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多参数分析揭示了代谢和血管效应,这些效应导致了与运动性脑震荡病史相关的基于血氧水平依赖性功能磁共振成像的脑血管反应性差异。

Multi-parametric analysis reveals metabolic and vascular effects driving differences in BOLD-based cerebrovascular reactivity associated with a history of sport concussion.

作者信息

Champagne Allen A, Coverdale Nicole S, Germuska Michael, Cook Douglas J

机构信息

a Centre for Neuroscience Studies, Queen's University , Kingston , ON , Canada.

b Cardiff University Brain Research Imaging Center, Cardiff University , Cardiff , UK.

出版信息

Brain Inj. 2019;33(11):1479-1489. doi: 10.1080/02699052.2019.1644375. Epub 2019 Jul 27.

Abstract

: Identify alterations in cerebrovascular reactivity (CVR) based on the history of sport-related concussion (SRC). Further explore possible mechanisms underlying differences in vascular physiology using hemodynamic parameters modeled using calibrated magnetic resonance imaging (MRI). : End-tidal targeting and dual-echo MRI were combined to probe hypercapnic and hyperoxic challenges in athletes with (n = 32) and without (n = 31) a history of SRC. Concurrent blood oxygenation level dependent (BOLD) and arterial spin labeling (ASL) data were used to compute BOLD-CVR, ASL-CVR, and other physiological parameters including resting oxygen extraction fraction (OEF) and cerebral blood volume (CBV). Multiple linear and logistic regressions were then used to identify dominant parameters driving group-differences in BOLD-CVR. : Robust evidence for elevated BOLD-CVR were found in athletes with SRC history spreading over parts of the cortical hemispheres. Follow-up analyses showed co-localized differences in ASL-CVR (representing modulation of cerebral blood flow) and hemodynamic factors representing static vascular (i.e., CBV) and metabolic (i.e., OEF) effects suggesting that group-based differences in BOLD-CVR may be driven by a mixed effect from factors with vascular metabolic origins. : These results emphasize that while BOLD-CVR offers promises as a surrogate non-specific biomarker for cerebrovascular health following SRC, multiple hemodynamic parameters can affect its relative measurements. : [dHb]: concentration of deoxyhemoglobin; AFNI: Analysis of Functional NeuroImages ( https://afni.nimh.nih.gov ); ASL: arterial spin labeling; BIG: position group: defensive and offensive linemen; BIG-SKILL: position group: full backs, linebackers, running backs, tight-ends; BOLD: blood oxygen level dependent; CBF: cerebral blood flow; CMRO2: cerebral metabolic rate of oxygen consumption; CTL: group of control subjects; CVR: cerebrovascular reactivity; fMRI: functional magnetic resonance imaging; FSL: FMRIB software library ( https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/ ); HC: hypercapnia; HO: hyperoxia; HX: group with history of concussion; M: maximal theoretical BOLD signal upon complete removal of venous dHb; pCASL: pseudo-continuous arterial spin labeling; PCO: end-tidal carbon dioxide; PO: end-tidal oxygen; SCAT: sport-concussion assessment tool; SKILL: position group: defensive backs, kickers, quarterbacks, safeties, wide-receivers; SRC: sport-related concussion.

摘要

基于运动相关脑震荡(SRC)病史识别脑血管反应性(CVR)的改变。使用校准磁共振成像(MRI)建模的血流动力学参数,进一步探索血管生理差异背后的潜在机制。:将呼气末靶向和双回波MRI相结合,对有(n = 32)和无(n = 31)SRC病史的运动员进行高碳酸血症和高氧血症挑战测试。同时使用血氧水平依赖(BOLD)和动脉自旋标记(ASL)数据来计算BOLD-CVR、ASL-CVR以及其他生理参数,包括静息氧摄取分数(OEF)和脑血容量(CBV)。然后使用多元线性和逻辑回归来确定驱动BOLD-CVR组间差异的主要参数。:在有SRC病史的运动员中,发现了BOLD-CVR升高的有力证据,这种升高分布在部分皮质半球。后续分析显示,ASL-CVR(代表脑血流量的调节)以及代表静态血管(即CBV)和代谢(即OEF)效应的血流动力学因素存在共同定位差异,这表明基于组别的BOLD-CVR差异可能由血管代谢起源的因素的混合效应驱动。:这些结果强调,虽然BOLD-CVR有望作为SRC后脑血管健康的替代非特异性生物标志物,但多个血流动力学参数会影响其相对测量值。:[dHb]:脱氧血红蛋白浓度;AFNI:功能神经影像分析(https://afni.nimh.nih.gov);ASL:动脉自旋标记;BIG:位置组:防守和进攻前锋;BIG-SKILL:位置组:全卫、线卫、跑卫、近端锋;BOLD:血氧水平依赖;CBF:脑血流量;CMRO2:脑氧代谢率;CTL:对照组;CVR:脑血管反应性;fMRI:功能磁共振成像;FSL:FMRIB软件库(https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/);HC:高碳酸血症;HO:高氧血症;HX:有脑震荡病史的组;M:完全去除静脉血dHb后的最大理论BOLD信号;pCASL:伪连续动脉自旋标记;PCO:呼气末二氧化碳;PO:呼气末氧气;SCAT:运动脑震荡评估工具;SKILL:位置组:防守后卫、踢球者、四分卫、安全员、外接手;SRC:运动相关脑震荡

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