Departments of Psychiatry and Neurology, University of Utah, Salt Lake City, Utah, USA.
Department of Psychology and Neuroscience Center, Brigham Young University, P.O. Box 1968, Provo, Utah, 84603, USA.
Neuropsychol Rev. 2023 Mar;33(1):5-41. doi: 10.1007/s11065-020-09474-0. Epub 2021 Mar 3.
Region of interest (ROI) volumetric assessment has become a standard technique in quantitative neuroimaging. ROI volume is thought to represent a coarse proxy for making inferences about the structural integrity of a brain region when compared to normative values representative of a healthy sample, adjusted for age and various demographic factors. This review focuses on structural volumetric analyses that have been performed in the study of neuropathological effects from mild traumatic brain injury (mTBI) in relation to neuropsychological outcome. From a ROI perspective, the probable candidate structures that are most likely affected in mTBI represent the target regions covered in this review. These include the corpus callosum, cingulate, thalamus, pituitary-hypothalamic area, basal ganglia, amygdala, and hippocampus and associated structures including the fornix and mammillary bodies, as well as whole brain and cerebral cortex along with the cerebellum. Ventricular volumetrics are also reviewed as an indirect assessment of parenchymal change in response to injury. This review demonstrates the potential role and limitations of examining structural changes in the ROIs mentioned above in relation to neuropsychological outcome. There is also discussion and review of the role that post-traumatic stress disorder (PTSD) may play in structural outcome in mTBI. As emphasized in the conclusions, structural volumetric findings in mTBI are likely just a single facet of what should be a multimodality approach to image analysis in mTBI, with an emphasis on how the injury damages or disrupts neural network integrity. The review provides an historical context to quantitative neuroimaging in neuropsychology along with commentary about future directions for volumetric neuroimaging research in mTBI.
感兴趣区域（ROI）容积评估已成为定量神经影像学的标准技术。与代表健康样本的正常数值相比，ROI 体积被认为是一种粗略的代理指标，可以用于推断大脑区域的结构完整性，同时考虑到年龄和各种人口统计学因素的影响。本综述重点介绍了在轻度创伤性脑损伤（mTBI）的神经病理学效应与神经心理学结果相关的研究中进行的结构容积分析。从 ROI 的角度来看，mTBI 中最有可能受到影响的可能候选结构代表了本综述涵盖的目标区域。这些结构包括胼胝体、扣带回、丘脑、垂体-下丘脑区域、基底节、杏仁核和海马体以及相关结构，包括穹窿和乳头体，以及整个大脑和大脑皮层以及小脑。脑室容积也作为对损伤反应的实质变化的间接评估进行了综述。本综述展示了检查上述 ROI 中的结构变化与神经心理学结果之间的潜在作用和局限性。还讨论了创伤后应激障碍（PTSD）在 mTBI 的结构结果中可能发挥的作用。正如结论中所强调的，mTBI 中的结构容积发现可能只是 mTBI 图像分析中应该采用多模态方法的一个方面，重点是损伤如何损害或破坏神经网络的完整性。该综述提供了神经心理学中定量神经影像学的历史背景，并对 mTBI 中容积神经影像学研究的未来方向进行了评论。
