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轻度创伤性脑损伤后的早期纵向皮质下容积变化。

Early Stage Longitudinal Subcortical Volumetric Changes following Mild Traumatic Brain Injury.

机构信息

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.

出版信息

Brain Inj. 2021 May 12;35(6):725-733. doi: 10.1080/02699052.2021.1906445. Epub 2021 Apr 6.

Abstract

: 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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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