我们要感谢加拿大卫生研究所（CIHR）和安大略省Neurotrauma基金会（ONF）已为这项研究提供资金的机构。

1。受伤前的神经心理学的Baseline Profile获取主题<ol><li>到达主体进行测试之前，确保所有设备的正常运行，准备进行测试，该房间是不必要​​的分心。 </li><li>在审查父母和当事人的同意，测量和记录受试者的身高，体重，头围。 </li><li>管理平衡的评估，同时受力板是站在下列条件的顺序为：A1 - 力板，睁眼; A2 - 力板，闭眼; A3 - 力板，而穿着的视觉冲突圆顶。 </li><li>广场AirexBalance垫力板和重复管理主体的立场上AirexBalance垫和力量结合板的顶部资产评估条件（A1 - A3的）的顶部。 </li><li>测量和记录手的握力和管理的左手和右手的沟槽pegboard测试。 </li><li>管理上跳垫的跳的考验，首先从一蹲的位置，然后反方向变动，完成3项试验，每个位置。 </li><li>进行腿部最大的自愿收缩测试使用力板和力量吧。 </li><li>神经心理测验电池管理按下列顺序根据评估手册说明：脑震荡后的量表修订;孩子情绪清单自我报告;惨败偏手性问卷;雷伊综合图测试：复制审判;言语流畅性测试;雷伊综合图测试：立即召回审判;言语工作记忆任务;雷伊听觉言语学习测试;雷伊综合图测试：延迟召回审判;雷伊综合图测试：识别审判;的Stroop颜色和Word测试;符号位数的方式测试;儿童颜色滑道测试;视觉工作记忆任务;雷伊听觉口语学习测验：延迟回忆;雷伊听觉口语学习测验：确认审判;儿童节奏的听觉串行注意任务（见的语言和视觉工作记忆任务的说明，图1）。 </li><li>以下相应的测试手册说明，在适当的神经心理测验得分。 </li><li>输入到数据库中的所有测试成绩。 </li></ol> 2。收购主体结构和功能磁共振成像基准图像<ol><li>在此之前的测试会议，通过电话进行MRI检查采访，以确保参与者可以放心地接受了核磁共振检查。 </li><li>在到达他们的测试会议，同意/同意的形式审查的主体和他们的父母（S），重复MRI检查，MRI机器和年龄适当的方式进行实验提供了一个彻底的方向和概述。问如果这个问题有任何疑问。 </li><li>有主题删除所有的金属饰品，配件及口袋对象。 </li><li>展示的主题是如何应对通过使用Lumitouch桨（MRI安全的“鼠标”，只与左，右按钮）的工作记忆任务期间提出的刺激。 </li><li>有主题的插入耳塞。 </li><li>让主体躺在扫描仪床上。 </li><li>头部的位置在头部线圈和稳定的头部使用泡沫插入提醒表带和整个额头。如果参加者需要矫正镜片，看到电脑屏幕上，配合适当的处方强度与MRI兼容的护目镜。 </li><li>移动到扫描仪扫描仪床。 </li><li>扫描仪和东方受镜头线圈工作记忆任务将被投影孔以外地方的视频画面。 </li><li>获取T1加权反转准备（3D SPGR IRprep）（见扫描参数为一个完整的描述见表1）使用三维扰相梯度结构图像。 </li><li>管理工作记忆任务，并收集了读数 7 /螺旋功能磁共振图像使用单次的T2 *加权成像。 </li><li>获取的FLAIR图像。 </li><li>获取PD/T2加权像使用双回波快速自旋回波（2D - FSE - XL）使用资产。资产是关闭的，如果是白质高信号的FLAIR图像上看到。 </li><li>获得T2 *加权使用召回梯度回波（GRE）的结构图像。 </li><li>如果时间允许），采用单杆双自旋回波回波平面成像，获取2弥散张量成像（DTI）的数据集（3。 </li><li>从扫描仪中取出的主题。 </li></ol> 3。记录的命中部队和方向的头，用头部撞击遥测（HIT）系统<ol><li>获得适当的配合为主体的脑袋上的曲棍球头盔。 </li><li>取下头盔和完全充电的电池，然后返回到头盔。 </li><li>确保头盔和HIT系统发送和接收数据，分别为前，收集游戏数据。 </li><li>在玩游戏，recordi收集数据吴每个曲棍球期间的停止和启动时间。 </li><li>发送数据通过同步机制使用互联网连接，以Simbex处理。 </li></ol> 4。表演邮政mTBI神经心理学后续试验<ol><li>就在同一天收到伤亡报告，完成与母公司的命中伤亡报告表，获得临床和功能细节方面的伤害。 </li><li>管理PCS - R的主题，并确定目前的症状的严重程度。 </li><li>大约1天伤后：管理PCS - R。如果症状尚未解决的（即没有恢复到基线水平），不管理全面的神经心理测试电池。 </li><li>如果主体的症状许可证，完成资产评估（参见1.3和1.4）和跳跃测试（参见1.6）。 </li><li>如果主题的症状许可，管理的腿最大的自愿收缩试验（见1.7）。 </li><li>如果主体的症状许可证是完成了一次物理测试，管理，语言和视觉工作记忆任务。 </li><li>继续管理PCS - R，直至症状消失（即恢复到基线水平）根据表2中所述的时间表。 </li><li>大约5天伤后：管理PCS - R。如果症状未解决的重复测试序列以上（参考4.3至4.6）。 </li><li>如果症状仍然没有解决，伤后7天之后继续管理PCS - R的每周一次，直到症状解决。 </li><li>对于科目，其症状已解决，请重复步骤1.2至1.9。 </li><li>进行结构和功能磁共振成像后续扫描会话（请参阅第5节）。 </li></ol> 5。获取结构和功能磁共振成像后mTBI后续图片<ol><li>附表后续伤后72小时内扫描会议的主题。 </li><li>重复步骤上面列出2.2-2.16。 </li><li>如果症状是在第一次未解决的后续扫描会话，安排第二，按照扫描会话，一旦症状得到解决，并重复步骤2.2-2.16上面列出。 </li></ol> 6。执行匹配控制主体的神经心理学后续试验<ol><li>检查所有受试者的年龄（即年，月）参加了实验，并产生潜在的年龄和性别匹配的对照组，根据生日相应的3个月内，在同一日历年内为每个mTBI主题列表。 </li><li>联系控制科目和时间安排测试会议。 </li><li>复制测试协议的后续会议的时间和数量方面的匹配mTBI主题。重复步骤1.2-1.16上述表示。例如，如果mTBI主体的症状在24小时内得到解决，他们只完成了一项跟进测试会议，包括整个神经心理学电池，然后复制这个协议与匹配的控制主体。 </li><li>进行结构和功能磁共振成像后续扫描会话（请参阅第7条）。 </li></ol> 7。获取的结构和功能磁共振成像对照主题图片<ol><li>重复步骤上面列出2.2-2.16。 </li><li>如果控制的主题是相匹配的一个mTBI的问题，完成了两个后续扫描会话由于悬而未决的症状，安排第二次测试会话匹配上面列出的会议之间的时间间隔（即天数），并重复步骤2.2-2.16。 </li></ol> 8。数据分析<ol><li>计算每个球员的头部获得哈工大系统，每个球​​员每场比赛的数据正常化的幅度和点击次数的描述性统计（平均数和标准差）。 </li><li>计算mTBI所有的每个神经心理测验得分和匹配的对照组从基线的变化评分。 </li><li>主体之间的因素（即mTBI与控制）和神经心理学测试性能的变化作为因变量来分析神经心理功能的效​​果mTBI执行组匹配的样本t检验。 </li><li>使用临床PD/T2-weighted的影像集，以生成全脑容积的措施，以衡量在全球的大脑立即mTBI后肿胀。 </li><li>对于每个mTBI主题，T1加权像被用来计算非线性形变场的免费使用两个计算组织体积的焦点变化。首先，注册基线扫描每个后续的扫描。其次，计算之间的变形对连续扫描，捕捉短期的扫描，扫描的差异。 </li><li>正确的电涡流扭曲和头部运动的英国贸工部的数据，和调整前的梯度方向计算扩散张量参数。 mTBI与非mTBI组研究，道基于空间统计（TBSS）最近由牛津大学第8组的介绍，使用方法。 </li><li> FLAIR图像和微出血在GRE图像识别任何的白质高信号分开那些经历过伤害后mTBI 9的正常脑白质区域。使用这些地点提取来自英国贸工部（各向异性分数，足总杯，平均扩散，研发，和径向扩散，DR）的量化措施。 </li><li>对于DTI分析，关联命中telemetery数据（即幅度和点击次数，以头）TBSS体素值，使用偏最小二乘多元分析方法10 - 13。偏最小二乘（PLS）是一个多元的技术，它可以识别全脑活动模式的实验条件或行为变化。 </li><li>通过预进程空间运行，以正确的头部运动的第一次成像，通过三维傅立叶变换插值coregistration从早期的基准量的fMRI图像。 </li><li>空间正常化运动校正后的图像到一个内部使用高斯滤波器的6毫米全宽半最大的12个参数的仿射变换的sinc插值和平稳增加信号噪音的功能磁共振成像螺旋模板比率。 </li><li>在每次运行中删除最初的五个形象卷，在瞬态信号的变化发生脑磁化强度达到稳定状态。 </li><li>使用统计参数图（SPM2）对应每个事件的发生时间确定图像的向量卷积的血流动力学响应函数（HRF），进入到一个明智的体素 14多元线性回归进行单因素分析。 </li><li>计算每个反映BOLD信号的变化，每个事件类型，相对于基线协变量的参数估计。 </li><li>使用体素水平的t -统计量进行对比，比较活动的大脑区域，不同的任务（例如，工作记忆与控制任务）和团体（如mTBI与控制）从事。 </li><li>从哈工大系统结构和功能神经影像数据（即平均每个球员的头部影响幅度）相结合的信息。为了评估这些相互关系，利用PLS分析。 </li><li>使用平均幅度为每个球员的头部影响运行行为的薪酬水平，这将涉及在大脑活动模式的差异，在工作记忆任务上的性能平均幅度。 </li></ol> 9。代表性的成果头部撞击遥测系统表3给出了图2所示的相应影响的定量数据记录。山顶直线加速线性加速过程中的影响是最大的一个球员的头部。单位是g的。一克是在海平面（每平方秒9.8米）的加速度重力。山顶的旋转加速度的加速过程中影响最大的一个球员的头部转动。单位为每平方秒的弧度。方位角是衡量影响的位置。方位是指0 ° -180 °至180 °在头部右侧头部和积极的方位角回。海拔是影响位置的其他措施。高程的定义是，从0 °（水平面，通过传递重力的头部中心）到90 °（头冠）。 功能磁共振成像图3描述了串行fMRI结果与症状的决议和B）与没有症状的决议）的脑震荡运动员。注：任务相关的大脑额叶区域活动，显然只有在观察运动员的症状决议。 <img src="/files/ftp_upload/2226/2226fig1.jpg" alt="图1" /> 图1。外部有序的工作记忆任务的示意图。 <img src="/files/ftp_upload/2226/2226fig2.jpg" alt="图2" /> 图2。哈工大系统数据的例子界面显示定向矢量表示为表3中所描述的六命中的位置。 Simbex 2006年。 <img src="/files/ftp_upload/2226/2226fig3.jpg" alt="图3" /> 图3。串行fMRI结果与症状的决议和B）与没有症状的决议）的脑震荡运动员。 PCS =脑震荡后的症状; N =科目;▲血氧变化的血氧水平依赖信号; DLPC =背外侧前额叶皮层。 <table border="1"><tbody><tr><td> 扫描类型 </td><td> 序列 </td><td> TE/TR/TI/FA1 </td><td> 矩阵/视野（厘米）2 </td><td> NEX3 </td><td> SLICË厚度/片</td><td> 其他 </td><td> 扫描时间 </td></tr><tr><td> T1加权</td><td>三维反演准备宠坏梯度回波（SPGR IRprep） </td><td> 5.9/1.3/300/20 </td><td> 256二十二分之一百六十○ </td><td> 2 </td><td> 1.4/128 </td><td></td><td> 7:30 </td></tr><tr><td> PD/T2加权</td><td>双回波快速自旋回波（FSE） </td><td> 20102 / 2.9s / </td><td> 256二十二分之一百九十二</td><td> 2 </td><td> 3 / 48 </td><td>交错</td><td> 12:00 </td></tr><tr><td> FLAIR </td><td> FSE - IRprep </td><td> 140/9.3s/2.2s / </td><td> 256二十二分之一百九十二</td><td> 1 </td><td> 3 / 48 </td><td></td><td> 4:12 </td></tr><tr><td>弥散张量</td><td>单杆，双自旋回波平面回波成像</td><td>最小/〜9 / </td><td> 12833分之128 </td><td> 2 </td><td> 2.6/50 + </td><td> B -值：1000 s/mm2 梯度方向：23 B0：2 周边浇注</td><td> 6:30 </td></tr><tr><td> T2 * </td><td>梯度回波</td><td>三百五十○分之二十/ / 20 </td><td> 256二十二分之一百九十二</td><td> 1 </td><td> 3 / 48 </td><td>交错</td><td> 4:30 </td></tr><tr><td>功能磁共振成像</td><td>单次T2 *，/读出螺旋</td><td> 30/2s / / 70 </td><td> 64二十○分之六十四</td><td></td><td> 5 / 26 </td><td>外围监测：呼吸，心脏</td><td> 12:00-15:00 </td></tr><tr><td> qT2 </td><td>潘和Henkleman </td><td>二千五分之一十/ </td><td> 128二十四分之一百二十八</td><td> 4 </td><td> 4 / 1 </td><td></td><td> 21:00 </td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td> 总计 </td><td> 70:42 </td></tr></tbody></table> 表1。3T序列的临床和功能磁共振扫描参数的详细信息。 1 TE（回波时间）TR（重复时间）; TI（反转时间）; FA（翻转角） 2视野（视野） 3国家执行（激发数） <table border="1"><tbody><tr><td> 时间 </td><td> 脑震荡后症状量表（PCS） </td><td> 工作 内存 任务 </td><td> 资产负债 </td><td> 协调 </td><td> 神经心理学 评估 </td></tr><tr><td> 基准年1 </td><td> X </td><td> X </td><td> X </td><td> X </td><td> X </td></tr><tr><td> 脑震荡后（PC）的第1天 </td><td> X </td><td> X </td><td> X </td><td> X </td><td></td></tr><tr><td> PC第2天 </td><td> X </td><td></td><td></td><td></td><td></td></tr><tr><td> 电脑每天3-4 </td><td> X </td><td></td><td></td><td></td><td></td></tr><tr><td> PC日5-6 </td><td> X </td><td> X </td><td> X </td><td> X </td><td></td></tr><tr><td> PC第7天 </td><td> X </td><td></td><td></td><td></td><td></td></tr><tr><td> 每周后第7天 </td><td> X </td><td></td><td></td><td></td><td></td></tr><tr><td> PCS的决议 </td><td> X </td><td> X </td><td> X </td><td> X </td><td> X </td></tr><tr><td> 基准年2 </td><td> X </td><td> X </td><td> X </td><td> X </td><td> X </td></tr></tbody></table> 表2。政府的所有科目的神经心理学措施。 注：每一个人的脑震荡主题将与骨科和无损伤对照组相匹配。对照组脑震荡的主题，它们是匹配的同一时间内将管理的措施。例如，如果一个脑震荡的主题，也将是管理经验丰富的决议第14天，骨科控制主体以及无损伤控制主体的PCS症状全面的神经心理评估上的第14天（即治疗，但他们的“PCS”症状解决第14天），以匹配数据点。 <table border="1"><tbody><tr><td> 活动日期 </td><td> 活动时间</td><td> 线性加速度峰值 </td><td> 旋转加速度峰值 </td><td> 方位角 </td><td> 海拔 </td></tr><tr><td> 2006-10-29 </td><td> 15:39:01:410 </td><td> 22.45 </td><td> 2842.32 </td><td> -67.30 </td><td> 29.05 </td></tr><tr><td> 2006-10-29 </td><td> 15:47:02:120 </td><td> 7.09 </td><td> 478.66 </td><td> -116.53 </td><td> -61.24 </td></tr><tr><td> 2006-10-29 </td><td> 16:21:40:190 </td><td> 15.25 </td><td> 1288.01 </td><td> -83.96 </td><td> -52.09 </td></tr><tr><td> 2006-10-29 </td><td> 16:48:31:910 </td><td> 8.91 </td><td> 603.32 </td><td> -134.04 </td><td> 16.33 </td></tr><tr><td> 2006-10-29 </td><td> 16:48:32:060 </td><td> 18.18 </td><td> 1256.09 </td><td> 60.36 </td><td> 10.36 </td></tr><tr><td> 2006-10-29 </td><td> 17:04:50:110 </td><td> 20.18 </td><td> 1093.22 </td><td> -4.47 </td><td> 50.31 </td></tr></tbody></table> 表3。样本收集到的数据从一个球员有一个头盔。

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T., Anderson, S., Gatlin, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+study+of+head+impacts+in+football:+a+comparison+of+National+Collegiate+Athletic+Association+Division+I+versus+high+school+impacts.">In vivo study of head impacts in football: a comparison of National Collegiate Athletic Association Division I versus high school impacts.</a> Neurosurgery. 60, 490-495 (2007).</li><li>Chen, J. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+abnormalities+in+symptomatic+concussed+athletes:+an+fMRI+study.">Functional abnormalities in symptomatic concussed athletes: an fMRI study.</a> Neuroimage. 22, 68-82 (2004).</li><li>Glover, G. H., Law, C. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spiral-in/out+BOLD+fMRI+for+increased+SNR+and+reduced+susceptibility+artifacts.">Spiral-in/out BOLD fMRI for increased SNR and reduced susceptibility artifacts.</a> Magn. Reson. Med. 46, 515-522 (2001).</li><li>Smith, S. M., Jenkinson, M., Johansen-Berg, H., Rueckert, D., Nichols, T. E., Mackay, C. E., Watkins, K. E., Ciccarelli, O., Cader, M. Z., Matthews, P. M., Behrens, T. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tract-based+spatial+statistics:+voxelwise+analysis+of+multi-subject+diffusion+data.">Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data.</a> Neuroimage. 31, 1487-1505 (2006).</li><li>Gibson, E., Gao, F., Black, S. E., Lobaugh, N. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Automatic+Segmentation+of+White+Matter+Hyperintensities+in+FLAIR+images+at+3T.">Automatic Segmentation of White Matter Hyperintensities in FLAIR images at 3T.</a> J. Magn. Reson. Imaging. , (2009).</li><li>McIntosh, A. R., Bookstein, F. L., Haxby, J. V., Grady, C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spatial+pattern+analysis+of+functional+brain+images+using+Partial+Least+Squares.">Spatial pattern analysis of functional brain images using Partial Least Squares.</a> NeuroImage. 3, 143-157 (1996).</li><li>McIntosh, A., Gonzalez-Lima, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Network+interactions+among+limbic+cortices,+basal+forebrain+and+cerebellum+differentiate+a+tone+conditioned+as+a+Pavlovian+excitor+or+inhibitor:+fluorodeoxyglucose+and+covariance+structural+modeling.">Network interactions among limbic cortices, basal forebrain and cerebellum differentiate a tone conditioned as a Pavlovian excitor or inhibitor: fluorodeoxyglucose and covariance structural modeling.</a> J. Neurophysiol. 72, 1717-1733 (1994).</li><li>McIntosh, A., Lobaugh, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Partial+least+squares+analysis+of+neuroimaging+data:+applications+and+advances.">Partial least squares analysis of neuroimaging data: applications and advances.</a> Neuroimage. 23, 250-263 (2004).</li><li>Frackowiack, R. S. J., Frith, C. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Human Brain Function. , (2003).</li></ol>

我们预测显示脑白质影响最大的青少年将显示大脑活动的最大的重组，最长的行为和神经恢复时期。这项研究将提供一个更好地了解小儿脑震荡后的事件和医疗上有重大影响，因为它将使我们能够建立一个回收协议，基于研究的证据表明，是儿童和青年的具体。这样一个协议，然后可以转换为利益相关者，包括父母，教练和医生。为了实现这些目标，我们将定性和量化，进一步在小儿脑震荡运动?...

<table border="1"><tbody><tr><td>名称</td><td>公司</td><td>评论</td></tr><tr><td> AccuGait便携式步态和平衡平台 （平衡评估） </td><td> AMTI </td><td> <a href="http://www.amti.biz/">www.amti.biz</a> </td></tr><tr><td> NetForce平衡数据采集软件</td><td> AMTI </td><td> <a href="http://www.amti.biz/">www.amti.biz</a> </td></tr><tr><td>视觉冲突半球</td><td></td><td>研究人员编造仿照：洛弗尔议员，柯林斯兆瓦。高校足球运动员的神经心理学评估。J头部外伤复健。 1998年，13（2）:9 - 26。 </td></tr><tr><td> AIREX平衡垫</td><td> AIREX </td><td> <a href="http://www.bebalanced.net/">www.bebalanced.net</a> </td></tr><tr><td> Smedlay的测功机，100公斤（握力） </td><td> TTM，东京</td><td></td></tr><tr><td>沟槽Pegboard测试</td><td>拉法耶特仪器公司</td><td> <a href="http://www.lafayetteinstrument.com/">www.lafayetteinstrument.com</a> </td></tr><tr><td>轴突跳转垫</td><td> Vacumed </td><td> <a href="http://www.vacumed.com/">www.vacumed.com</a> </td></tr><tr><td>强度大律师</td><td></td><td> 捏造的研究人员： <ul><li> 31“钛长曲棍球处理</li><li>两个40“实用链</li><li> 24“X 26”胶合板平台</li><li>两个码头环紧固件</li><li>两个U型螺栓（1“的宽度） </li></ul></td></tr><tr><td>头部撞击遥测（HIT）的系统</td><td> Simbex </td><td> <a href="http://www.simbex.com/">www.simbex.com</a> </td></tr><tr><td>修脑震荡后症状量表（PCS - R） </td><td></td><td>改编自： 洛弗尔议员，柯林斯兆瓦。高校足球运动员的神经心理学评估。J头部外伤复健。 1998年，13（2）:9 - 26。 </td></tr><tr><td>通用电气公司发现™MR750 3.0T核磁共振成像扫描仪</td><td>通用电气公司</td><td> <a href="http://www.gehealthcare.com/">www.gehealthcare.com</a> </td></tr><tr><td> GE 8通道头线圈</td><td>通用电气公司</td><td> <a href="http://www.gehealthcare.com/">www.gehealthcare.com</a> </td></tr><tr><td> Lumitouch回覆系统</td><td>光波医药工业</td><td>不列颠哥伦比亚省温哥华1-（604）-875-4529 </td></tr><tr><td>背投影屏幕（提出的fMRI刺激） </td><td>未知</td><td></td></tr><tr><td>一次性发泡耳塞</td><td> PAR公司</td><td> <a href="http://www.parinc.com/">www.parinc.com</a> </td></tr><tr><td>神经心理测验</td><td>皮尔逊评估</td><td> <a href="http://www.pearsonassessments.com/">www.pearsonassessments.com</a> </td></tr></tbody></table>

an investigation of the effects of sports-related concussion in youth using functional magnetic resonance imaging and the head impact telemetry system

在参与体育运动的孩子们最常见的受伤之一是脑震荡或轻度脑外伤（mTBI）1 。参与有组织的体育活动，如竞争曲棍球的儿童及青少年更容易出现剧烈震荡，在参与体力活动等休闲2的儿童相比，近6倍。而最常见的认知mTBI后遗症出现类似的儿童和成年人，恢复配置文件和广度儿童的后果在很大程度上仍然不明2，因为没有受伤前的特征（如性别）和受伤的细节（影响大小和方向长期结果的影响）。如曲棍球，竞技体育，允许利用一个前后期的设计，以获得在受伤前的数据，前脑震荡发生在青年的特点和运作，并与这结果损伤后的难得机遇。我们的首要目标是完善小儿脑震荡诊断和基于研究的证据表明，是儿童和青年的具体管理。要做到这一点，我们使用新的，多模式和一体化的方法，将： <ol><li>评估头部外伤的直接影响，在青年</li><li>监测脑震荡后症状的决议（PCS）和复苏过程中的认知表现</li><li>利用新的方法来验证性脑损伤和恢复</li></ol>为了实现我们的目标，我们已经实施的头部撞击遥测（HIT）的系统。 （Simbex;黎巴嫩，新罕布什尔州，美国）。该系统配备市售伊斯顿S9的曲棍球头盔（伊斯顿贝尔体育范Nuys，CA，美国）设计的单轴加速度计，实时头部加速度测量过程中接触的运动项目参与3 - 5。利用遥测技术，加速，并在参与体育活动的所有头影响的位置的大小，可以客观地检测和记录。我们还使用功能性磁共振成像（fMRI）定位和评估在颞额叶的神经活动的变化表现在认知任务，因为这些是最敏感震荡颅脑损伤6的脑区。最后，我们收购构造成像脑白质损伤的敏感数据。

Watch this Scientific Journal Video about An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System at JoVE

An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

本文提供了一个多模态的方法，轻度创伤性脑损伤的诊断和恢复在青年的概述。这种方法结合了神经心理测试，功能磁共振成像和头部撞击遥测系统，以监测在认知测试头的影响和大脑活动之间的关系。

在使用功能性磁共振成像和头部撞击遥测系统的青年与体育有关的震荡影响的调查

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth ...

an-investigation-effects-sports-related-concussion-youth-using

Research

JoVE Journal

Medicine

15.7K 次观看.  University of Toronto. 本文提供了一个多模态的方法，轻度创伤性脑损伤的诊断和恢复在青年的概述。这种方法结合了神经心理测试，功能磁共振成像和头部撞击遥测系统，以监测在认知测试头的影响和大脑活动之间的关系。

视频: An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

Purpose: An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that strain is a more sensitive and earlier marker for contractile dysfunction than the frequently used parameter EF. Current technologies for CMR are time consuming and difficult to implement in clinical practice. Feature tracking is a technology that can lead to more automization and robustness of quantitative analysis of medical images with less time consumption than comparable methods.
Methods: An automatic or manual input in a single phase serves as an initialization from which the system starts to track the displacement of individual patterns representing anatomical structures over time. The specialty of this method is that the images do not need to be manipulated in any way beforehand like e.g. tagging of CMR images.
Results: The method is very well suited for tracking muscular tissue and with this allowing quantitative elaboration of myocardium and also blood flow.
Conclusions: This new method offers a robust and time saving procedure to quantify myocardial tissue and blood with displacement, velocity and deformation parameters on regular sequences of CMR imaging. It therefore can be implemented in clinical practice.

An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that strain is a more sensitive and earlier marker for contractile dysfunction than the frequently used parameter EF.

磁共振衍生的心肌劳损评估使用特征跟踪

Purpose: An accurate and practical method to measure parameters like strain in myocardial tissue is of great clinical value, since it has been shown, that ...

科研

医学

Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases

Diffusion tensor imaging (DTI) techniques provide information on the microstructural processes of the cerebral white matter (WM) in vivo. The present applications are designed to investigate differences of WM involvement patterns in different brain diseases, especially neurodegenerative disorders, by use of different DTI analyses in comparison with matched controls. 	
DTI data analysis is performed in a variate fashion, i.e. voxelwise comparison of regional diffusion direction-based metrics such as fractional anisotropy (FA), together with fiber tracking (FT) accompanied by tractwise fractional anisotropy statistics (TFAS) at the group level in order to identify differences in FA along WM structures, aiming at the definition of regional patterns of WM alterations at the group level. Transformation into a stereotaxic standard space is a prerequisite for group studies and requires thorough data processing to preserve directional inter-dependencies. The present applications show optimized technical approaches for this preservation of quantitative and directional information during spatial normalization in data analyses at the group level. On this basis, FT techniques can be applied to group averaged data in order to quantify metrics information as defined by FT. Additionally, application of DTI methods, i.e. differences in FA-maps after stereotaxic alignment, in a longitudinal analysis at an individual subject basis reveal information about the progression of neurological disorders. Further quality improvement of DTI based results can be obtained during preprocessing by application of a controlled elimination of gradient directions with high noise levels.	
In summary, DTI is used to define a distinct WM pathoanatomy of different brain diseases by the combination of whole brain-based and tract-based DTI analysis.

Diffusion tensor imaging (DTI) basically serves as an MRI-based tool to identify in vivo the microstructure of the brain and pathological processes due to neurological disorders within the cerebral white matter. DTI-based analyses allow for application to brain diseases both at the group level and in single subject data.

磁共振扩散张量成像在神经退行性疾病的分析

Diffusion tensor imaging (DTI) techniques provide information on the microstructural processes of the cerebral white matter (WM) in vivo. The present ...

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport

Along with their traditional role as detergents that facilitate fat absorption, emerging literature indicates that bile acids are potent signaling molecules that affect multiple organs; they modulate gut motility and hormone production, and alter vascular tone, glucose metabolism, lipid metabolism, and energy utilization. Changes in fecal bile acids may alter the gut microbiome and promote colon pathology including cholerrheic diarrhea and colon cancer. Key regulators of fecal bile acid composition are the small intestinal Apical Sodium-dependent Bile Acid Transporter (ASBT) and fibroblast growth factor-19 (FGF19). Reduced expression and function of ASBT decreases intestinal bile acid up-take. Moreover, in vitro data suggest that some FDA-approved drugs inhibit ASBT function. Deficient FGF19 release increases hepatic bile acid synthesis and release into the intestines to levels that overwhelm ASBT. Either ASBT dysfunction or FGF19 deficiency increases fecal bile acids and may cause chronic diarrhea and promote colon neoplasia. Regrettably, tools to measure bile acid malabsorption and the actions of drugs on bile acid transport in vivo are limited. To understand the complex actions of bile acids, techniques are required that permit simultaneous monitoring of bile acids in the gut and metabolic tissues. This led us to conceive an innovative method to measure bile acid transport in live animals using a combination of proton (1H) and fluorine (19F) magnetic resonance imaging (MRI). Novel tracers for fluorine (19F)-based live animal MRI were created and tested, both in vitro and in vivo. Strengths of this approach include the lack of exposure to ionizing radiation and translational potential for clinical research and practice.

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport

Tools to diagnose bile acid malabsorption and measure bile acid transport in vivo are limited. An innovative approach in live animals is described that utilizes combined proton (1H) plus fluorine (19F) magnetic resonance imaging; this novel methodology has translational potential to screen for bile acid malabsorption in clinical practice.

使用多氟化胆汁酸和<em&gt;在体内</em&gt;磁共振成像来衡量胆汁酸运输

Along with their traditional role as detergents that facilitate fat absorption, emerging literature indicates that bile acids are potent signaling ...

Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle

Skeletal muscle mitochondrial oxidative phosphorylation (OXPHOS) capacity, which is critically important in health and disease, can be measured in vivo and noninvasively in humans via phosphorus-31 magnetic resonance spectroscopy (31PMRS). However, the approach has not been widely adopted in translational and clinical research, with variations in methodology and limited guidance from the literature. Increased optimization, standardization, and dissemination of methods for in vivo 31PMRS would facilitate the development of targeted therapies to improve OXPHOS capacity and could ultimately favorably impact cardiovascular health. 31PMRS produces a noninvasive, in vivo measure of OXPHOS capacity in human skeletal muscle, as opposed to alternative measures obtained from explanted and potentially altered mitochondria via muscle biopsy. It relies upon only modest additional instrumentation beyond what is already in place on magnetic resonance scanners available for clinical and translational research at most institutions. In this work, we outline a method to measure in vivo skeletal muscle OXPHOS. The technique is demonstrated using a 1.5 Tesla whole-body MR scanner equipped with the suitable hardware and software for 31PMRS, and we explain a simple and robust protocol for in-magnet resistive exercise to rapidly fatigue the quadriceps muscle. Reproducibility and feasibility are demonstrated in volunteers as well as subjects over a wide range of functional capacities.

Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle

This work demonstrates the feasibility of an in vivo phosphorus-31 magnetic resonance spectroscopy (31PMRS) technique to quantify mitochondrial oxidative phosphorylation (OXPHOS) capacity in human skeletal muscle.

磷31磁共振波谱分析：一种测量工具<em&gt;在体内</em&gt;线粒体氧化磷酸化能力人骨骼肌

Skeletal muscle mitochondrial oxidative phosphorylation (OXPHOS) capacity, which is critically important in health and disease, can be measured in vivo ...

Cardiac Magnetic Resonance Imaging at 7 Tesla

CMR at an ultra-high field (magnetic field strength B0&#160;&#8805; 7 Tesla) benefits from the signal-to-noise ratio (SNR) advantage inherent at higher magnetic field strengths and potentially provides improved signal contrast and spatial resolution. While promising results have been achieved, ultra-high field CMR is challenging due to energy deposition constraints and physical phenomena such as transmission field non-uniformities and magnetic field inhomogeneities. In addition, the magneto-hydrodynamic effect renders the synchronization of the data acquisition with the cardiac motion difficult. The challenges are currently addressed by explorations into novel magnetic resonance technology. If all impediments can be overcome, ultra-high field CMR may generate new opportunities for functional CMR, myocardial tissue characterization, microstructure imaging or metabolic imaging. Recognizing this potential, we show that multi-channel radio frequency (RF) coil technology tailored for CMR at 7 Tesla together with higher order B0 shimming and a backup signal for cardiac triggering facilitates high fidelity functional CMR. With the proposed setup, cardiac chamber quantification can be accomplished in examination times similar to those achieved at lower field strengths. To share this experience and to support the dissemination of this expertise, this work describes our setup and protocol tailored for functional CMR at 7 Tesla.

The sensitivity gain inherent to ultrahigh field magnetic resonance holds promise for high spatial resolution imaging of the heart. Here, we describe a protocol customized for functional cardiovascular magnetic resonance (CMR) at 7 Tesla using an advanced multi-channel radio-frequency coil, magnetic field shimming and a triggering concept.

7号特斯拉的心脏磁共振成像

CMR at an ultra-high field (magnetic field strength B0&#160;&#8805; 7 Tesla) benefits from the signal-to-noise ratio (SNR) advantage inherent at higher ...

In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Meni&#232;re's Disease Ears and Normal Hearing Ears

Analysis of neural structures in Meni&#232;re's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this patient group but has yet to be confirmed. This protocol describes a method of in vivo evaluation of neural changes especially well suitable for cranial nerve analysis using magnetic resonance imaging (MRI). MD-patients and normal hearing persons were examined in a 3-T MR-scanner using a scan protocol including strongly T2-weighted 3D gradient-echo-sequence (3D-CISS). In the patient group, MD was additionally confirmed using MRI-based assessment of endolymphatic hydrops. Morphometric analysis was performed using a freeware DICOM viewer. Evaluation of cranial nerves included measurements of cross-sectional areas (CSAs) of the nerves at different levels as well as orthogonal diametric measurements.

&lt;em&gt;In Vivo&lt;/em&gt; Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Meni&amp;#232;re&#039;s Disease Ears and Normal Hearing Ears

To evaluate morphological changes of cranial nerves such as loss of neural structures or swelling of cranial nerves in Meni&#232;re&#39;s Disease (MD) or in healthy persons in vivo, a protocol of evaluation has been developed using magnetic resonance imaging (MRI). Additional MRI-based confirmation of MD was performed.

体内Menière 病耳和正常听觉的磁共振成像对人颅神经的形态学分析

Analysis of neural structures in Meni&#232;re's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this ...

Phase Contrast Magnetic Resonance Imaging in the Rat Common Carotid Artery

Phase contrast magnetic resonance imaging (PC-MRI) is a noninvasive approach that can quantify flow-related parameters such as blood flow. Previous studies have shown that abnormal blood flow may be associated with systemic vascular risk. Thus, PC-MRI can facilitate the translation of data obtained from animal models of cardiovascular diseases to pertinent clinical investigations. In this report, we describe the procedure for measuring blood flow in the common carotid artery (CCA) of rats using cine-gated PC-MRI and discuss relevant analysis methods. This procedure can be performed in a live, anesthetized animal and does not require euthanasia after the procedure. The proposed scanning parameters yield repeatable measurements for blood flow, indicating excellent reproducibility of the results. The PC-MRI procedure described in this article can be used for pharmacological testing, pathophysiological assessment, and cerebral hemodynamics evaluation.

The overall goal of this procedure is to measure the blood flow in the rat common carotid artery by using noninvasive phase contrast magnetic resonance imaging.

大鼠颈总动脉的相位对比磁共振成像

Phase contrast magnetic resonance imaging (PC-MRI) is a noninvasive approach that can quantify flow-related parameters such as blood flow. Previous ...

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To date, return-to-activity decision-making has been anchored in the monitoring of self-reported concussion symptoms and neurocognitive testing. However, multi-modal assessments that corroborate objective physiological measures with traditional subjective symptom reporting are needed and can be valuable. Heart rate variability (HRV) is a non-invasive physiological indicator of the autonomic nervous system, capturing the reciprocal interplay between the sympathetic and parasympathetic nervous systems. There is a dearth of literature exploring the effect of concussion on HRV in youth athletes, and developmental differences preclude the application of adult findings to a pediatric population. Further, the current state of HRV methodology has primarily included short-term (5-15 min) recordings, by using resting state or short-term physical exertion testing to elucidate changes following concussion. The novelty in utilizing a 24 h&#160;recording methodology is that it has the potential to capture natural variation in autonomic function, directly related to the activities a youth athlete performs on a regular basis. Within a prospective, longitudinal research setting, this novel approach to quantifying autonomic function can provide important information regarding the recovery trajectory, alongside traditional self-report symptom measures. Our objectives regarding a 24 h recording methodology were to (1) evaluate the physiological effects of a concussion in youth athletes, and (2) describe the trajectory of physiological change, while considering the resolution of self-reported post-concussion symptoms. To achieve these objectives, non-invasive sensor technology was implemented. The raw beat-to-beat time intervals captured can be transformed to derive time domain and frequency domain measures, which reflect an individual&#39;s ability to adapt and be flexible to their ever-changing environment. By using non-invasive heart rate technology, autonomic function can be quantified outside of a traditional controlled research setting.

We demonstrate a 24 h heart rate recording methodology to evaluate the influence of concussion across the recovery trajectory in youth athletes, within an ecologically valid context.

青年运动员脑震荡后的自主功能: 用24小时记录法探讨心率变异性

Participation in organized sports makes a significant contribution to youth development, but places youth at a higher risk for sustaining a concussion. To ...

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

We present the conventional cardiac magnetic resonance (CMR) protocol for evaluating a suspected thrombus and highlight emerging techniques.&#160;The appearance of a mass on certain magnetic resonance (MR) sequences can help differentiate a thrombus from competing diagnoses such as a tumor. T1 and T2 signal characteristics of a thrombus are related to the evolution of hemoglobin properties. A thrombus typically does not enhance following contrast administration, which also helps differentiation from a tumor. We also highlight the emerging role of T1 mapping in the evaluation of a thrombus, which can add another level of support in diagnosis. Prior to any CMR exam, patient screening and interviews are critical to ensure safety and to optimize patient comfort. Effective communication during the exam between the technologist and the patient promotes proper breath holding technique and higher quality images. Volumetric post processing and structured reporting are helpful to ensure that the radiologist answers the ordering services&#39; question and communicates these results effectively. Optimal pre-MR safety evaluation, CMR exam execution, and post exam processing and reporting allow for delivery of high quality radiological service in the evaluation of a suspected cardiac thrombus.

The goal of this article is to describe how cardiac magnetic resonance can be used for the evaluation and diagnosis of a suspected cardiac thrombus. The method presented will describe data acquisition as well as the pre-procedure and post-procedure protocol.

心脏磁共振评估疑似心脏血栓:常规和新兴技术

We present the conventional cardiac magnetic resonance (CMR) protocol for evaluating a suspected thrombus and highlight emerging techniques.&#160;The ...

Quantitative Mapping of Specific Ventilation in the Human Lung using Proton Magnetic Resonance Imaging and Oxygen as a Contrast Agent

Specific ventilation imaging (SVI) is a functional magnetic resonance imaging technique capable of quantifying specific ventilation &#8213; the ratio of the fresh gas entering a lung region divided by the region&#8217;s end-expiratory volume &#8213; in the human lung, using only inhaled oxygen as a contrast agent. Regional quantification of specific ventilation has the potential to help identify areas of pathologic lung function. Oxygen in solution in tissue shortens the tissue&#8217;s longitudinal relaxation time (T1), and thus a change in tissue oxygenation can be detected as a change in T1-weighted signal with an inversion recovery acquired image. Following an abrupt change between two concentrations of inspired oxygen, the rate at which lung tissue within a voxel equilibrates to a new steady-state reflects the rate at which resident gas is being replaced by inhaled gas. This rate is determined by specific ventilation. To elicit this sudden change in oxygenation, subjects alternately breathe 20-breath blocks of air (21% oxygen) and 100% oxygen while in the MRI scanner. A stepwise change in inspired oxygen fraction is achieved through use of a custom three-dimensional (3D)-printed flow bypass system with a manual switch during a short end-expiratory breath hold. To detect the corresponding change in T1, a global inversion pulse followed by a single shot fast spin echo sequence was used to acquire two-dimensional T1-weighted images in a 1.5&#160;T MRI scanner, using an eight-element torso coil. Both single slice and multi-slice imaging are possible, with slightly different imaging parameters. Quantification of specific ventilation is achieved by correlating the time-course of signal intensity for each lung voxel with a library of simulated responses to the air/oxygen stimulus. SVI estimations of specific ventilation heterogeneity have been validated against multiple breath washout and proved to accurately determine the heterogeneity of the specific ventilation distribution.

Specific ventilation imaging is a functional magnetic resonance imaging technique that allows for quantification of regional specific ventilation in the human lung, using inhaled oxygen as a contrast agent. Here, we present a protocol to collect and analyze specific ventilation imaging data.

以质子磁共振成像和氧为造影剂对人肺特异性通气进行定量定位

Specific ventilation imaging (SVI) is a functional magnetic resonance imaging technique capable of quantifying specific ventilation &#8213; the ratio of ...