Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Department of Physical Medicine and Rehabilitation, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
J Neurosci Res. 2019 May;97(5):568-581. doi: 10.1002/jnr.24383. Epub 2019 Jan 24.
Aims of this study were to investigate white matter (WM) and thalamus microstructure 72 hr and 3 months after mild traumatic brain injury (TBI) with diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI), and to relate DKI and DTI findings to postconcussional syndrome (PCS). Twenty-five patients (72 hr = 24; 3 months = 23) and 22 healthy controls were recruited, and DKI and DTI data were analyzed with Tract-Based Spatial Statistics (TBSS) and a region-of-interest (ROI) approach. Patients were categorized into PCS or non-PCS 3 months after injury according to the ICD-10 research criteria for PCS. In TBSS analysis, significant differences between patients and controls were seen in WM, both in the acute stage and 3 months after injury. Fractional anisotropy (FA) reductions were more widespread than kurtosis fractional anisotropy (KFA) reductions in the acute stage, while KFA reductions were more widespread than the FA reductions at 3 months, indicating the complementary roles of DKI and DTI. When comparing patients with PCS (n = 9), without PCS (n = 16), and healthy controls, in the ROI analyses, no differences were found in the acute DKI and DTI metrics. However, near-significant differences were observed for several DKI metrics obtained in WM and thalamus concurrently with symptom assessment (3 months after injury). Our findings indicate a combined utility of DKI and DTI in detecting WM microstructural alterations after mild TBI. Moreover, PCS may be associated with evolving alterations in brain microstructure, and DKI may be a promising tool to detect such changes.
本研究的目的是使用扩散峰度成像（DKI）和扩散张量成像（DTI）来研究轻度创伤性脑损伤（TBI）后 72 小时和 3 个月时的白质（WM）和丘脑的微观结构，并将 DKI 和 DTI 的发现与脑震荡后综合征（PCS）相关联。共招募了 25 名患者（72 小时=24 名；3 个月=23 名）和 22 名健康对照者，并用基于体素的空间统计学（TBSS）和感兴趣区（ROI）方法分析 DKI 和 DTI 数据。根据 ICD-10 研究标准，根据损伤后 3 个月时的 PCS，将患者分为 PCS 或非 PCS 组。在 TBSS 分析中，在 WM 中，无论是在急性期还是在损伤后 3 个月，都发现了患者与对照组之间的显著差异。在急性期，FA 的减少比 KFA 的减少更为广泛，而在 3 个月时，KFA 的减少比 FA 的减少更为广泛，这表明 DKI 和 DTI 的互补作用。当比较 PCS 患者（n=9）、无 PCS 患者（n=16）和健康对照组时，在 ROI 分析中，急性期的 DKI 和 DTI 指标无差异。然而，在与症状评估同时获得的 WM 和丘脑的几个 DKI 指标中观察到接近显著的差异（损伤后 3 个月）。我们的研究结果表明，DKI 和 DTI 在检测轻度 TBI 后 WM 微观结构改变方面具有联合作用。此外，PCS 可能与脑微观结构的不断变化有关，DKI 可能是检测这种变化的一种很有前途的工具。
