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缺氧缺血性脑损伤患者意识水平与丘脑皮质束和默认模式网络的相关性:使用昏迷恢复量表修订版进行的比较研究。

Correlation between Thalamocortical Tract and Default Mode Network with Consciousness Levels in Hypoxic-Ischemic Brain Injury Patients: A Comparative Study Using the Coma Recovery Scale-Revised.

机构信息

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea.

Department of Physical Therapy, College of Health Sciences, Dankook University, Cheonan, South Korea.

出版信息

Med Sci Monit. 2024 May 14;30:e943802. doi: 10.12659/MSM.943802.

Abstract

BACKGROUND The thalamocortical tract (TCT) links nerve fibers between the thalamus and cerebral cortex, relaying motor/sensory information. The default mode network (DMN) comprises bilateral, symmetrical, isolated cortical regions of the lateral and medial parietal and temporal brain cortex. The Coma Recovery Scale-Revised (CRS-R) is a standardized neurobehavioral assessment of disorders of consciousness (DOC). In the present study, 31 patients with hypoxic-ischemic brain injury (HI-BI) were compared for changes in the TCT and DMN with consciousness levels assessed using the CRS-R. MATERIAL AND METHODS In this retrospective study, 31 consecutive patients with HI-BI (17 DOC,14 non-DOC) and 17 age- and sex-matched normal control subjects were recruited. Magnetic resonance imaging was used to diagnose HI-BI, and the CRS-R was used to evaluate consciousness levels at the time of diffusion tensor imaging (DTI). The fractional anisotropy (FA) values and tract volumes (TV) of the TCT and DMN were compared. RESULTS In patients with DOC, the FA values and TV of both the TCT and DMN were significantly lower compared to those of patients without DOC and the control subjects (p<0.05). When comparing the non-DOC and control groups, the TV of the TCT and DMN were significantly lower in the non-DOC group (p<0.05). Moreover, the CRS-R score had strong positive correlations with the TV of the TCT (r=0.501, p<0.05), FA of the DMN (r=0.532, p<0.05), and TV of the DMN (r=0.501, p<0.05) in the DOC group. CONCLUSIONS This study suggests that both the TCT and DMN exhibit strong correlations with consciousness levels in DOC patients with HI-BI.

摘要

背景

丘脑皮质束(TCT)连接丘脑和大脑皮层之间的神经纤维,传递运动/感觉信息。默认模式网络(DMN)由双侧、对称、孤立的外侧和内侧顶叶和颞叶大脑皮层皮质区域组成。修订后的昏迷恢复量表(CRS-R)是一种用于评估意识障碍(DOC)的标准化神经行为评估。在本研究中,将 31 例缺氧缺血性脑损伤(HI-BI)患者与使用 CRS-R 评估的意识水平进行比较,观察 TCT 和 DMN 的变化。

材料与方法

本回顾性研究纳入 31 例连续 HI-BI 患者(17 例 DOC,14 例非 DOC)和 17 例年龄和性别匹配的正常对照组。使用磁共振成像诊断 HI-BI,并在弥散张量成像(DTI)时使用 CRS-R 评估意识水平。比较 TCT 和 DMN 的各向异性分数(FA)值和束流体积(TV)。

结果

在 DOC 患者中,与非 DOC 患者和对照组相比,TCT 和 DMN 的 FA 值和 TV 值均显著降低(p<0.05)。与对照组相比,非 DOC 组 TCT 和 DMN 的 TV 值显著降低(p<0.05)。此外,DOC 组 CRS-R 评分与 TCT 的 TV 值(r=0.501,p<0.05)、DMN 的 FA 值(r=0.532,p<0.05)和 DMN 的 TV 值(r=0.501,p<0.05)呈强正相关。

结论

本研究表明,在 HI-BI 伴有 DOC 的患者中,TCT 和 DMN 与意识水平均具有较强的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d040/11409902/ed85221a3339/medscimonit-30-e943802-g001.jpg

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