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脑震荡数年之后儿童及青少年的脑血流量

Cerebral blood flow in children and adolescents several years after concussion.

作者信息

Brooks Brian L, Low Trevor A, Plourde Vickie, Virani Shane, Jadavji Zeanna, MacMaster Frank P, Barlow Karen M, Lebel R Marc, Yeates Keith Owen

机构信息

a Departments of Paediatrics, Clinical Neurosciences, and Psychology , University of Calgary , Calgary , Alberta , Canada.

b Alberta Children's Hospital Research Institute , University of Calgary , Calgary , Alberta , Canada.

出版信息

Brain Inj. 2019;33(2):233-241. doi: 10.1080/02699052.2018.1540798. Epub 2018 Oct 31.

Abstract

OBJECTIVES

The long-term effects of concussion in youth remain poorly understood. The objective of this study was to determine the association between history of concussion and cerebral blood flow (CBF) in youth.

METHODS

A total of 53 children and adolescents with a history of concussion (n = 37) or orthopaedic injury (OI; n = 16) were considered. Measures included pseudo-continuous arterial spin labelling magnetic resonance imaging to quantify CBF, post-concussion symptoms, psychological symptoms, and cognitive testing.

RESULTS

Participants (mean age: 14.4 years, 95% CI = 13.8-15.4, range = 8-19) were on average 2.7 years (95% CI = 2.2-3.1) post-injury. Youth with a history of concussion had higher parent-reported physical, cognitive, anxiety, and depression symptoms than children with OI, but the groups did not differ on self-reported symptoms (post-concussive or psychological) or cognitive testing. Global CBF did not differ between groups. Regional CBF analyses suggested that youth with a history of concussion had hypoperfusion in posterior and inferior regions and hyperperfusion in anterior/frontal/temporal regions as compared to those with OI. However, neither global nor regional CBF were significantly associated with demographics, pre-injury functioning, number of concussions, time since injury, post-concussive symptoms, psychological symptoms, or cognitive abilities.

CONCLUSIONS

Youth with a history of concussion demonstrate differences in regional CBF (not global CBF), but without clear clinical expression.

摘要

目的

青少年脑震荡的长期影响仍未得到充分了解。本研究的目的是确定青少年脑震荡史与脑血流量(CBF)之间的关联。

方法

共纳入53名有脑震荡史(n = 37)或骨科损伤(OI;n = 16)的儿童和青少年。测量指标包括用于量化CBF的伪连续动脉自旋标记磁共振成像、脑震荡后症状、心理症状和认知测试。

结果

参与者(平均年龄:14.4岁,95%CI = 13.8 - 15.4,范围 = 8 - 19岁)受伤后平均2.7年(95%CI = 2.2 - 3.1)。有脑震荡史的青少年在家长报告的身体、认知、焦虑和抑郁症状方面高于患有OI的儿童,但两组在自我报告的症状(脑震荡后或心理症状)或认知测试方面没有差异。两组之间的全脑CBF没有差异。区域CBF分析表明,与患有OI的青少年相比,有脑震荡史的青少年在后脑和下部区域存在灌注不足,在前部/额叶/颞叶区域存在灌注过度。然而,全脑或区域CBF均与人口统计学、伤前功能、脑震荡次数、受伤时间、脑震荡后症状、心理症状或认知能力无显著关联。

结论

有脑震荡史的青少年在区域CBF(而非全脑CBF)方面存在差异,但无明确的临床表现。

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