Östberg Anna, Ledig Christian, Katila Ari, Maanpää Henna-Riikka, Posti Jussi P, Takala Riikka, Tallus Jussi, Glocker Ben, Rueckert Daniel, Tenovuo Olli
Division of Clinical Neurosciences, Turku Brain Injury Centre, Turku University Hospital, Turku, Finland.
Department of Neurology, Institute of Clinical Medicine, University of Turku, Turku, Finland.
Front Neurol. 2020 Aug 13;11:832. doi: 10.3389/fneur.2020.00832. eCollection 2020.
The cholinergic nuclei in the basal forebrain innervate frontal cortical structures regulating attention. Our aim was to investigate if cognitive test results measuring attention relate to the longitudinal volume change of cholinergically innervated structures following traumatic brain injury (TBI). During the prospective, observational TBIcare project patients with all severities of TBI ( = 114) and controls with acute orthopedic injuries ( = 17) were recruited. Head MRI was obtained in both acute (mean 2 weeks post-injury) and late (mean 8 months) time points. T1-weighted 3D MR images were analyzed with an automatic segmentation method to evaluate longitudinal, structural brain volume change. The cognitive outcome was assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB). Analyses included 16 frontal cortical structures, of which four showed a significant correlation between post-traumatic volume change and the CANTAB test results. The strongest correlation was found between the volume loss of the supplementary motor cortex and motor screening task results (R-sq 0.16, < 0.0001), where poorer test results correlated with greater atrophy. Of the measured sum structures, greater cortical gray matter atrophy rate showed a significant correlation with the poorer CANTAB test results. TBI caused volume loss of frontal cortical structures that are heavily innervated by cholinergic neurons is associated with neuropsychological test results measuring attention.
基底前脑的胆碱能核团支配调节注意力的额叶皮质结构。我们的目的是研究测量注意力的认知测试结果是否与创伤性脑损伤（TBI）后胆碱能神经支配结构的纵向体积变化相关。在前瞻性观察性TBIcare项目中，招募了所有严重程度的TBI患者（n = 114）和急性骨科损伤对照组（n = 17）。在急性（平均伤后2周）和晚期（平均8个月）两个时间点均进行了头部MRI检查。采用自动分割方法分析T1加权3D MR图像，以评估大脑结构的纵向体积变化。使用剑桥神经心理测试自动成套系统（CANTAB）评估认知结果。分析包括16个额叶皮质结构，其中4个结构的创伤后体积变化与CANTAB测试结果之间存在显著相关性。在辅助运动皮层的体积损失与运动筛查任务结果之间发现了最强的相关性（R平方0.16，P < 0.0001），测试结果越差与萎缩越严重相关。在所测量的总和结构中，更大的皮质灰质萎缩率与更差的CANTAB测试结果显著相关。TBI导致受胆碱能神经元大量支配的额叶皮质结构体积损失，这与测量注意力的神经心理测试结果相关。
