Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, China.
Hum Brain Mapp. 2020 Oct 15;41(15):4431-4441. doi: 10.1002/hbm.25135. Epub 2020 Jul 13.
Deficits in information processing speed (IPS) are among the earliest and most prominent cognitive manifestations in mild traumatic brain injury (mTBI). We investigated the impact of white matter fiber location on IPS outcome in an individual basis assessment. A total of 112 acute mild TBI with all CT negative underwent brain DTI and blood sampling for inflammation cytokines within 7 days postinjury and 72 age- and sex matched healthy controls with same assessments were enrolled. IPS outcome was assessed by the trail making test at 6-12 month postinjury in mild TBI. Fractional anisotropy (FA) features were extracted using a novel lesion-load analytical strategy to capture spatially heterogeneous white matter injuries and minimize implicit assumptions of uniform injury across diverse clinical presentations. Acute mild TBI exhibited a general pattern of increased and decreased FA in specific white matter tracts. The power of acute FA measures to identify patients developing IPS deficits with 92% accuracy and further improved to 96% accuracy by adding inflammation cytokines. The classifiers predicted individual's IPS and working memory ratings (r = .74 and .80, respectively, p < .001). The thalamo-cortical circuits and commissural tracts projecting or connecting frontal regions became important predictors. This prognostic model was also verified by an independent replicate sample. Our findings highlighted damage to frontal interhemispheric and thalamic projection fiber tracts harboring frontal-subcortical neuronal circuits as a predictor for processing speed performance in mild TBI.
信息处理速度（IPS）缺陷是轻度创伤性脑损伤（mTBI）最早和最突出的认知表现之一。我们在个体基础评估中研究了白质纤维位置对 IPS 结果的影响。共有 112 例 CT 均为阴性的急性轻度 TBI 患者在损伤后 7 天内接受了大脑 DTI 和炎症细胞因子血液采样，同时还招募了 72 名年龄和性别匹配的健康对照者进行相同的评估。在轻度 TBI 患者受伤后 6-12 个月通过连线测试评估 IPS 结果。使用新的病变负荷分析策略提取各向异性分数（FA）特征，以捕捉空间异质的白质损伤并最大限度地减少对不同临床表现下均匀损伤的隐含假设。急性轻度 TBI 显示出特定白质束中 FA 增加和减少的一般模式。急性 FA 测量值能够以 92%的准确率识别出出现 IPS 缺陷的患者，通过添加炎症细胞因子，准确率进一步提高到 96%。分类器预测了个体的 IPS 和工作记忆评分（分别为 r =.74 和 r =.80，p <.001）。丘脑皮质回路和投射或连接额叶的连合束成为重要的预测因子。该预后模型也通过独立的复制样本得到了验证。我们的研究结果强调了额叶间和丘脑投射纤维束的损伤作为预测轻度 TBI 处理速度表现的额叶-皮质下神经元回路的重要预测因子。
