Department of Psychology, Northeastern University, Boston, Massachusetts, USA.
Center for Cognitive & Brain Health, Northeastern University, Boston, Massachusetts, USA.
Ann Clin Transl Neurol. 2024 Sep;11(9):2314-2326. doi: 10.1002/acn3.52145. Epub 2024 Jul 19.
Traumatic brain injury (TBI) is associated with sleep deficits, but it is not clear why some report sleep disturbances and others do not. The objective of this study was to assess the associations between axonal injury, sleep, and memory in chronic and acute TBI.
Data were acquired from two independent datasets which included 156 older adult veterans (69.8 years) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) with prior moderate-to-severe TBIs and 90 (69.2 years) controls and 374 (39.6 years) from Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) with a recent mild TBI (mTBI) and 87 controls (39.6 years), all who completed an MRI, memory assessment, and sleep questionnaire.
Older adults with a prior TBI had a significant association between axonal injury and sleep disturbances [β = 9.52, 95% CI (4.1, 14.9), p = 0.01]. Axonal injury predicted changes in memory over 1-year in TBI [β = -8.72, 95% CI (-18, -2.7), p = 0.03]. We externally validated those findings in TRACK-TBI where axonal injury within 2 weeks after mTBI was significantly associated with higher sleep disturbances in the TBI group at 2 weeks[β = -7.2, 95% CI (-14, -0.50), p = 0.04], 6 months [β = -16, 95% CI (-24, -7.6), p ≤ 0.01], and 12 months post-injury [β = -11, 95% CI (-19, -0.85), p = 0.03]. These associations were not significant in controls.
Axonal injury, specifically to the left anterior internal capsule is robustly associated with sleep disturbances in multiple TBI populations. Early assessment of axonal injury following mTBI could identify those at risk for persistent sleep disturbances following injury.
创伤性脑损伤（TBI）与睡眠不足有关，但尚不清楚为什么有些人会出现睡眠障碍，而有些人则不会。本研究的目的是评估慢性和急性 TBI 中的轴突损伤、睡眠和记忆之间的关联。
数据来自两个独立的数据集，包括来自阿尔茨海默病神经影像学倡议（ADNI）的 156 名有既往中重度 TBI 的老年退伍军人（69.8 岁）和 90 名对照者（69.2 岁），以及来自转化研究和临床知识在 TBI（TRACK-TBI）中的 374 名（39.6 岁）近期轻度 TBI（mTBI）患者和 87 名对照者（39.6 岁），所有参与者均完成了 MRI、记忆评估和睡眠问卷。
有既往 TBI 的老年人轴突损伤与睡眠障碍之间存在显著关联[β=9.52，95%CI（4.1，14.9），p=0.01]。轴突损伤预测 TBI 患者在 1 年内记忆的变化[β=-8.72，95%CI（-18，-2.7），p=0.03]。我们在 TRACK-TBI 中对这些发现进行了外部验证，其中 mTBI 后 2 周内的轴突损伤与 TBI 组在 2 周[β=-7.2，95%CI（-14，-0.50），p=0.04]、6 个月[β=-16，95%CI（-24，-7.6），p≤0.01]和损伤后 12 个月[β=-11，95%CI（-19，-0.85），p=0.03]时的睡眠障碍显著相关。这些关联在对照组中并不显著。
轴突损伤，特别是左侧前内囊的轴突损伤，与多个 TBI 人群的睡眠障碍密切相关。在 mTBI 后早期评估轴突损伤，可能会识别出那些在损伤后持续存在睡眠障碍风险的患者。
