Los Angeles Biomedical Research Institute, Psychology Division, Department of Psychiatry, Harbor-University of California, Los Angeles Medical Center, 1124 W. Carson St., B-4 South (Box 490), Torrance, CA, 90502, USA,
Brain Imaging Behav. 2013 Sep;7(3):307-15. doi: 10.1007/s11682-013-9231-6.
Traumatic brain injury often results in acute metabolic crisis. We recently demonstrated that this is associated with chronic brain atrophy, which is most prominent in the frontal and temporal lobes. Interestingly, the neuropsychological profile of traumatic brain injury is often characterized as 'frontal-temporal' in nature, suggesting a possible link between acute metabolic crisis-related brain atrophy and neurocognitive impairment in this population. While focal lesions and diffuse axonal injury have a well-established role in the neuropsychological deficits observed following traumatic brain injury, no studies to date have examined the possible contribution of acute metabolic crisis-related atrophy in the neuropsychological sequelae of traumatic brain injury. In the current study we employed positron emission tomography, magnetic resonance imaging, and neuropsychological assessments to ascertain the relationship between acute metabolic crisis-related brain atrophy and neurocognitive outcome in a sample of 14 right-handed traumatic brain injury survivors. We found that acute metabolic crisis-related atrophy in the frontal and temporal lobes was associated with poorer attention, executive functioning, and psychomotor abilities at 12 months post-injury. Furthermore, participants with gross frontal and/or temporal lobe atrophy exhibited numerous clinically significant neuropsychological deficits in contrast to participants with other patterns of brain atrophy. Our findings suggest that interventions that reduce acute metabolic crisis may lead to improved functional outcomes for traumatic brain injury survivors.
创伤性脑损伤常导致急性代谢危机。我们最近的研究表明，这与慢性脑萎缩有关，而慢性脑萎缩在额叶和颞叶最为明显。有趣的是，创伤性脑损伤的神经心理学特征通常表现为“额叶-颞叶”性质，这表明急性代谢危机相关的脑萎缩与该人群的神经认知障碍之间可能存在联系。虽然局灶性病变和弥漫性轴索损伤在创伤性脑损伤后观察到的神经心理学缺陷中具有明确的作用，但迄今为止尚无研究探讨急性代谢危机相关萎缩在创伤性脑损伤神经心理学后遗症中的可能作用。在目前的研究中，我们使用正电子发射断层扫描、磁共振成像和神经心理学评估来确定 14 名右利手创伤性脑损伤幸存者中与急性代谢危机相关的脑萎缩与神经认知结果之间的关系。我们发现，额叶和颞叶的急性代谢危机相关萎缩与损伤后 12 个月时注意力、执行功能和精神运动能力较差有关。此外，与其他类型的脑萎缩相比，具有明显额颞叶萎缩的参与者表现出许多临床上显著的神经心理学缺陷。我们的研究结果表明，减少急性代谢危机的干预措施可能会改善创伤性脑损伤幸存者的功能结局。
