The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA.
Brain Imaging Behav. 2012 Jun;6(2):329-42. doi: 10.1007/s11682-012-9175-2.
To identify and characterize otherwise occult inter-individual spatial variation of white matter abnormalities across mild traumatic brain injury (mTBI) patients. After informed consent and in compliance with Health Insurance Portability and Accountability Act (HIPAA), Diffusion tensor imaging (DTI) was performed on a 3.0 T MR scanner in 34 mTBI patients (19 women; 19-64 years old) and 30 healthy control subjects. The patients were imaged within 2 weeks of injury, 3 months after injury, and 6 months after injury. Fractional anisotropy (FA) images were analyzed in each patient. To examine white matter diffusion abnormalities across the entire brain of individual patients, we applied Enhanced Z-score Microstructural Assessment for Pathology (EZ-MAP), a voxelwise analysis optimized for the assessment of individual subjects. Our analysis revealed areas of abnormally low or high FA (voxel-wise P-value < 0.05, cluster-wise P-value < 0.01(corrected for multiple comparisons)). The spatial pattern of white matter FA abnormalities varied among patients. Areas of low FA were consistent with known patterns of traumatic axonal injury. Areas of high FA were most frequently detected in the deep and subcortical white matter of the frontal, parietal, and temporal lobes, and in the anterior portions of the corpus callosum. The number of both abnormally low and high FA voxels changed during follow up. Individual subject assessments reveal unique spatial patterns of white matter abnormalities in each patient, attributable to inter-individual differences in anatomy, vulnerability to injury and mechanism of injury. Implications of high FA remain unclear, but may evidence a compensatory mechanism or plasticity in response to injury, rather than a direct manifestation of brain injury.
识别和描述轻度创伤性脑损伤（mTBI）患者之间存在的、否则难以察觉的白质异常的个体间空间变异性，并对其特征进行描述。
在获得知情同意并符合《健康保险流通与责任法案》（HIPAA）的前提下，对 34 名 mTBI 患者（19 名女性；19-64 岁）和 30 名健康对照者在 3.0T 磁共振扫描仪上进行弥散张量成像（DTI）检查。患者在损伤后 2 周、3 个月和 6 个月进行成像。对每位患者的各向异性分数（FA）图像进行分析。为了在个体患者的整个大脑中检查白质弥散异常，我们应用了增强 Z 分数微观结构评估病理学（EZ-MAP），这是一种针对个体受试者评估进行优化的体素分析方法。我们的分析揭示了 FA 值异常降低或升高的区域（体素水平 P 值<0.05，簇水平 P 值<0.01（经多重比较校正））。FA 值异常的白质空间模式在患者之间存在差异。FA 值降低的区域与已知的创伤性轴索损伤模式一致。FA 值升高的区域最常出现在额、顶、颞叶的深部和皮质下白质以及胼胝体的前部。在随访过程中，FA 值异常降低和升高的体素数量发生了变化。个体受试者评估揭示了每个患者独特的白质异常空间模式，这归因于解剖学、易受伤性和损伤机制的个体间差异。FA 值升高的确切含义尚不清楚，但可能表明存在一种补偿机制或可塑性，以应对损伤，而不是脑损伤的直接表现。
