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电击伤后轻度认知障碍患者认知回路的稳态脑血容量和扩散张量成像研究

Investigation of cognitive circuits using steady-state cerebral blood volume and diffusion tensor imaging in patients with mild cognitive impairment following electrical injury.

作者信息

Park Chang-Hyun, Seo Cheong Hoon, Jung Myung Hun, Joo So Young, Jang Soyeon, Lee Ho Young, Ohn Suk Hoon

机构信息

Department of Psychiatry, College of Medicine, Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 06591, Republic of Korea.

Department of Physical Medicine and Rehabilitation, Hangang Sacred Heart Hospital, Hallym University College of Medicine, 12 Beodeunaru-ro 7 Gil Yeongdeungpo-gu, Seoul, 07247, Republic of Korea.

出版信息

Neuroradiology. 2017 Sep;59(9):915-921. doi: 10.1007/s00234-017-1876-1. Epub 2017 Jul 8.

Abstract

PURPOSE

We utilized cerebral blood volume (CBV) magnetic resonance imaging and diffusion tensor imaging (DTI) to investigate changes in cognitive networks in patients experiencing cognitive dysfunction following electrical injury.

METHODS

Cognitive function was assessed across various domains, including attention, verbal memory, executive function, and language. Depressive symptoms were also evaluated. CBV maps and DTI measures were obtained from 24 patients (age, 41.8 ± 5.8 years; education, 13.3 ± 1.9 years) and 24 healthy controls (age, 42.3 ± 2.7 years; education, 14.3 ± 1.9 years). CBV maps and DTI measures were compared between patients and controls, and correlations between these measures and each cognitive assessment score were examined.

RESULTS

Patients exhibited lower attention, verbal memory, and executive function scores than controls (all p < 0.01). Patients also exhibited higher depression scores than controls (p < 0.01), as well as a predominant increase in CBV in the cerebellar vermis relative to that of controls (height p < uncorrected 0.001, extent p < corrected 0.05). Correlation analyses revealed a strong association between executive function scores and CBV in the bilateral posterior cingulate cortex and left mammillary body in patients (height p < uncorrected 0.001, extent p < corrected 0.05). There were no significant differences in DTI measures between patients and controls.

CONCLUSION

The CBV maps showed hypermetabolism in the cerebello-limbic system; DTI did not find any microstructural changes. Our results suggest that patients experiencing cognitive dysfunction following electrical injury may possess a cognitive reserve that protects against deteriorating conditions such as dementia.

摘要

目的

我们利用脑血容量(CBV)磁共振成像和弥散张量成像(DTI)来研究电击伤后出现认知功能障碍的患者认知网络的变化。

方法

对包括注意力、言语记忆、执行功能和语言在内的多个领域的认知功能进行评估。还评估了抑郁症状。从24例患者(年龄41.8±5.8岁;受教育年限13.3±1.9年)和24例健康对照者(年龄42.3±2.7岁;受教育年限14.3±1.9年)获取CBV图和DTI测量值。比较患者与对照者之间的CBV图和DTI测量值,并检查这些测量值与各项认知评估分数之间的相关性。

结果

患者的注意力、言语记忆和执行功能得分低于对照者(均p<0.01)。患者的抑郁得分也高于对照者(p<0.01),并且相对于对照者,患者小脑蚓部的CBV显著增加(高度p<未校正0.001,范围p<校正后0.05)。相关性分析显示,患者双侧后扣带回皮质和左侧乳头体的执行功能得分与CBV之间存在强关联(高度p<未校正0.001,范围p<校正后0.05)。患者与对照者之间的DTI测量值无显著差异。

结论

CBV图显示小脑-边缘系统存在代谢亢进;DTI未发现任何微观结构变化。我们的结果表明,电击伤后出现认知功能障碍的患者可能具有认知储备,可防止出现如痴呆等病情恶化。

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