Neuroimaging Methods for Diagnosis of Mild Traumatic Brain Injury

描述(由申请人提供)： 摘要/项目摘要轻度创伤性脑损伤(MTBI)是最近在伊拉克和阿富汗服役的退伍军人的主要发病率来源。使用弥散张量成像(DTI)来评估与mTBI相关的脑白质损害已经引起了人们的浓厚兴趣。该建议的目标是通过与一大批非脑外伤退伍军人进行比较，在单个受试者中提供脑白质损伤的定量评估和可视化。我们的方法包括执行全脑分析以创建FA(分数各向异性)图，该图通过与100名参照组的平均FA进行比较，提示单个受试者的脑白质损伤。我们提出了用于显著性检验的初步和验证性分析方法：(I)使用一种称为置换检验的非参数统计方法，然后对多个比较测试进行一种新颖的无阈值校正；(Ii)使用基于总体的推理统计来计算全脑Z-统计图，然后对多个比较进行更典型的基于聚类的校正。我们的初步数据表明，可以在单个受试者中有效地评估脑白质损伤。因此，我们的建议超越了将DTI应用于mTBI研究的传统方法，以进行小组比较。如果成功并在更大规模的研究中得到证实，我们提出的方法将为临床诊断单个mTBI患者提供客观的损伤证据。

DESCRIPTION (provided by applicant): Abstract / Project Summary Mild traumatic brain injury (mTBI) is a source of major morbidity in recent veterans who served in Iraq and Afghanistan. There has been keen interest in using diffusion tensor imaging (DTI) to assess white matter damage associated with mTBI. The goal of this proposal is to provide quantitative assessment and visualization of white matter damage in a single subject that is based on comparison to a large reference group of non-TBI veterans. Our approach involves performing a whole-brain analysis to create an FA (fractional anisotropy) map that is suggestive of white matter injury in a single subject by comparison to mean FA from a reference group of 100 subjects. We propose primary and confirmatory analytic methods for significance testing: (i) using a method of non-parametric statistics known as permutation testing followed by a novel "threshold-free" correction for multiple comparison testing, and (ii) using population based inferential statistics to compute whole brain Z-statistic map followed by more typical cluster-based correction for multiple comparisons. Our preliminary data suggests that white matter damage can be effectively assessed in single subjects. Thus, our proposal moves beyond the conventional application of DTI to mTBI research for making group comparisons. If successful and then confirmed in a larger scale study, the approach we propose would provide objective evidence of injury for diagnosing individual patients with mTBI in the clinical setting.