Shi Jian, Teng Jing, Du Xianping, Li Na
Department of Spine Surgury, The Third Xiangya Hospital, Central South University, Changsha, China.
School of Control and Computer Engineering, North China Electric Power University, Beijing, China.
Front Neurol. 2021 May 17;12:639760. doi: 10.3389/fneur.2021.639760. eCollection 2021.
Various cognitive disorders have been reported for mild traumatic brain injury (mTBI) patients during the acute stage. This acute stage provides an opportunity for clinicians to optimize treatment protocols, which are based on the evaluation of brain structural connectivity. So far, most brain functional magnetic resonance imaging studies are focused on moderate to severe traumatic brain injuries (TBIs). In this study, we prospectively collected resting state data on 50 mTBI within 3 days of injury and 50 healthy volunteers and analyzed them using Amplitude of low-frequency fluctuation (ALFF), Regional Homogeneity (ReHo), graph theory methods and behavior measure, to explore the dysfunctional brain regions in acute mTBI. In our study, a total of 50 patients suffering <3 days mTBI and 50 healthy subjects were tested in rs-fMRI, as well as under neuropsychological examinations including the Wechsler Intelligence Scale and Stroop Color and Word Test. The correlation analysis was conducted between graph theoretic parameters and neuropsychological results. For the mTBI group, the ReHo of the inferior temporal gyrus and the cerebellum superior are significantly lower than in the control group, and the ALFF of the left insula, the cerebellum inferior, and the middle occipital gyrus were significantly higher than in the control group, which implies the dysfunctionality usually observed in Parkinson's disease. Executive function disorder was significantly correlated with the global efficiencies of the dorsolateral superior frontal gyrus and the anterior cingulate cortex, which is consistent with the literature: the acute mTBI patients demonstrate abnormality in terms of motor speed, association, information processing speed, attention, and short-term memory function. Correlation analysis between the neuropsychological outcomes and the network efficiency for the mTBI group indicates that executive dysfunction might be caused by local brain changes. Our data support the idea that the cerebral internal network has compensatory reactions in response to sudden pathological and neurophysiological changes. In the future, multimode rs-fMRI analysis could be a valuable tool for evaluating dysfunctional brain regions after mTBI.
据报道，轻度创伤性脑损伤（mTBI）患者在急性期会出现各种认知障碍。这一急性期为临床医生提供了一个优化治疗方案的机会，这些方案基于对脑结构连通性的评估。到目前为止，大多数脑功能磁共振成像研究都集中在中度至重度创伤性脑损伤（TBI）上。在本研究中，我们前瞻性地收集了50例受伤后3天内的mTBI患者和50名健康志愿者的静息态数据，并使用低频振幅（ALFF）、局部一致性（ReHo）、图论方法和行为测量进行分析，以探索急性mTBI中功能失调的脑区。在我们的研究中，共有50例受伤<3天的mTBI患者和50名健康受试者接受了静息态功能磁共振成像（rs-fMRI）测试，以及包括韦氏智力量表和斯特鲁普颜色和文字测验在内的神经心理学检查。对图论参数和神经心理学结果进行了相关性分析。对于mTBI组，颞下回和小脑上部的ReHo显著低于对照组，左侧岛叶、小脑下部和枕中回的ALFF显著高于对照组，这意味着通常在帕金森病中观察到的功能失调。执行功能障碍与背外侧额上回和前扣带回皮质的全局效率显著相关，这与文献一致：急性mTBI患者在运动速度、联想、信息处理速度、注意力和短期记忆功能方面表现异常。mTBI组神经心理学结果与网络效率之间的相关性分析表明，执行功能障碍可能是由局部脑变化引起的。我们的数据支持这样一种观点，即脑内网络对突然的病理和神经生理变化会有代偿反应。未来，多模式rs-fMRI分析可能是评估mTBI后功能失调脑区的一个有价值的工具。
