Ross David E, Seabaugh John D, Seabaugh Jan M, Alvarez Claudia, Ellis Laura Peyton, Powell Christopher, Hall Christopher, Reese Christopher, Cooper Leah, Ochs Alfred L
Virginia Institute of Neuropsychiatry, Midlothian, VA, USA.
Randolph Macon College, Ashland, VA, USA.
Brain Inj. 2020;34(1):11-19. doi: 10.1080/02699052.2019.1669074. Epub 2019 Sep 25.
Much less is known about brain volume abnormalities in patients with chronic mild or moderate traumatic brain injury (TBI) compared with patients with more severe injury. Commercially available software methods including NeuroQuant® are being used increasingly to assess MRI brain volume in patients with TBI. 50 patients with mild or moderate TBI were compared to the NeuroQuant® normal control database ( = thousands) with respect to MRI brain volume. The patients had many areas of abnormal enlargement and fewer areas of atrophy, including abnormally small cerebral white matter (CWM) limited to the first 10 months after injury. Examination of correlations within the patient group between CWM volume and volumes of the abnormally enlarged regions showed multiple significant negative correlations, indicating that CWM atrophy correlated with enlargement of the other regions. The finding of many regions of abnormal brain enlargement was relatively new, although a couple of previous studies of patients with mild TBI found similar but more limited findings. The cause of the abnormal enlargement was unknown, but possibilities included: (1) hyperactivity and hypertrophy; or (2) chronic neuro-inflammation and edema. ADNI: Alzheimer's Disease Neuroimaging Initiative; CWM: cerebral white matter; GM: cerebral cortical gray matter; ICC: intraclass correlations coefficient; IFT: infratentorial; MRI: magnetic resonance imaging; mTBI: mild TBI; NQ: NeuroQuant®; SCN: subcortical nuclei; t0: time of injury; t1: time of first NeuroQuanted MRI scan after injury; t2: time of second NeuroQuanted MRI scan after injury; TBI: traumatic brain injury; VBR: ventricle-to-brain ratio; WBP: whole-brain parenchyma.
与重度创伤性脑损伤（TBI）患者相比，关于慢性轻度或中度TBI患者脑容量异常的了解要少得多。包括NeuroQuant®在内的商用软件方法越来越多地用于评估TBI患者的MRI脑容量。将50例轻度或中度TBI患者的MRI脑容量与NeuroQuant®正常对照数据库（=数千例）进行比较。这些患者有许多异常增大区域，萎缩区域较少，包括仅限于受伤后前10个月的异常小的脑白质（CWM）。对患者组中CWM体积与异常增大区域体积之间的相关性进行检查，发现了多个显著的负相关，表明CWM萎缩与其他区域的增大相关。脑异常增大的区域较多这一发现相对较新，尽管之前有几项针对轻度TBI患者的研究发现了类似但更有限的结果。异常增大的原因尚不清楚，但可能包括：（1）活动亢进和肥大；或（2）慢性神经炎症和水肿。ADNI：阿尔茨海默病神经影像学倡议；CWM：脑白质；GM：大脑皮质灰质；ICC：组内相关系数；IFT：幕下；MRI：磁共振成像；mTBI：轻度TBI；NQ：NeuroQuant®；SCN：皮质下核；t0：受伤时间；t1：受伤后首次进行NeuroQuant®MRI扫描的时间；t2：受伤后第二次进行NeuroQuant®MRI扫描的时间；TBI：创伤性脑损伤；VBR：脑室与脑比率；WBP：全脑实质。
