Max Jeffrey E, Levin Harvey S, Schachar Russell J, Landis Julie, Saunders Ann E, Ewing-Cobbs Linda, Chapman Sandra B, Dennis Maureen
Department of Psychiatry at the University of California, San Diego, CA 92123, USA.
J Neuropsychiatry Clin Neurosci. 2006 Winter;18(1):21-32. doi: 10.1176/jnp.18.1.21.
Phenomenology and predictive factors of personality change due to traumatic brain injury (TBI) 6 to 24 months after injury was investigated in children, ages 5 to 14 years, enrolled from consecutive admissions and followed prospectively for 2 years. Injury and preinjury psychosocial variables were assessed. Personality change occurred in 13% of participants between 6 and 12 months after injury and 12% in the second year after injury. Severity of injury consistently predicted personality change, and preinjury adaptive function predicted personality change only in the second year postinjury. Lesions of the superior frontal gyrus were associated with personality change between 6 and 12 months following injury, after controlling for severity of injury and the presence of other brain lesions. Only lesions in the frontal lobe white matter were significantly related to personality change in the second year after injury. After childhood TBI, neural correlates of personality change evolve between 6 and 12 months and 12 to 24 months after injury. The data implicate the dorsal prefrontal cortex and frontal lobe white matter in the emergence of personality change involving the effortful or conscious regulation of affective states.
对5至14岁儿童创伤性脑损伤（TBI）后6至24个月人格改变的现象学及预测因素进行了研究，这些儿童来自连续入院病例，并进行了为期2年的前瞻性随访。评估了损伤及伤前心理社会变量。13%的参与者在伤后6至12个月出现人格改变，12%在伤后第二年出现人格改变。损伤严重程度始终可预测人格改变，而伤前适应功能仅在伤后第二年可预测人格改变。在控制损伤严重程度及其他脑损伤存在的情况下，额上回病变与伤后6至12个月的人格改变相关。仅额叶白质病变与伤后第二年的人格改变显著相关。儿童TBI后，人格改变的神经关联在伤后6至12个月以及12至24个月之间演变。数据表明背侧前额叶皮质和额叶白质与涉及情感状态努力或有意识调节的人格改变的出现有关。
