Wang Xin, Xie Hong, Cotton Andrew S, Tamburrino Marijo B, Brickman Kristopher R, Lewis Terrence J, McLean Samuel A, Liberzon Israel
1 Department of Psychiatry, University of Toledo , Toledo, Ohio.
J Neurotrauma. 2015 Apr 1;32(7):455-63. doi: 10.1089/neu.2014.3492. Epub 2015 Jan 26.
In a motor vehicle collision (MVC), survivors often receive mild traumatic brain injuries (mTBI). Although there have been some reports of early white matter changes after an mTBI, much less is known about early cortical structural changes. To investigate early cortical changes within a few days after an MVC, we compared cortical thickness of mTBI survivors with non-mTBI survivors, then reexamined cortical thickness in the same survivors 3 months later. MVC survivors were categorized as mTBI or non-mTBI based on concussive symptoms documented in emergency departments (EDs). Cortical thickness was measured from MRI images using FreeSurfer within a few days and again at 3 months after MVC. Post-traumatic stress symptoms and physical conditions were also assessed. Compared with the non-mTBI group (n = 23), the mTBI group (n = 21) had thicker cortex in the left rostral middle frontal (rMFG) and right precuneus gyri, but thinner cortex in the left posterior middle temporal gyrus at 7.2 ± 3.1 days after MVC. After 3 months, cortical thickness had decreased in left rMFG in the mTBI group but not in the non-mTBI group. The cortical thickness of the right precuneus region in the initial scans was positively correlated with acute traumatic stress symptoms for all survivors and with the number of reduced activity days for mTBI survivors who completed the follow-up. The preliminary results suggest that alterations in cortical thickness may occur at an early stage of mTBI and that frontal cortex structure may change dynamically over the initial 3 months after mTBI.
在机动车碰撞事故(MVC)中,幸存者常常会受到轻度创伤性脑损伤(mTBI)。尽管已有一些关于mTBI后早期白质变化的报道,但对于早期皮质结构变化的了解却少得多。为了研究MVC后几天内的早期皮质变化,我们比较了mTBI幸存者与非mTBI幸存者的皮质厚度,然后在3个月后对同一批幸存者的皮质厚度进行了重新检查。根据急诊科(ED)记录的震荡症状,将MVC幸存者分为mTBI组或非mTBI组。在MVC后几天内以及3个月后,使用FreeSurfer从MRI图像中测量皮质厚度。还评估了创伤后应激症状和身体状况。与非mTBI组(n = 23)相比,mTBI组(n = 21)在MVC后7.2±3.1天,左侧额中回前部(rMFG)和右侧楔前回的皮质较厚,但左侧颞中回后部的皮质较薄。3个月后,mTBI组左侧rMFG的皮质厚度下降,而非mTBI组则没有。在初始扫描中,所有幸存者右侧楔前区的皮质厚度与急性创伤应激症状呈正相关,对于完成随访的mTBI幸存者,其与活动减少天数呈正相关。初步结果表明,皮质厚度改变可能在mTBI的早期阶段出现,并且额叶皮质结构在mTBI后的最初3个月内可能会动态变化。