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成人创伤性脑损伤后使用弥散张量成像检测到的慢性白质变化及其与认知的关系。

Chronic white matter changes detected using diffusion tensor imaging following adult traumatic brain injury and their relationship to cognition.

机构信息

Faculty of Health & Medical Sciences, University of Adelaide.

Australian E-Health Research Centre, CSIRO.

出版信息

Neuropsychology. 2020 Nov;34(8):881-893. doi: 10.1037/neu0000690.

Abstract

White matter (WM) changes detected using diffusion tensor imaging (DTI) are reportedly related to cognitive outcomes following traumatic brain injury (TBI), but much existing research is underpowered or has only examined general outcomes, rather than cognitive functioning. A large sample of adults who had sustained mild, moderate or severe TBIs seven months prior ( = 165) and a control group ( = 106) underwent DTI and cognitive testing. Fractional anisotropy and mean diffusivity were calculated for 5 regions (corpus callosum: genu, body, splenium; fornix; superior longitudinal fasciculus) that recent meta-analyses identified as being affected by TBI and related to cognition following TBI. Memory, attention and executive functioning, which are often affected by TBI, were assessed. Overall, mild TBI did not show significant WM or cognitive changes, relative to controls, but moderate to severe TBI was associated with large WM alterations (all regions) and poorer cognitive performance. No significant correlations were found between DTI findings and cognition in the moderate to severe group. The findings have shown that moderate to severe TBI leads to considerable WM and cognitive changes. Early and ongoing examination of mild TBI is needed to determine whether WM and cognitive changes are initially present and, if so, when they resolve. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

摘要

据报道,使用弥散张量成像(DTI)检测到的白质(WM)变化与创伤性脑损伤(TBI)后的认知结果有关,但许多现有研究的效力不足,或者仅检查了一般结果,而不是认知功能。 一个大样本的成年人在七个月前(= 165)遭受了轻度、中度或重度 TBI,以及一个对照组(= 106)接受了 DTI 和认知测试。计算了 5 个区域(胼胝体:膝部、体部、压部;穹窿;上纵束)的分数各向异性和平均弥散度,最近的荟萃分析确定这些区域受 TBI 影响,并与 TBI 后的认知有关。评估了经常受到 TBI 影响的记忆、注意力和执行功能。 总体而言,与对照组相比,轻度 TBI 并没有显示出明显的 WM 或认知变化,但中度至重度 TBI 与较大的 WM 改变(所有区域)和较差的认知表现相关。在中度至重度组中,DTI 结果与认知之间没有发现显著相关性。研究结果表明,中度至重度 TBI 会导致相当大的 WM 和认知变化。需要对轻度 TBI 进行早期和持续检查,以确定 WM 和认知变化是否最初存在,如果存在,何时会消失。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。

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