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车底爆炸致超加速引起的中枢神经系统变化:一项体内扩散张量成像和磁共振波谱研究

Central Nervous System Changes Induced by Underbody Blast-Induced Hyperacceleration: An in Vivo Diffusion Tensor Imaging and Magnetic Resonance Spectroscopy Study.

作者信息

Tang Shiyu, Xu Su, Fourney William L, Leiste Ulrich H, Proctor Julie L, Fiskum Gary, Gullapalli Rao P

机构信息

1 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland , Baltimore, Maryland.

2 Core for Translational Research in Imaging at Maryland, University of Maryland , Baltimore, Maryland.

出版信息

J Neurotrauma. 2017 Jun 1;34(11):1972-1980. doi: 10.1089/neu.2016.4650. Epub 2017 Mar 21.

DOI:10.1089/neu.2016.4650
PMID:28322622
Abstract

Blast-related traumatic brain injury (bTBI) resulting from improvised explosive devices is the hallmark injury of recent wars, and affects many returning veterans who experienced either direct or indirect exposure. Many of these veterans have long-term neurocognitive symptoms. However, there is very little evidence to show whether blast-induced acceleration alone, in the absence of secondary impacts, can cause mild TBI. In this study, we examine the effect of under-vehicle blast-induced hyperacceleration (uBIH) of ∼1700 g on the biochemical and microstrucutral changes in the brain using diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). Two groups of adult male Sprague-Dawley (SD) rats were subjected to a sham procedure and uBIH, respectively. Axonal and neurochemical alterations were assessed using in vivo DTI and MRS at 2 h, 24 h, and 7 days after uBIH. Significant reduction in mean diffusivity, axial diffusivity, and radial diffusivity were observed in the hippocampus, thalamus, internal capsule, and corpus callosum as early as 2 h, and sustained up to 7 days post-uBIH. Total creatine (Cr) and glutamine (Gln) were reduced in the internal capsule at 24 h post-uBIH. The reductions in DTI parameters, Cr and Gln in vivo suggest potential activation of astrocytes and diffuse axonal injury following a single underbody blast, confirming previous histology reports.

摘要

简易爆炸装置导致的爆炸相关创伤性脑损伤(bTBI)是近期战争中的标志性损伤,影响了许多经历过直接或间接暴露的退伍军人。这些退伍军人中有许多人存在长期神经认知症状。然而,几乎没有证据表明在没有二次撞击的情况下,单纯爆炸引起的加速度是否会导致轻度创伤性脑损伤。在本研究中,我们使用扩散张量成像(DTI)和磁共振波谱(MRS),研究了约1700 g的车底爆炸引起的超加速度(uBIH)对大脑生化和微观结构变化的影响。两组成年雄性Sprague-Dawley(SD)大鼠分别接受假手术和uBIH处理。在uBIH后2小时、24小时和7天,使用体内DTI和MRS评估轴突和神经化学改变。早在2小时时,在海马体、丘脑、内囊和胼胝体中就观察到平均扩散率、轴向扩散率和径向扩散率显著降低,并持续到uBIH后7天。uBIH后24小时,内囊中总肌酸(Cr)和谷氨酰胺(Gln)减少。体内DTI参数、Cr和Gln的降低表明单次车底爆炸后星形胶质细胞可能被激活以及弥漫性轴突损伤,这证实了先前的组织学报告。

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