Division of Pediatric Neuropsychology, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
J Int Neuropsychol Soc. 2011 Nov;17(6):1143-52. doi: 10.1017/S1355617711001226. Epub 2011 Oct 12.
The current pilot study examined functional magnetic resonance imaging (fMRI) activation in children with mild traumatic brain injury (mTBI) during tasks of working memory and inhibitory control, both of which are vulnerable to impairment following mTBI. Thirteen children with symptomatic mTBI and a group of controls completed a version of the Tasks of Executive Control (TEC) during fMRI scanning. Both groups showed greater prefrontal activation in response to increased working memory load. Activation patterns did not differ between groups on the working memory aspects of the task, but children with mTBI showed greater activation in the posterior cerebellum with the addition of a demand for inhibitory control. Children with mTBI showed greater impairment on symptom report and "real world" measures of executive functioning, but not on traditional "paper and pencil" tasks. Likewise, cognitive testing did not correlate significantly with imaging results, whereas increased report of post-concussive symptoms were correlated with increased cerebellar activation. Overall, results provide some evidence for the utility of symptom report as an indicator of recovery and the hypothesis that children with mTBI may experience disrupted neural circuitry during recovery. Limitations of the study included a small sample size, wide age range, and lack of in-scanner accuracy data.
本初步研究利用功能磁共振成像（fMRI）技术，检测了轻度创伤性脑损伤（mTBI）儿童在工作记忆和抑制控制任务中的大脑活动情况。这两种认知功能在 mTBI 后均易受损。13 名有症状的 mTBI 患儿和一组对照组在 fMRI 扫描期间完成了执行功能测试（TEC）的一个版本。两组在工作记忆任务中，前额叶的激活程度均随工作记忆负荷的增加而增加。在抑制控制需求增加的情况下，小脑后叶的激活模式在任务的工作记忆方面两组之间没有差异，但 mTBI 患儿的激活程度更高。mTBI 患儿在症状报告和“现实世界”执行功能测试中表现出更大的障碍，但在传统的“纸笔”测试中没有差异。同样，认知测试与影像学结果没有显著相关，而脑震荡后症状的增加与小脑激活的增加有关。总的来说，研究结果为症状报告作为恢复指标的有效性提供了一些证据，也为 mTBI 患儿在恢复过程中可能经历神经回路中断的假设提供了证据。研究的局限性包括样本量小、年龄范围广以及缺乏扫描内准确性数据。
