Division of Cerebrovascular Diseases and Neurocritical Care, Department of Neurology, The Ohio State University, Columbus, OH, USA.
Division of Neurosciences Critical Care, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Curr Neurol Neurosci Rep. 2016 May;16(5):44. doi: 10.1007/s11910-016-0642-9.
There is a paucity of accurate and reliable biomarkers to detect traumatic brain injury, grade its severity, and model post-traumatic brain injury (TBI) recovery. This gap could be addressed via advances in brain mapping which define injury signatures and enable tracking of post-injury trajectories at the individual level. Mapping of molecular and anatomical changes and of modifications in functional activation supports the conceptual paradigm of TBI as a disorder of large-scale neural connectivity. Imaging approaches with particular relevance are magnetic resonance techniques (diffusion weighted imaging, diffusion tensor imaging, susceptibility weighted imaging, magnetic resonance spectroscopy, functional magnetic resonance imaging, and positron emission tomographic methods including molecular neuroimaging). Inferences from mapping represent unique endophenotypes which have the potential to transform classification and treatment of patients with TBI. Limitations of these methods, as well as future research directions, are highlighted.
目前缺乏准确可靠的生物标志物来检测创伤性脑损伤、对其严重程度进行分级，并对创伤性脑损伤（TBI）后的恢复情况进行建模。这一差距可以通过脑图谱的进步来解决，脑图谱定义了损伤特征，并能够在个体水平上跟踪损伤后的轨迹。对分子和解剖变化以及功能激活的修饰的映射支持 TBI 作为一种大规模神经连接障碍的概念范例。具有特别相关性的成像方法是磁共振技术（弥散加权成像、弥散张量成像、磁化率加权成像、磁共振波谱、功能磁共振成像和正电子发射断层扫描方法，包括分子神经影像学）。映射的推断代表了独特的内表型，有可能改变 TBI 患者的分类和治疗。强调了这些方法的局限性以及未来的研究方向。
