Howard Calvin W, Ferguson Michael H, Siddiqi Shan H, Fox Michael D
Center for Brain Circuit Therapeutics, Department of Neurology Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA; Clinician Investigator Program, Postgraduate Medical Education, University of Manitoba, Winnipeg, Manitoba, Canada; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Center for Brain Circuit Therapeutics, Department of Neurology Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
Cortex. 2024 Mar;172:109-113. doi: 10.1016/j.cortex.2023.12.006. Epub 2023 Dec 30.
The Vietnam Head Injury Study has been curated by Dr Jordan Grafman since the 1980s in an effort to study patients with penetrating traumatic brain injuries suffered during the Vietnam War. Unlike many datasets of ischemic stroke lesions, the VHIS collected extraordinarily deep phenotyping and was able to sample lesion locations that are not constrained to typical vascular territories. For decades, this dataset has helped researchers draw causal links between neuroanatomical regions and neuropsychiatric symptoms. The value of the VHIS has only increased over time as techniques for analyzing the dataset have developed and evolved. Tools such as voxel lesion symptom mapping allowed one to relate symptoms to individual brain voxels. With the advent of the human connectome, tools such as lesion network mapping allow one to relate symptoms to connected brain networks by combining lesion datasets with new atlases of human brain connectivity. In a series of recent studies, lesion network mapping has been combined with the Vietnam Head Injury dataset to identify brain networks associated with spirituality, religiosity, consciousness, memory, emotion regulation, addiction, depression, and even transdiagnostic mental illness. These findings are enhancing our ability to make diagnoses, identify potential treatment targets for focal brain stimulation, and understand the human brain generally. Our techniques for studying brain lesions will continue to improve, as will our tools for modulating brain circuits. As these advances occur, the value of well characterized lesion datasets such as the Vietnam Head Injury Study will continue to grow. This study aims to review the history of the Vietnam Head Injury Study and contextualize its role in modern-day localization of neurological symptoms.
自20世纪80年代以来，乔丹·格拉夫曼博士负责整理越南头部损伤研究，旨在研究在越南战争期间遭受穿透性创伤性脑损伤的患者。与许多缺血性中风病变数据集不同，越南头部损伤研究收集了极其深入的表型分析数据，并且能够对不限于典型血管区域的病变位置进行采样。几十年来，这个数据集帮助研究人员在神经解剖区域和神经精神症状之间建立因果联系。随着分析该数据集的技术不断发展和演变，越南头部损伤研究的价值与日俱增。诸如体素病变症状映射等工具使人们能够将症状与单个脑体素联系起来。随着人类连接组学的出现，诸如病变网络映射等工具使人们能够通过将病变数据集与新的人类脑连接图谱相结合，将症状与相连的脑网络联系起来。在最近的一系列研究中，病变网络映射已与越南头部损伤数据集相结合，以识别与灵性、宗教信仰、意识、记忆、情绪调节、成瘾、抑郁甚至跨诊断精神疾病相关的脑网络。这些发现正在提高我们进行诊断的能力，确定局灶性脑刺激的潜在治疗靶点，并增进我们对人类大脑的总体理解。我们研究脑损伤的技术将继续改进，调节脑回路的工具也将如此。随着这些进展的出现，像越南头部损伤研究这样特征明确的病变数据集的价值将继续增长。本研究旨在回顾越南头部损伤研究的历史，并阐述其在现代神经症状定位中的作用。
