Working memory and corpus callosum microstructural integrity after pediatric traumatic brain injury: a diffusion tensor tractography study.
Working memory and corpus callosum microstructural integrity after pediatric traumatic brain injury: a diffusion tensor tractography study.
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DOI：
10.1089/neu.2013.2934
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发表时间：
2013-10
影响因子：
4.2
通讯作者：
Amery Treble;K. Hasan;Amal Iftikhar;K. Stuebing;L. Kramer;C. Cox;P. Swank;L. Ewing-Cobbs
中科院分区：
文献类型：
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作者：
Amery Treble;K. Hasan;Amal Iftikhar;K. Stuebing;L. Kramer;C. Cox;P. Swank;L. Ewing-Cobbs
工作记忆（WM）缺陷是小儿创伤性脑损伤（TBI）的常见后果，并被认为是导致认知和学术领域困难的原因。TBI后胼胝体（CC）的完整性降低可能会破坏WM基础的双侧额顶叶神经网络之间的连接。在目前的调查中，弥散张量成像（DTI）纤维束成像的8个胼胝体亚区（CC 1-CC 8）进行了检查，在74名儿童持续TBI和49个典型的发展对照儿童的言语和视觉空间WM的措施。相对于对照组，TBI儿童表现出较差的视觉空间WM，但可比的口头WM。在脑损伤的儿童中，CC的微结构显著受损，在所有胼胝体子区域中具有较低的各向异性分数（FA）和较高的轴向和径向扩散率指标。在这两组儿童中，较低的FA和/或较高的径向扩散在胼胝体分区连接前和后顶叶皮质区预测较差的言语WM，而较高的径向扩散在胼胝体分区连接前和后顶叶，以及颞叶，皮质区预测较差的视觉空间WM。DTI指标，特别是径向扩散，在预测胼胝体亚区占显着的差异，在WM以上剩余的胼胝体亚区。CC的微结构完整性降低，特别是在连接顶叶和颞叶皮质的子区域，可能是导致长期WM缺陷的神经病理机制。神经解剖学生物标志物的未来临床应用可能允许早期识别WM缺陷风险最高的儿童，并为这些儿童提供早期干预措施。
Deficits in working memory (WM) are a common consequence of pediatric traumatic brain injury (TBI) and are believed to contribute to difficulties in a range of cognitive and academic domains. Reduced integrity of the corpus callosum (CC) after TBI may disrupt the connectivity between bilateral frontoparietal neural networks underlying WM. In the present investigation, diffusion tensor imaging (DTI) tractography of eight callosal subregions (CC1-CC8) was examined in relation to measures of verbal and visuospatial WM in 74 children sustaining TBI and 49 typically developing comparison children. Relative to the comparison group, children with TBI demonstrated poorer visuospatial WM, but comparable verbal WM. Microstructure of the CC was significantly compromised in brain-injured children, with lower fractional anisotropy (FA) and higher axial and radial diffusivity metrics in all callosal subregions. In both groups of children, lower FA and/or higher radial diffusivity in callosal subregions connecting anterior and posterior parietal cortical regions predicted poorer verbal WM, whereas higher radial diffusivity in callosal subregions connecting anterior and posterior parietal, as well as temporal, cortical regions predicted poorer visuospatial WM. DTI metrics, especially radial diffusivity, in predictive callosal subregions accounted for significant variance in WM over and above remaining callosal subregions. Reduced microstructural integrity of the CC, particularly in subregions connecting parietal and temporal cortices, may act as a neuropathological mechanism contributing to long-term WM deficits. The future clinical use of neuroanatomical biomarkers may allow for the early identification of children at highest risk for WM deficits and earlier provision of interventions for these children.