质子磁共振波谱分析结果与创伤性脑损伤中的神经心理功能相关。
Proton MR spectroscopic findings correspond to neuropsychological function in traumatic brain injury.
作者信息
Friedman S D, Brooks W M, Jung R E, Hart B L, Yeo R A
机构信息
Center for Non-Invasive Diagnosis, and Department of Psychology, University of New Mexico, Albuquerque 87131, USA.
出版信息
AJNR Am J Neuroradiol. 1998 Nov-Dec;19(10):1879-85.
BACKGROUND AND PURPOSE
Traumatic brain injury (TBI) causes substantial irreversible damage to neurons. Our aim was to investigate whether proton MR spectroscopic measures of diffuse cellular integrity were related to neuropsychological dysfunction after TBI.
METHODS
Twelve patients with TBI (mean, 53 +/- 23 days postinjury) and 14 control subjects were included in the study using paired MR spectroscopy and neuropsychological assessment. N-acetylaspartate (NAA), creatine, and choline were measured in normal-appearing occipitoparietal white and occipital gray matter using short-echo quantitative spectroscopy. A composite measure of neuropsychological function was calculated from z-scored individual tests probing the major functional domains commonly impaired after head trauma.
RESULTS
Patients with TBI displayed reduced NAA in white matter and elevated choline in gray matter, suggestive of neuronal injury and inflammation, respectively. NAA and creatine in white and gray matter were significantly associated with composite neuropsychological function and many individual neuropsychological tests. Gray matter choline, although abnormal, was not related to neuropsychological function.
CONCLUSION
The concordance between neurometabolic levels and behavioral function supports the hypothesis that diffuse axonal injury is an important contributor to brain dysfunction after TBI.
背景与目的
创伤性脑损伤（TBI）会对神经元造成严重的不可逆损伤。我们的目的是研究质子磁共振波谱测量的弥漫性细胞完整性是否与TBI后的神经心理功能障碍有关。
方法
本研究纳入了12例TBI患者（平均受伤后53±23天）和14名对照受试者，采用配对磁共振波谱和神经心理评估。使用短回波定量波谱法测量枕顶叶正常白质和枕叶灰质中的N-乙酰天门冬氨酸（NAA）、肌酸和胆碱。通过对头部外伤后常见受损的主要功能领域进行z评分的个体测试计算出神经心理功能的综合指标。
结果
TBI患者白质中NAA降低，灰质中胆碱升高，分别提示神经元损伤和炎症。白质和灰质中的NAA及肌酸与神经心理综合功能及许多个体神经心理测试显著相关。灰质胆碱虽异常，但与神经心理功能无关。
结论
神经代谢水平与行为功能之间的一致性支持了弥漫性轴索损伤是TBI后脑功能障碍重要原因的假说。
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