Trajectories of Neuroimaging and Blood-Based Biomarkers After Remote Traumatic Brain Injury and Associations with Dementia Risk
Abstract
Background/Rationale: Traumatic brain injury (TBI) is common, affecting both civilians and military Service Members, and is a major public health burden. The consequences from TBI can have long-lasting effects and multiple studies have identified that TBI is associated with an increased risk of later-life development of dementia. After TBI, there are measurable changes that indicate that, if the health of the brain is affected, two useful tools to identify these changes are blood-based biomarkers and brain magnetic resonance imaging (MRI). Blood-based biomarkers can be obtained from a simple blood draw where concentrations of certain biomarkers of brain health can be measured. MRI allows both a structural and functional look at the brain post- injury and there are a variety of sequences that can be used, each with their own strengths, that reveal different properties of brain health. Using these two tools, a significant amount of previous research has focused on the effects of TBI in the short-term time frame after injury (days to months post-injury) and the trajectory of neuroimaging and blood-based biomarkers is clearly established in this time period. However, there is limited research studying these two tools in the long-term post-injury time period, (i.e., decades after a TBI). Additionally, the relationship between these biomarkers over time and the risk of developing dementia among older individuals with prior TBI is not well established. Objectives: The overall objective of this proposal is to identify biomarkers of TBI-related dementia. Using existing data from one of the largest and most well characterized community-based prospective studies, the Atherosclerosis Risk in Communities (ARIC) Study, we will characterize trajectories of neuroimaging and blood-based biomarkers in the remote post-injury time-period (>5 years to decades) and investigate associations of biomarker trajectories with dementia risk among individuals with a history of TBI. The ARIC Study is comprised of nearly 16,000 community dwelling black and white adults (27% military veterans, 31% with prior head injury occurring approximately 32 years prior to the first biomarker assessment). Types of Patients That Will Be Helped by This Research and Clinical Applications, Benefits, and Risk: The work generated from this proposal has the potential to help anyone who has suffered from a TBI. There is limited information about the brain decades after a brain injury and this proposal will help to determine if the brain remains impacted by the TBI or if there is some improvement over time. Additionally, the work generated from this proposal has the ability to help develop clinical tools that can be used for more accurate diagnosis or treatment of TBI-related dementia. The potential risks of this proposal are minimal because only existing data will be used (no new participant recruitment). There will be no direct identifying information in the data used in order to minimize and breach of confidentiality risks. There is no anticipated direct benefit of this proposal to the ARIC Study participants, but there is potential to help the greater population at large and future generations in the prevention of TBI-related dementia. Timeline: The projected 3-year timeline for this award is feasible because we propose three aims using existing data from the ARIC Study. No new data will be collected, and no new participants will be recruited as part of this proposed project. Our study team has the expertise needed to carry out the proposed work, including expertise in TBI, dementia, MRI/neuroimaging biomarkers, blood-based biomarkers, and biostatistics. Alignment with FY22 TBIPHRP IIRA Focus Areas: This proposal is clearly aligned with the FY22 TBIPHRP IIRA’s intent, vision, mission, and focus areas as we propose to use existing data from the community-based ARIC cohort to identify trajectories of neuroimaging and blood-based biomarkers as
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310980
Entities
People
- Alexa Walter
Organizations
- United States Army
- University of Pennsylvania