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)，虽然通常被认为是最轻微的创伤性脑损伤(TBI)，但 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 在高中和大学运动员中，每年有380万人发生SRC。运动员急性发作 脑震荡具有广泛的临床症状和体征，包括心理困扰、认知障碍、 损害和躯体症状。在某些情况下，这些症状会持续存在，轻度脑外伤患者可能会 患神经退行性疾病的风险更高，未来的脑损伤，以及在反复损伤的情况下，慢性损伤 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的病理生理基础及术后生理恢复的时间进程 受伤情况尚不清楚。目前迫切需要解决长期的异质性问题。 SRC促进脑震荡治疗的后果。这项拟议的研究旨在了解为什么 一些脑震荡运动员的恢复时间延长了，更重要的是，如何检测到这种极端情况 案子。 弥漫性轴索损伤通常被认为是与轻度白质神经病变相关的最初的白质神经病理。 TBI。然而，在人类轻度脑损伤中，这种微观损伤更难检测到。现代扩散磁共振成像 技术为描述白质改变提供了更高的生物学特异性。因此，目标是 拟议的研究旨在确定这些新的轴突指标：(1)是否提供了间接证据 人类SRC中的弥漫性轴突损伤；(2)有助于解释个体恢复轨迹的异质性；以及(3) 提示我们对SRC轴突损伤与其临床表现的关系的认识。

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.