in the clinical management of acute concussion, the underlying pathophysiology of SRC and the time course of physiological recovery after injury remain unclear. There is an immediate need to address the heterogeneity in the long-term consequences of SRC to facilitate concussion management. The proposed research aims to understand why some concussed athletes have prolonged recovery time and, more importantly, how to detect such extreme cases. Diffuse axonal injury is generally believed to be the initial white matter neuropathology associated with mild TBI. Nevertheless, this microscopic injury is more difficult to detect in human mild TBI. Modern diffusion MRI techniques offer increased biological specificity for describing white-matter alterations. Therefore, the goal of the proposed research is to determine whether these novel axonal metrics: (1) provide indirect evidence of diffuse axonal injury in human SRC; (2) help to explain heterogeneity in individual recovery trajectories; and (3) inform our understanding of the relationship between axonal injury in SRC and clinical manifestations of SRC.