Department of Biomedical Engineering, Yonsei University, Wonju, Gangwon-do, Republic of Korea.
School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
BMC Ophthalmol. 2024 Sep 27;24(1):422. doi: 10.1186/s12886-024-03697-y.
Traumatic brain injury (TBI) often precipitates a cascade of neurophysiological alterations, impacting structures such as the optic nerve and ocular motor system. However, the literature lacks expansive investigations into the longitudinal changes in the optic chiasm and its relationship with the clinical recovery of visual processing. This study aimed to scrutinize longitudinal changes in optic chiasm volume (OCV) and establish the relationship of OCV with process speed index at 12 months post-injury. Process speed index is derived from Wechsler Adult Intelligence Scale IV.
Thorough cross-sectional and longitudinal analyses were executed, involving 42 patients with moderate to severe TBI and 35 healthy controls. OCV was acquired at 3, 6, and 12 months post-injury using T1-weighted images. OCV of healthy controls and that of patients with TBI at 3, 6, and 12 months post-injury were compared using a Mann-Whitney U test. A multiple linear regression model was constructed to assess the association between OCV and PSI and to predict PSI at 12 months post-injury using OCV at 3 months post-injury.
OCV of patients with TBI was significantly larger compared to healthy controls, persisting from 3 to 12 months post-injury (p < 0.05). This increased OCV negatively correlated with PSI at 12 months post-injury, indicating that larger OCV sizes were associated with decreased PSI (p = 0.031). Furthermore, the multiple linear regression model was significant in predicting PSI at 12 months post-injury utilizing OCV at 3 months post-injury (p = 0.024).
For the first time, this study elucidates the increased OCV and the significant association between OCV in sub-chronic stage and PSI at 12 months post-injury, potentially providing clinicians with a tool for anticipatory cognitive rehabilitation strategies following TBI.
颅脑损伤（TBI）常引发一连串神经生理改变，影响视神经和眼动系统等结构。然而，文献中缺乏对视交叉纵向变化及其与视觉处理临床康复关系的广泛研究。本研究旨在探讨视交叉体积（OCV）的纵向变化，并确定 OCV 与伤后 12 个月时的过程速度指数（PSI）的关系。PSI 是从韦氏成人智力量表第四版得出的。
进行了全面的横断面和纵向分析，纳入 42 例中重度 TBI 患者和 35 名健康对照者。使用 T1 加权图像在伤后 3、6 和 12 个月时获得 OCV。使用 Mann-Whitney U 检验比较健康对照组和 TBI 患者在伤后 3、6 和 12 个月时的 OCV。构建多元线性回归模型，评估 OCV 与 PSI 之间的关联，并使用伤后 3 个月的 OCV 预测伤后 12 个月的 PSI。
TBI 患者的 OCV 明显大于健康对照组，从伤后 3 个月持续到 12 个月（p<0.05）。这种增大的 OCV 与伤后 12 个月时的 PSI 呈负相关，表明较大的 OCV 与 PSI 降低有关（p=0.031）。此外，多元线性回归模型在使用伤后 3 个月的 OCV 预测伤后 12 个月的 PSI 方面具有显著意义（p=0.024）。
本研究首次阐明了亚慢性期 OCV 的增加以及 OCV 与伤后 12 个月时 PSI 之间的显著关联，这可能为临床医生提供一种在 TBI 后进行预期认知康复策略的工具。
