Hellstrøm T, Westlye L T, Server A, Løvstad M, Brunborg C, Lund M J, Nordhøy W, Andreassen O A, Andelic N
a Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway.
b KG Jebsen Centre for Psychosis Research/Norwegian Centre for Mental Disorder Research (NORMENT), Division of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway.
Brain Inj. 2016;30(13-14):1683-1691. doi: 10.1080/02699052.2016.1199905. Epub 2016 Oct 24.
This study compared cortical and sub-cortical volumes between patients with complicated (i.e. presence of intracranial abnormality on the day-of-injury CT) and uncomplicated (i.e. absence of intracranial abnormality) mild traumatic brain injury (MTBI) 4 weeks post-injury. The study hypothesized regionally decreased brain volumes and reduced cortical thickness in patients with complicated MTBIs compared with uncomplicated MTBI.
This study was part of a larger 2 years cohort study on MTBI. Baseline clinical and magnetic resonance imaging (MRI) data were compared for those with complicated and uncomplicated MTBI. It identified 168 patients with MTBI (90 uncomplicated and 78 complicated), aged 16-65 years. 3T MRI-system (Signa HDxt, GE Medical Systems, Milwaukee, WI) and cortical reconstruction and volumetric segmentation by FreeSurfer software have been used.
No significant differences between uncomplicated and complicated MTBIs were found in neuroanatomic volumes and cortical thickness after controlling for age, gender and education. The complicated MTBI group showed larger ventricles compared with the uncomplicated group, but this effect diluted when adjusting for potential confounders.
The study findings suggest that the classification of complicated and uncomplicated MTBI may be too broad to differentiate volumetric and morphometric effects of injury in the early post-injury phase.
本研究比较了复杂型（即受伤当天CT显示颅内异常）和非复杂型（即无颅内异常）轻度创伤性脑损伤（MTBI）患者在受伤后4周时的皮质和皮质下体积。该研究假设，与非复杂型MTBI相比，复杂型MTBI患者的脑体积在局部区域减小，皮质厚度变薄。
本研究是一项针对MTBI的为期2年的大型队列研究的一部分。对复杂型和非复杂型MTBI患者的基线临床和磁共振成像（MRI）数据进行了比较。研究纳入了168例年龄在16至65岁之间的MTBI患者（90例非复杂型和78例复杂型）。使用了3T MRI系统（Signa HDxt，GE医疗系统公司，威斯康星州密尔沃基）以及FreeSurfer软件进行皮质重建和体积分割。
在控制年龄、性别和教育程度后，非复杂型和复杂型MTBI患者在神经解剖体积和皮质厚度方面未发现显著差异。与非复杂型组相比，复杂型MTBI组的脑室更大，但在调整潜在混杂因素后，这种效应减弱。
研究结果表明，复杂型和非复杂型MTBI的分类可能过于宽泛，无法区分受伤后早期损伤的体积和形态学效应。
