Evaluating the relationship between memory functioning and cingulum bundles in acute mild traumatic brain injury using diffusion tensor imaging.
Evaluating the relationship between memory functioning and cingulum bundles in acute mild traumatic brain injury using diffusion tensor imaging.
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DOI：
10.1089/neu.2009.1110
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发表时间：
2010-02
影响因子：
4.2
通讯作者：
T. Wu;E. Wilde;E. Bigler;R. Yallampalli;S. McCauley;M. Troyanskaya;Z. Chu;Xiaoqi Li;Gerri R. Hanten;J. Hunter;H. Levin
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文献类型：
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作者：
T. Wu;E. Wilde;E. Bigler;R. Yallampalli;S. McCauley;M. Troyanskaya;Z. Chu;Xiaoqi Li;Gerri R. Hanten;J. Hunter;H. Levin
记忆功能受损是轻度创伤性脑损伤（mTBI）后常见的认知后遗症之一。扩散张量成像（DTI）已被证明是足够敏感的检测后mTBI的早期微结构病理改变。考虑到其位置和形状，由扣带回（灰质）和扣带束（白色物质）组成的扣带选择性地易受mTBI的影响。在这项研究中，我们研究了扣带束的完整性，以及扣带束和记忆功能之间的关系。研究了12名患有mTBI的青少年和11名人口统计学匹配的健康对照。所有mTBI参与者的格拉斯哥昏迷量表评分为15分，CT扫描无颅内发现。平均在受伤后2.92天进行脑部扫描，所有参与者都进行了言语选择性提醒测试（VSRT），这是一种情景性言语学习和记忆任务。与对照组相比，mTBI参与者双侧表观扩散系数（ADC）显著降低（p < 0.001）。尽管各向异性分数（FA）的组间差异具有边缘显著性，但组间效应量为中等（d = 0.66）。在认知方面，健康对照组在即时和延迟回忆方面的表现优于TBI组;然而，差异没有达到统计学意义。在mTBI组中，左侧扣带回束的FA与30分钟延迟回忆显著相关（r =-0.56，p = 0.05）。左侧扣带回束ADC值与即刻回忆的总单词数之间存在轻微的显著相关性（r = 0.59，p = 0.07）。对照组的DTI指标和记忆功能之间没有显着的相关性。这些初步研究结果表明，扣带回损伤可能有助于在早期阶段mTBI后看到的认知后遗症。
Compromised memory functioning is one of the commonly reported cognitive sequelae seen following mild traumatic brain injury (mTBI). Diffusion tensor imaging (DTI) has been shown to be sufficiently sensitive at detecting early microstructural pathological alterations after mTBI. Given its location and shape, the cingulate, which is comprised of the cingulate gyrus (gray matter) and cingulum bundles (white matter), is selectively vulnerable to mTBI. In this study we examined the integrity of cingulum bundles using DTI, and the relationship between cingulum bundles and memory functioning. Twelve adolescents with mTBI and 11 demographically-matched healthy controls were studied. All participants with mTBI had a Glasgow Coma Scale score of 15, and were without intracranial findings on CT scan. Brain scans were performed on average 2.92 days post-injury, and all participants were administered the Verbal Selective Reminding Test (VSRT), an episodic verbal learning and memory task. Participants with mTBI had a significantly lower apparent diffusion coefficient (ADC) bilaterally than controls (p < 0.001). Despite the marginal significance of the group difference in fractional anisotropy (FA), the effect size between groups was moderate (d = 0.66). Cognitively, healthy controls performed better than the TBI group on immediate and delayed recall; however, the difference did not reach statistical significance. In the mTBI group, FA of the left cingulum bundle was significantly correlated with 30-min delayed recall (r = -0.56, p = 0.05). A marginally significant correlation was found between ADC of the left cingulum bundle and the total words of immediate recall (r = 0.59, p = 0.07). No significant correlation was found between DTI metrics and memory functioning for the control group. These preliminary findings indicate that cingulate injury likely contributes to the cognitive sequelae seen during the early phase post-mTBI.