San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (Mr Sorg); Veterans Affairs San Diego Healthcare System (VASDHS) (Drs Delano-Wood, Schiehser, Hanson, Nation, Jak, Meloy, Frank, Lohr, and Bondi and Mr Luc and Mss Lanni); Center of Excellence for Stress and Mental Health, VASDHS (Drs Delano-Wood, Schiehser, Hanson, Jak, Frank, Lohr, and Bondi); and Departments of Psychiatry (Drs Delano-Wood, Schiehser, Hanson, Jak, Meloy, Lohr, and Bondi) and Radiology (Drs Lu and Frank), School of Medicine, University of California, San Diego.
J Head Trauma Rehabil. 2014 Jan-Feb;29(1):21-32. doi: 10.1097/HTR.0b013e31828a1aa4.
We investigated using diffusion tensor imaging (DTI) and the association between white matter integrity and executive function (EF) performance in postacute mild traumatic brain injury (mTBI). In addition, we examined whether injury severity, as measured by loss of consciousness (LOC) versus alterations in consciousness (AOC), is related to white matter microstructural alterations and neuropsychological outcome.
Thirty Iraq and Afghanistan War era veterans with a history of mTBI and 15 healthy veteran control participants.
There were no significant overall group differences between control and mTBI participants on DTI measures. However, a subgroup of mTBI participants with EF decrements (n = 13) demonstrated significantly decreased fractional anisotropy of prefrontal white matter, corpus callosum, and cingulum bundle structures compared with mTBI participants without EF decrements (n = 17) and control participants. Participants having mTBI with LOC were more likely to evidence reduced EF performances and disrupted ventral prefrontal white matter integrity when compared with either mTBI participants without LOC or control participants.
Findings suggest that altered white matter integrity contributes to reduced EF in subgroups of veterans with a history of mTBI and that LOC may be a risk factor for reduced EF as well as associated changes to ventral prefrontal white matter.
我们通过弥散张量成像（DTI）研究了急性轻度创伤性脑损伤（mTBI）后，白质完整性与执行功能（EF）表现之间的关系。此外，我们还研究了意识丧失（LOC）与意识改变（AOC）测量的损伤严重程度是否与白质微观结构改变和神经心理学结果相关。
30 名有 mTBI 病史的伊拉克和阿富汗战争时期退伍军人和 15 名健康退伍军人对照组参与者。
对照组和 mTBI 组参与者的 DTI 测量值之间没有显著的总体组间差异。然而，有 EF 下降的 mTBI 参与者亚组（n = 13）与没有 EF 下降的 mTBI 参与者（n = 17）和对照组参与者相比，前额叶白质、胼胝体和扣带回束结构的各向异性分数明显降低。与无 LOC 的 mTBI 参与者或对照组参与者相比，LOC 的 mTBI 参与者更有可能出现 EF 表现下降和腹侧前额叶白质完整性受损。
研究结果表明，改变的白质完整性可能导致有 mTBI 病史的退伍军人亚组的 EF 降低，而 LOC 可能是 EF 降低以及与腹侧前额叶白质相关改变的风险因素。
