Babikian Talin, Freier M Catherin, Tong Karen A, Nickerson Joshua P, Wall Christopher J, Holshouser Barbara A, Burley Todd, Riggs Matt L, Ashwal Stephen
Department of Psychology, Loma Linda University, Loma Linda, California, USA.
Pediatr Neurol. 2005 Sep;33(3):184-94. doi: 10.1016/j.pediatrneurol.2005.03.015.
Traumatic brain injury is among the most frequent pediatric neurologic disorders in the United States, affecting multiple aspects of neuropsychologic functioning. This study assessed the efficacy of susceptibility weighted imaging as a predictor of long-term neuropsychologic functioning after pediatric brain injury compared with magnetic resonance spectroscopic imaging. Susceptibility weighted imaging is a relatively new method that is considered superior to traditional magnetic resonance imaging sequences for detecting hemorrhagic diffuse axonal injury. In this study, imaging and spectroscopy were acquired 6 +/- 4 days after injury. Measures of neuropsychologic functioning were administered to 18 children and adolescents 1-4 years post injury. Negative correlations between lesion number and volume with neuropsychologic functioning were demonstrated. Lesion volume explained over 32% of the variance in cognitive performance, explaining at least an additional 20% beyond injury severity and age at injury alone and 19% beyond magnetic resonance spectroscopic metabolite variables. Exploratory analyses resulted in notable trends, with lesions in deeper brain regions more strongly associated with poorer neuropsychologic performance. Improved detection of the extent of diffuse axonal injury following a brain injury will allow for a better understanding of its association with long-term outcome, which in turn can improve prognostic efficacy for effective treatment planning.
创伤性脑损伤是美国最常见的儿科神经系统疾病之一，会影响神经心理功能的多个方面。本研究评估了与磁共振波谱成像相比，磁敏感加权成像作为儿科脑损伤后长期神经心理功能预测指标的有效性。磁敏感加权成像是一种相对较新的方法，在检测出血性弥漫性轴索损伤方面被认为优于传统的磁共振成像序列。在本研究中，成像和波谱分析在受伤后6±4天进行。对受伤后1至4年的18名儿童和青少年进行了神经心理功能测量。结果显示病变数量和体积与神经心理功能呈负相关。病变体积解释了认知表现中超过32%的变异，单独损伤严重程度和受伤年龄之外至少还能额外解释20%，磁共振波谱代谢物变量之外还能解释19%。探索性分析得出了显著趋势，脑深部区域的病变与较差的神经心理表现关联更强。改善对脑损伤后弥漫性轴索损伤范围的检测，将有助于更好地理解其与长期预后的关联，进而提高有效治疗方案规划的预后效果。
