Arakaki Xianghong, Shoga Michael, Li Lianyang, Zouridakis George, Tran Thao, Fonteh Alfred N, Dawlaty Jessica, Goldweber Robert, Pogoda Janice M, Harrington Michael G
Neurosciences, Huntington Medical Research Institutes, Pasadena, California, United States of America.
Biomedical Imaging Lab, University of Houston, Houston, Texas, United States of America.
PLoS One. 2018 Feb 14;13(2):e0188101. doi: 10.1371/journal.pone.0188101. eCollection 2018.
Diagnosing and monitoring recovery of patients with mild traumatic brain injury (mTBI) is challenging because of the lack of objective, quantitative measures. Diagnosis is based on description of injuries often not witnessed, subtle neurocognitive symptoms, and neuropsychological testing. Since working memory (WM) is at the center of cognitive functions impaired in mTBI, this study was designed to define objective quantitative electroencephalographic (qEEG) measures of WM processing that may correlate with cognitive changes associated with acute mTBI. First-time mTBI patients and mild peripheral (limb) trauma controls without head injury were recruited from the emergency department. WM was assessed by a continuous performance task (N-back). EEG recordings were obtained during N-back testing on three occasions: within five days, two weeks, and one month after injury. Compared with controls, mTBI patients showed abnormal induced and evoked alpha activity including event-related desynchronization (ERD) and synchronization (ERS). For induced alpha power, TBI patients had excessive frontal ERD on their first and third visit. For evoked alpha, mTBI patients had lower parietal ERD/ERS at the second and third visits. These exploratory qEEG findings offer new and non-invasive candidate measures to characterize the evolution of injury over the first month, with potential to provide much-needed objective measures of brain dysfunction to diagnose and monitor the consequences of mTBI.
由于缺乏客观、定量的测量方法，诊断和监测轻度创伤性脑损伤（mTBI）患者的恢复情况具有挑战性。诊断基于对通常未被目睹的损伤的描述、细微的神经认知症状以及神经心理学测试。由于工作记忆（WM）处于mTBI中受损的认知功能的核心位置，本研究旨在定义WM处理的客观定量脑电图（qEEG）测量方法，这些方法可能与急性mTBI相关的认知变化相关。从急诊科招募了首次发生mTBI的患者和无头部损伤的轻度外周（肢体）创伤对照者。通过连续性能任务（N-back）评估WM。在受伤后五天内、两周和一个月这三个时间点，在N-back测试期间进行脑电图记录。与对照组相比，mTBI患者表现出异常的诱发和诱发阿尔法活动，包括事件相关去同步化（ERD）和同步化（ERS）。对于诱发阿尔法功率，TBI患者在首次和第三次就诊时额叶ERD过多。对于诱发阿尔法，mTBI患者在第二次和第三次就诊时顶叶ERD/ERS较低。这些探索性的qEEG结果提供了新的、非侵入性的候选测量方法，以表征损伤在第一个月内的演变，有可能提供急需的脑功能障碍客观测量方法，用于诊断和监测mTBI的后果。
