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单纯轻度创伤性脑损伤后的生物心理社会结局。

Biopsychosocial outcome after uncomplicated mild traumatic brain injury.

机构信息

1 Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland .

出版信息

J Neurotrauma. 2014 Jan 1;31(1):108-24. doi: 10.1089/neu.2013.2941. Epub 2013 Nov 12.

Abstract

The purpose of this study was to examine the biopsychosocial outcome from uncomplicated mild traumatic brain injury (MTBI) within the first 3 weeks post injury. Participants were 48 prospectively enrolled patients from the Emergency Department of Tampere University Hospital, Finland, who sustained an uncomplicated MTBI. At 3 weeks post injury, diffusion tensor imaging (DTI) of the whole brain was undertaken using a Siemens 3T scanner. Measures of fractional anisotropy (FA) were calculated for 16 regions of interest (ROIs) and measures of apparent diffusion coefficient (ADC) were calculated for 10 ROIs. Twenty-four healthy control participants also completed DTI of the whole brain for comparison. Participants were administered a brief battery of self-report (e.g., postconcussion symptoms, depression, and fatigue) and neurocognitive measures (e.g., verbal learning and memory). There were no significant differences between the uncomplicated MTBI and healthy control group on any measures of learning and memory. Compared to the control group, the uncomplicated MTBI group reported a greater number of postconcussion symptoms and fatigue, but not depression. When considering all DTI ROIs simultaneously, the MTBI group had a significantly larger number of low DTI measures (FA values) compared to the healthy controls. MTBI patients with multifocal white matter changes did not show evidence of worse symptoms, cognitive impairment, or slower return to work compared to MTBI patients with broadly normal white matter.

摘要

这项研究的目的是在伤后 3 周内检查无并发症的轻度创伤性脑损伤 (MTBI) 的生物心理社会结局。参与者是来自芬兰坦佩雷大学医院急诊科的 48 名前瞻性入组患者,他们患有无并发症的 MTBI。伤后 3 周时,使用西门子 3T 扫描仪对整个大脑进行弥散张量成像 (DTI)。计算了 16 个感兴趣区 (ROI) 的分数各向异性 (FA) 测量值,并计算了 10 个 ROI 的表观扩散系数 (ADC) 测量值。还对 24 名健康对照参与者进行了全脑 DTI 检查以进行比较。对参与者进行了简短的自我报告(例如脑震荡后症状、抑郁和疲劳)和神经认知测试(例如语言学习和记忆)。在任何学习和记忆测量指标上,无并发症的 MTBI 组与健康对照组之间均无显着差异。与对照组相比,无并发症的 MTBI 组报告的脑震荡后症状和疲劳较多,但抑郁较少。当同时考虑所有 DTI ROI 时,MTBI 组的低 DTI 测量值(FA 值)明显多于健康对照组。与广泛正常的脑白质相比,有多发性脑白质改变的 MTBI 患者没有表现出更严重的症状、认知障碍或恢复工作更慢的迹象。

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