Jang Sung H, Kim Seong H, Kwon Young H
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea.
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, South Korea.
Front Neurosci. 2018 May 29;12:348. doi: 10.3389/fnins.2018.00348. eCollection 2018.
This study investigated injuries of the ascending reticular activating system (ARAS) following whiplash injury, in patients with excessive daytime sleepiness (EDS). Twenty-three patients with whiplash injury and 26 healthy control subjects were recruited for this study. Epworth Sleepiness Scale (ESS) was used for evaluating sleepiness. According to the ESS score, the patients were classified into two groups: subgroup A - ESS score <10, and subgroup B - ESS score ≥10. Three components of the ARAS (lower dorsal, lower ventral, and upper) were evaluated for fractional anisotropy (FA) and tract volume (TV). No significant differences were observed in the FA and TV values of the lower dorsal and upper ARAS between the patient and control groups ( > 0.05). Conversely, the values of FA and TV in the lower ventral ARAS of the patient group were significantly lower than those of the control group ( < 0.05). Comparing the values of subgroups A and B, the TV value of subgroup B was significantly lower than subgroup A ( < 0.05). However, no significant differences were observed in the values of the FA and TV in the lower dorsal and upper ARAS, and the FA value in the lower ventral ARAS ( > 0.05). We found significant injury of the lower ventral ARAS in EDS patients with whiplash injury. These results suggest that diffusion tensor tractography (DTT) could provide useful information for detecting injuries of the ARAS following whiplash injury, in patients with EDS.
本研究调查了白天过度嗜睡（EDS）的鞭梢伤患者中上行网状激活系统（ARAS）的损伤情况。本研究招募了23名鞭梢伤患者和26名健康对照者。采用爱泼沃斯嗜睡量表（ESS）评估嗜睡程度。根据ESS评分，将患者分为两组：A组——ESS评分<10分，B组——ESS评分≥10分。对ARAS的三个组成部分（下背部、下腹部和上部）进行分数各向异性（FA）和纤维束体积（TV）评估。患者组和对照组在下背部和上部ARAS的FA和TV值方面未观察到显著差异（>0.05）。相反，患者组下腹部ARAS的FA和TV值显著低于对照组（<0.05）。比较A组和B组的值，B组的TV值显著低于A组（<0.05）。然而，在下背部和上部ARAS的FA和TV值以及下腹部ARAS的FA值方面未观察到显著差异（>0.05）。我们发现，患有鞭梢伤的EDS患者的下腹部ARAS存在明显损伤。这些结果表明，弥散张量纤维束成像（DTT）可为检测患有鞭梢伤的EDS患者中ARAS的损伤提供有用信息。
