Psychology Department, Brigham Young University, Provo, Utah, USA.
Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA.
J Neurotrauma. 2020 Oct 15;37(20):2188-2197. doi: 10.1089/neu.2019.6691. Epub 2020 May 15.
White matter (WM) abnormalities, such as atrophy and hyperintensities (WMH), can be accessed via magnetic resonance imaging (MRI) after pediatric traumatic brain injury (TBI). Several methods are available to classify WM abnormalities (i.e., total WM volumes and WMHs), but automated and manual volumes and clinical ratings have yet to be compared in pediatric TBI. In addition, WM integrity has been associated reliably with processing speed. Consequently, methods of assessing WM integrity should relate to processing speed to have clinical application. This study had two goals: (1) to compare Scheltens rating scale, manual tracing, FreeSurfer, and NeuroQuant methods of assessing WM abnormalities, and (2) to relate WM methods to processing speed scores. We report findings from the Social Outcomes of Brain Injury in Kids (SOBIK) study, a multi-center study of 60 children with chronic TBI (65% male) from ages 8-13. Scheltens WMH ratings had good to excellent agreement with WMH volumes for both NeuroQuant (ICC = 0.62; r = 0.29, = 0.005) and manual tracing (ICC = 0.82; r = 0.50, = 0.000). NeuroQuant WMH volumes did not correlate with manually traced WMH volumes (r = 0.12, = 0.21) and had poor agreement (ICC = 0.24). NeuroQuant and FreeSurfer total WM volumes correlated (r = 0.38, = 0.004) and had fair agreement (ICC = 0.52). The WMH assessment methods, both ratings and volumes, were associated with processing speed scores. In contrast, total WM volume was not related to processing speed. Measures of WMH may hold clinical utility for predicting cognitive functioning after pediatric TBI.
脑白质（WM）异常，如萎缩和高信号（WMH），可通过磁共振成像（MRI）在儿科创伤性脑损伤（TBI）后进行评估。有几种方法可用于分类 WM 异常（即总 WM 体积和 WMH），但在儿科 TBI 中尚未比较自动和手动体积与临床评分。此外，WM 完整性与处理速度可靠相关。因此，评估 WM 完整性的方法应该与处理速度相关才有临床应用。本研究有两个目标：（1）比较 Scheltens 评分量表、手动追踪、FreeSurfer 和 NeuroQuant 评估 WM 异常的方法，以及（2）将 WM 方法与处理速度评分相关联。我们报告了来自脑损伤儿童社会结局（SOBIK）研究的结果，这是一项多中心研究，纳入了 60 名年龄在 8-13 岁的慢性 TBI 儿童（65%为男性）。Scheltens WMH 评分与 NeuroQuant（ICC=0.62；r=0.29，p=0.005）和手动追踪（ICC=0.82；r=0.50，p=0.000）的 WMH 体积均具有良好到极好的一致性。NeuroQuant 的 WMH 体积与手动追踪的 WMH 体积不相关（r=0.12，p=0.21），一致性也较差（ICC=0.24）。NeuroQuant 和 FreeSurfer 的总 WM 体积相关（r=0.38，p=0.004），一致性为中等（ICC=0.52）。WMH 评估方法（评分和体积）与处理速度评分相关。相比之下，总 WM 体积与处理速度无关。WMH 测量值可能对预测儿科 TBI 后的认知功能具有临床效用。
