Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Brain Inj. 2021 May 12;35(6):725-733. doi: 10.1080/02699052.2021.1906445. Epub 2021 Apr 6.
: To investigate early brain volumetric changes from acute to 6 months following mild traumatic brain injury (mTBI) in deep gray matter regions and their association with patient 6-month outcome.: Fifty-six patients with mTBI underwent MRI and behavioral evaluation at acute (<10 days) and approximately 1 and 6 months post injury. Regional volume changes were investigated in key gray matter regions: thalamus, hippocampus, putamen, caudate, pallidum, and amygdala, and compared with volumes from 34 healthy control subjects. In patients with mTBI, we further assessed associations between longitudinal regional volume changes with patient outcome measures at 6 months including post-concussive symptoms, cognitive performance, and overall satisfaction with life.: Reduction in thalamic and hippocampal volumes was observed at 1 month among patients with mTBI. Such volume reduction persisted in the thalamus until 6 months. Changes in thalamic volumes also correlated with multiple symptom and functional outcome measures in patients at 6 months.: Our results indicate that the thalamus may be differentially affected among patients with mTBI, resulting in both structural and functional deficits with subsequent post-concussive sequelae and may serve as a biomarker for the assessment of efficacy of novel therapeutic interventions.
探讨轻度创伤性脑损伤(mTBI)后急性至 6 个月时深部灰质区域的早期脑容量变化及其与患者 6 个月结局的关系。
56 例 mTBI 患者在伤后<10 天、约 1 个月和 6 个月时进行 MRI 和行为评估。研究了关键灰质区域(丘脑、海马体、壳核、尾状核、苍白球和杏仁核)的区域体积变化,并与 34 名健康对照者的体积进行了比较。在 mTBI 患者中,我们进一步评估了纵向区域体积变化与患者 6 个月时的预后测量指标(如脑震荡后症状、认知表现和对生活的总体满意度)之间的相关性。
mTBI 患者在 1 个月时观察到丘脑和海马体体积减少。这种体积减少在丘脑体中持续到 6 个月。丘脑体体积的变化也与 6 个月时患者的多种症状和功能预后指标相关。
我们的研究结果表明,mTBI 患者的丘脑体可能会受到不同程度的影响,导致结构和功能缺陷,进而出现脑震荡后后遗症,并且可能成为评估新型治疗干预措施疗效的生物标志物。