1 Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
10 University of Cincinnati College of Medicine , Cincinnati, Ohio.
J Neurotrauma. 2019 Mar 1;36(5):721-734. doi: 10.1089/neu.2018.5737. Epub 2018 Oct 3.
Special Weapons and Tactics (SWAT) personnel who conduct breacher exercises are at risk for blast-related head trauma. We aimed to investigate the potential impact of low-level blast exposure during breacher training on the neural functioning of working memory and auditory network connectivity. We also aimed to evaluate the effects of a jugular vein compression collar, designed to internally mitigate slosh energy absorption, preserving neural functioning and connectivity, following blast exposure. A total of 23 SWAT personnel were recruited and randomly assigned to a non-collar (n = 11) and collar group (n = 12). All participants completed a 1-day breacher training with multiple blast exposure. Prior to and following training, 18 participants (non-collar, n = 8; collar, n = 10) completed functional magnetic resonance imaging (fMRI) of working memory using N-Back task; 20 participants (non-collar, n = 10; collar, n = 12) completed resting-state fMRI. Key findings from the working memory analysis include significantly increased fMRI brain activation in the right insular, right superior temporal pole, right inferior frontal gyrus, and pars orbitalis post-training for the non-collar group (p < 0.05, threshold-free cluster enhancement corrected), but no changes were noted for the collar group. The elevation in fMRI activation in the non-collar group was found to correlate significantly (n = 7, r = 0.943, p = 0.001) with average peak impulse amplitude experienced during the training. In the resting-state fMRI analysis, significant pre- to post-training increase in connectivity between the auditory network and two discrete regions (left middle frontal gyrus and left superior lateral occipital/angular gyri) was found in the non-collar group, while no change was observed in the collar group. These data provided initial evidence of the impact of low-level blast on working memory and auditory network connectivity as well as the protective effect of collar on brain function following blast exposure, and is congruent with previous collar findings in sport-related traumatic brain injury.
参与破门演习的特殊武器和战术（SWAT）人员有因爆炸相关头部创伤的风险。我们旨在研究在破门训练期间进行低水平爆炸暴露对工作记忆和听觉网络连通性的神经功能的潜在影响。我们还旨在评估颈静脉压缩套圈的效果，该套圈旨在内部减轻晃动能量吸收，从而在爆炸暴露后保护神经功能和连通性。共招募了 23 名 SWAT 人员，并将其随机分配到非套圈组（n = 11）和套圈组（n = 12）。所有参与者都完成了为期一天的破门训练，其中包括多次爆炸暴露。在训练之前和之后，18 名参与者（非套圈组，n = 8；套圈组，n = 10）使用 N-Back 任务完成了工作记忆的功能磁共振成像（fMRI）；20 名参与者（非套圈组，n = 10；套圈组，n = 12）完成了静息状态 fMRI。工作记忆分析的主要发现包括，在非套圈组中，在训练后右岛叶、右颞上极、右下额回和眶额部的 fMRI 脑激活显著增加（p < 0.05，无阈值聚类增强校正），而套圈组则没有变化。发现非套圈组中 fMRI 激活的升高与训练期间经历的平均峰值脉冲幅度显著相关（n = 7，r = 0.943，p = 0.001）。在静息状态 fMRI 分析中，在非套圈组中，在听觉网络与两个离散区域（左侧额中回和左侧额上外侧枕叶/角回）之间发现了从训练前到训练后的连通性的显著增加，而在套圈组中则没有观察到变化。这些数据提供了低水平爆炸对工作记忆和听觉网络连通性的影响的初步证据，以及套圈对爆炸暴露后大脑功能的保护作用，与之前在运动相关创伤性脑损伤中的套圈研究结果一致。
