Sussman Dafna, da Costa Leodante, Chakravarty Mallar M, Pang Elizabeth W, Taylor Margot J, Dunkley Benjamin T
Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Canada.
Division of Neurosurgery, Sunnybrook Hospital, Toronto, Canada.
Neurosci Lett. 2017 May 22;650:52-59. doi: 10.1016/j.neulet.2017.04.026. Epub 2017 Apr 17.
Concussion induces transient, and oftentimes chronic, lingering impairment to mental functioning, which must be driven by some underlying neurobiological perturbation - however, the physical changes related to sequelae are difficult to detect. Previous imaging studies on concussion have focused on alterations to cortical anatomy, but few have examined the cerebrum, subcortex, and cerebellum. Here, we present an analysis of these structures in a single cohort (all males, 21 patients, 22 controls) using MRI and diagnosed with a single-concussive episode in the acute and sub-acute stages of injury. Structural images were segmented into 78 cortical brain regions and 81,924 vertices using the CIVET algorithm. Subcortical volumetric analyses of the cerebellum, thalamus, globus pallidus, caudate and putamen were conducted following segmentation. Participants with concussion were found to have reduced white and grey matter volume, total cortical volume, as well as cortical thinning, primarily in left frontal areas. No differences were observed in the cerebellum or subcortical structures. In conclusion, just a single concussive episode induces measurable changes in brain structure manifesting as diffuse and local patterns of altered neuromorphometry.
脑震荡会导致精神功能出现短暂的，而且常常是慢性的、持续的损害，这必定是由某些潜在的神经生物学扰动所驱动的——然而，与后遗症相关的身体变化很难检测到。先前关于脑震荡的影像学研究主要集中在皮质解剖结构的改变上，但很少有研究对大脑、皮质下结构和小脑进行检查。在此，我们对一个单一队列（全部为男性，21例患者，22例对照）中的这些结构进行了分析，这些受试者通过MRI进行诊断，且在损伤的急性和亚急性期经历过单次脑震荡事件。使用CIVET算法将结构图像分割为78个皮质脑区和81,924个顶点。分割后对小脑、丘脑、苍白球、尾状核和壳核进行了皮质下体积分析。发现脑震荡患者的白质和灰质体积、总皮质体积减少，以及皮质变薄，主要发生在左侧额叶区域。在小脑或皮质下结构中未观察到差异。总之，仅单次脑震荡事件就会导致大脑结构出现可测量的变化，表现为神经形态测量改变的弥漫性和局部性模式。
