轻度创伤性脑损伤患者眶额皮质变薄与攻击行为
Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients.
作者信息
Epstein Daniel J, Legarreta Margaret, Bueler Elliot, King Jace, McGlade Erin, Yurgelun-Todd Deborah
机构信息
Interdepartmental Program in Neuroscience University of Utah Salt Lake City UT USA; Cognitive Neuroimaging Laboratory Salt Lake City UT USA; Salt Lake City Rocky Mountain MIRECC Salt Lake City UT USA.
Cognitive Neuroimaging Laboratory Salt Lake City UT USA; Salt Lake City Rocky Mountain MIRECC Salt Lake City UT USA.
出版信息
Brain Behav. 2016 Sep 28;6(12):e00581. doi: 10.1002/brb3.581. eCollection 2016 Dec.
INTRODUCTION
Although mild traumatic brain injury (mTBI) comprises 80% of all TBI, the morphological examination of the orbitofrontal cortex (OFC) in relation to clinical symptoms such as aggression, anxiety and depression in a strictly mTBI sample has never before been performed.
OBJECTIVES
The primary objective of the study was to determine if mTBI patients would show morphological differences in the OFC and if the morphology of this region would relate to clinical symptoms.
METHODS
Using structural images acquired in a 3T MRI machine, the cortical thickness and cortical volume (corrected for total brain volume) of the OFC was collected for healthy control (= 27) subjects and chronic mTBI (= 55) patients at least one year post injury. Also, during clinical interviews, measures quantifying the severity of clinical symptoms, including aggression, anxiety, and depression, were collected.
RESULTS
MTBI subjects displayed increased aggression, anxiety, and depression, and anxiety and depression measures showed a relationship with the number of mTBI in which the subject lost consciousness. The cortical thickness of the right lateral OFC displayed evidence of thinning in the mTBI group; however, after correction for multiple comparisons, this difference was no longer significant. Clinical measures were not significantly related with OFC morphometry.
CONCLUSION
This study found increased aggression, anxiety, and depression, in the mTBI group as well as evidence of cortical thinning in the right lateral OFC. The association between clinical symptoms and the number of mTBI with loss of consciousness suggests the number and severity of mTBI may influence clinical symptoms long after injury. Future studies examining other brain regions involved in the production and regulation of affective processes and inclusion of subjects with well-characterized mood disorders could further elucidate the relationship between mTBI, brain morphology, and clinical symptoms.
引言
尽管轻度创伤性脑损伤（mTBI）占所有创伤性脑损伤的80%，但此前从未在严格的mTBI样本中对眶额皮质（OFC）与攻击、焦虑和抑郁等临床症状相关的形态学进行检查。
目的
本研究的主要目的是确定mTBI患者的OFC是否会出现形态学差异，以及该区域的形态是否与临床症状相关。
方法
使用在3T磁共振成像（MRI）机器上采集的结构图像，收集至少受伤一年后的健康对照者（n = 27）和慢性mTBI患者（n = 55）的OFC皮质厚度和皮质体积（校正全脑体积）。此外，在临床访谈期间，收集量化临床症状严重程度的指标，包括攻击、焦虑和抑郁。
结果
mTBI受试者表现出更高的攻击、焦虑和抑郁水平，焦虑和抑郁指标与受试者失去意识的mTBI次数相关。mTBI组右侧外侧OFC的皮质厚度有变薄迹象；然而，在进行多重比较校正后，这种差异不再显著。临床指标与OFC形态测量无显著相关性。
结论
本研究发现mTBI组攻击、焦虑和抑郁水平升高，以及右侧外侧OFC皮质变薄的证据。临床症状与伴有意识丧失的mTBI次数之间的关联表明，mTBI的次数和严重程度可能在受伤后很长时间影响临床症状。未来研究检查参与情感过程产生和调节的其他脑区，并纳入具有明确特征的情绪障碍受试者，可能会进一步阐明mTBI、脑形态和临床症状之间的关系。
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