Department of Neurology, The University of Texas Dell Medical School, Austin, TX, 78712, USA.
Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78712, USA.
Mil Med. 2021 Jan 25;186(Suppl 1):515-522. doi: 10.1093/milmed/usaa426.
Traumatic brain injuries are of concern to the sports and military communities because of the age of the participants and costly burden to society. To markedly reduce the impact of traumatic brain injury and its sequela (TBI-S), it is necessary to determine the initial vulnerability of individuals as well as identify new technologies that indicate early signs of TBI-S.
Currently, diverse methods have been used by the authors and others in laboratory settings to reveal early signs of persistent TBI-S including simulation modeling of the effect of rapid deceleration on the deviatoric strain (shear force) imposed on specific brain regions, auditory evoked potential (AEP) measurements to determine injury to the auditory cortex optokinetic nystagmus (OKN) measures sensitive to vestibular trauma, and optical coherence tomography (OCT) measures that reveal changes in central visual function obtained noninvasively by examination of the retina.
Simulation studies provided technical information on maximal deviatoric strain at the base of the sulci and interface of gray and white matter consistent with results from neuropathology and from magnetic resonance imaging. The AEP and OKN reveal measurable injury to similar regions below the Sylvian fissure including auditory cortex and midbrain, and the OCT reveals changes to the retina consistent with forceful deceleration effects.
The studies and results are consistent with prior work demonstrating that noninvasive tests may be sensitive to the presence of TBI-S, potentially in the training field as advances in the portability of test instruments are underway. When combined with baseline data gathered from individuals in quantitative form, key variances can emerge. Therefore, it is hypothesized that AEP, OKN, and OCT, taken together, may yield faster objective and quantitative neurophysiological measures serving as a "signature" of neural injury and more indicative of potentially persistent TBI-S-recommending larger scale longitudinal studies.
由于参与者的年龄和对社会的高成本负担，创伤性脑损伤引起了运动界和军事界的关注。为了显著降低创伤性脑损伤及其后遗症（TBI-S）的影响，有必要确定个体的初始脆弱性，并确定表明 TBI-S 早期迹象的新技术。
目前，作者和其他人在实验室环境中使用了多种方法来揭示持续性 TBI-S 的早期迹象，包括模拟减速对特定大脑区域施加的偏应变（剪切力）的影响，测量听觉诱发电位 (AEP) 以确定听觉皮层的损伤，测量视动性眼球震颤 (OKN) 以确定对前庭创伤敏感的区域，以及测量光学相干断层扫描 (OCT) 以揭示视网膜无创检查获得的中央视觉功能变化。
模拟研究提供了关于在沟基底和灰质与白质界面处最大偏应变的技术信息，这些信息与神经病理学和磁共振成像的结果一致。AEP 和 OKN 揭示了在包括听觉皮层和中脑在内的西尔维恩裂下方类似区域可测量的损伤，而 OCT 揭示了与强力减速效应一致的视网膜变化。
这些研究和结果与先前的工作一致，表明非侵入性测试可能对 TBI-S 的存在敏感，在便携式测试仪器的进步正在进行的情况下，潜在地在训练领域。当与以定量形式从个体收集的基线数据结合使用时，可能会出现关键差异。因此，假设 AEP、OKN 和 OCT 一起使用可能会产生更快的客观和定量神经生理学测量结果，作为神经损伤的“特征”，并且更能指示潜在的持续性 TBI-S，建议进行更大规模的纵向研究。
