Structural and Functional Integrity of the Intraparietal Sulcus in Moderate and Severe Traumatic Brain Injury.
Structural and Functional Integrity of the Intraparietal Sulcus in Moderate and Severe Traumatic Brain Injury.
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DOI：
10.1089/neu.2016.4570
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发表时间：
2017-04
影响因子：
4.2
通讯作者：
C. Sours;P. Raghavan;A. Medina;S. Roys;Li Jiang;J. Zhuo;R. Gullapalli
中科院分区：
文献类型：
--
作者：
C. Sours;P. Raghavan;A. Medina;S. Roys;Li Jiang;J. Zhuo;R. Gullapalli
重度和中度创伤性脑损伤（sTBI）通常会导致长期的认知缺陷，如处理速度和注意力下降。顶叶内沟（IPS）是一种新的大脑皮层结构，在多感觉加工和自上而下的注意等密切相关的过程中起着至关重要的作用。因此，我们假设IPS的功能和结构连接的中断可能在这种缺陷的发展中起作用。为了研究这些联系，我们使用静息状态磁共振成像（rsfMRI）和弥散峰度成像（DKI）对27名sTBI患者（29.3±8.9岁）和27名对照组（29.8±10.3岁）进行了队列研究。前瞻性招募参与者，并在损伤后超过6个月接受rsfMRI和神经心理学评估，包括自动神经心理学评估指标（ANAM）。一部分参与者接受了DKI扫描。结果表明，sTBI患者在ANAM的多个亚测试中表现不如对照组，表明认知能力下降。在sTBI患者中，观察到IPS与多感觉处理和背侧注意网络相关的皮质区域之间的静息状态功能连通性降低。通过平均峰度（MK）和分数各向异性（FA）的降低和平均扩散率（MD）的增加，患者还表现出连接IPS和前额叶区域的关键白质束上纵束（SLF）的结构完整性降低。此外，SLF结构完整性的降低与整体认知表现的降低有关。这些发现表明，IPS结构和功能连接的中断可能导致这些患者出现慢性认知缺陷。
Severe and moderate traumatic brain injury (sTBI) often results in long-term cognitive deficits such as reduced processing speed and attention. The intraparietal sulcus (IPS) is a neocortical structure that plays a crucial role in the deeply interrelated processes of multi-sensory processing and top down attention. Therefore, we hypothesized that disruptions in the functional and structural connections of the IPS may play a role in the development of such deficits. To examine these connections, we used resting state magnetic resonance imaging (rsfMRI and diffusion kurtosis imaging (DKI) in a cohort of 27 patients with sTBI (29.3 ± 8.9 years) and 27 control participants (29.8 ± 10.3 years). Participants were prospectively recruited and received rsfMRI and neuropsychological assessments including the Automated Neuropsychological Assessment Metrics (ANAM) at greater than 6 months post-injury. A subset of participants received a DKI scan. Results suggest that patients with sTBI performed worse than control participants on multiple subtests of the ANAM suggesting reduced cognitive performance. Reduced resting state functional connectivity between the IPS and cortical regions associated with multi-sensory processing and the dorsal attention network was observed in the patients with sTBI. The patients also showed reduced structural integrity of the superior longitudinal fasciculus (SLF), a key white matter tract connecting the IPS to anterior frontal areas, as measured by reduced mean kurtosis (MK) and fractional anisotropy (FA) and increased mean diffusivity (MD). Further, this reduced structural integrity of the SLF was associated with a reduction in overall cognitive performance. These findings suggest that disruptions in the structural and functional connectivity of the IPS may contribute to chronic cognitive deficits experienced by these patients.