Tate David F, Wade Benjamin S C, Velez Carmen S, Drennon Ann Marie, Bolzenius Jacob, Gutman Boris A, Thompson Paul M, Lewis Jeffrey D, Wilde Elisabeth A, Bigler Erin D, Shenton Martha E, Ritter John L, York Gerald E
Missouri Institute of Mental Health, University of Missouri, St. Louis, 4633 World Parkway Circle, Berkeley, MO, 63134-3115, USA.
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
J Neurol. 2016 Oct;263(10):2065-79. doi: 10.1007/s00415-016-8236-7. Epub 2016 Jul 19.
Mild traumatic brain injury (mTBI) is a significant health concern. The majority who sustain mTBI recover, although ~20 % continue to experience symptoms that can interfere with quality of life. Accordingly, there is a critical need to improve diagnosis, prognostic accuracy, and monitoring (recovery trajectory over time) of mTBI. Volumetric magnetic resonance imaging (MRI) has been successfully utilized to examine TBI. One promising improvement over standard volumetric approaches is to analyze high-dimensional shape characteristics of brain structures. In this study, subcortical shape and volume in 76 Service Members with mTBI was compared to 59 Service Members with orthopedic injury (OI) and 17 with post-traumatic stress disorder (PTSD) only. FreeSurfer was used to quantify structures from T1-weighted 3 T MRI data. Radial distance (RD) and Jacobian determinant (JD) were defined vertex-wise on parametric mesh-representations of subcortical structures. Linear regression was used to model associations between morphometry (volume and shape), TBI status, and time since injury (TSI) correcting for age, sex, intracranial volume, and level of education. Volumetric data was not significantly different between the groups. JD was significantly increased in the accumbens and caudate and significantly reduced in the thalamus of mTBI participants. Additional significant associations were noted between RD of the amygdala and TSI. Positive trend-level associations between TSI and the amygdala and accumbens were observed, while a negative association was observed for third ventricle. Our findings may aid in the initial diagnosis of mTBI, provide biological targets for functional examination, and elucidate regions that may continue remodeling after injury.
轻度创伤性脑损伤（mTBI）是一个重大的健康问题。大多数遭受mTBI的人会康复，尽管约20%的人会持续出现影响生活质量的症状。因此，迫切需要改善mTBI的诊断、预后准确性和监测（随时间的恢复轨迹）。容积磁共振成像（MRI）已成功用于检查TBI。相对于标准容积方法的一个有前景的改进是分析脑结构的高维形状特征。在本研究中，将76名患有mTBI的军人的皮质下形状和体积与59名患有骨科损伤（OI）的军人以及17名仅患有创伤后应激障碍（PTSD）的军人进行了比较。使用FreeSurfer从T1加权3T MRI数据中量化结构。在皮质下结构的参数化网格表示上逐顶点定义径向距离（RD）和雅可比行列式（JD）。使用线性回归对形态计量学（体积和形状）、TBI状态以及受伤时间（TSI）之间的关联进行建模，并对年龄、性别、颅内体积和教育水平进行校正。各组之间的容积数据无显著差异。mTBI参与者的伏隔核和尾状核的JD显著增加，丘脑的JD显著降低。杏仁核的RD与TSI之间还存在其他显著关联。观察到TSI与杏仁核和伏隔核之间呈正趋势水平关联，而第三脑室呈负关联。我们的研究结果可能有助于mTBI的初步诊断，为功能检查提供生物学靶点，并阐明受伤后可能继续重塑的区域。
