Postgraduate Program of Clinical Neuropsychology, Medical School, National and Kapodistrian University of Athens, Greece (Ms Kourtidou); University of Texas Health Sciences Center (Ms Kourtidou); Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas - Houston Medical School (Drs McCauley, Traipe, Wu, Levin, and Wilde and Ms Li); Departments of Radiology (Drs Traipe, Chu, Hunter, and Wilde), Neurology (Drs McCauley, Levin and Wilde), and Pediatrics (Drs McCauley and Levin), Baylor College of Medicine; Michael E. DeBakey Veterans Affairs Medical Center (Drs McCauley, Wilde and Levin); Department of Pediatric Radiology, Texas Children's Hospital (Drs Traipe, Chu, and Hunter), Houston, Texas; Departments of Psychology (Drs Bigler and Wu) and Neuroscience (Dr Bigler), Brigham Young University, Provo, Utah; and Department of Psychiatry and the Utah Brain Institute, University of Utah, Salt Lake City (Dr Bigler).
J Head Trauma Rehabil. 2013 Nov-Dec;28(6):433-41. doi: 10.1097/HTR.0b013e3182585d06.
This study investigated white matter alterations in the corpus callosum (CC) and centrum semiovale (CSO), using diffusion tensor imaging and magnetization transfer imaging, in participants with severe traumatic brain injury (TBI) and related these changes to processing speed measures.
Fourteen adult participants with severe TBI underwent neuroimaging and assessment, using the Symbol Digit Modalities Test and Trail-Making Test, Part B, at approximately 6 months postinjury. Thirteen demographically similar, neurologically intact adults were imaged for comparison.
The TBI group demonstrated lower fractional anisotropy (FA) for the right CSO and higher apparent diffusion coefficient (ADC) for the CSO bilaterally than the control group. Lower FA and higher ADC were noted in all CC regions. Magnetization transfer imaging revealed smaller magnetization transfer ratios (MTRs) in the right and left CSO and CC genu and splenium. Written Symbol Digit Modalities Test performance was related to right CSO FA, bilateral CSO ADC, CC FA, and right CSO MTR, whereas oral Symbol Digit Modalities Test was related to right CSO FA, ADC, and MTR. Trail-Making Test, Part B, was related to right CSO FA and MTR.
Advanced neuroimaging modalities such as diffusion tensor imaging and magnetization transfer imaging demonstrate significant alterations in white matter, which are related to processing speed. These techniques may be useful in quantifying the extent of injury even in normal appearing white matter after TBI.
本研究使用弥散张量成像和磁化传递成像技术，研究严重创伤性脑损伤（TBI）患者胼胝体（CC）和半卵圆中心（CSO）的白质改变，并将这些变化与处理速度测量相关联。
14 名成年严重 TBI 患者在损伤后约 6 个月接受神经影像学和符号数字模态测试（Symbol Digit Modalities Test，SDMT）和连线测试 B 部分（Trail-Making Test，Part B）评估。13 名在年龄、性别、神经学方面相似的健康成年人被成像以作对照。
TBI 组右侧 CSO 的各向异性分数（fractional anisotropy，FA）低于对照组，双侧 CSO 的表观扩散系数（apparent diffusion coefficient，ADC）高于对照组。所有 CC 区域的 FA 均较低，ADC 均较高。磁化传递成像显示右侧和左侧 CSO 以及 CC 体部和压部的磁化传递比值（magnetization transfer ratio，MTR）较小。SDMT 的书面测试成绩与右侧 CSO 的 FA、双侧 CSO 的 ADC、CC 的 FA 和右侧 CSO 的 MTR 相关，而 SDMT 的口头测试成绩与右侧 CSO 的 FA、ADC 和 MTR 相关。Trail-Making Test，Part B 与右侧 CSO 的 FA 和 MTR 相关。
弥散张量成像和磁化传递成像等高级神经影像学技术显示白质存在明显改变，与处理速度相关。这些技术可能有助于量化 TBI 后即使在正常表现的白质中损伤的严重程度。
