Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging.
Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging.
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DOI：
10.3390/ijerph20136274
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发表时间：
2023-07-01
影响因子：
--
通讯作者：
Versace, Amelia
中科院分区：
文献类型：
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作者：
Lima Santos, Joao Paulo;Jia-Richards, Meilin;Kontos, Anthony P;Collins, Michael W;Versace, Amelia
脑震荡后的情绪失调症状与情绪失调障碍（如抑郁和焦虑）的风险增加有关，特别是在青少年中。然而，预测脑震荡后情绪失调症状的出现或恶化，以及这种症状在多大程度上先于受伤后随后精神疾病的发病，仍然具有挑战性。虽然先进的神经成像技术，如功能性磁共振成像和弥散性磁共振成像，已经在研究环境中用于检测和监测脑震荡相关的大脑异常，但它们的临床应用仍然有限。在这篇叙述性综述中，我们对电子数据库（PubMed、Scopus和谷歌Scholar）中关于情绪调节、青少年脑震荡和先进神经成像技术的现有文献进行了全面的搜索。我们强调临床证据表明，高度易感性的青少年经历情绪失调症状后脑震荡。此外，我们描述并提供了广泛使用的磁共振成像模式（即功能和扩散成像）的经验支持，这些模式用于检测负责情绪调节的电路中的异常。此外，我们评估这些异常如何与青少年受伤后经常报告的情绪失调症状相关。然而，是否存在脑震荡相关异常的进展仍有待确定，特别是在青春期经历重大发育变化的大脑区域。我们的结论是，神经成像技术在预测和最终监测青少年脑震荡后情绪失调的治疗反应方面具有临床有用的工具潜力。
Emotional dysregulation symptoms following a concussion are associated with an increased risk for emotional dysregulation disorders (e.g., depression and anxiety), especially in adolescents. However, predicting the emergence or worsening of emotional dysregulation symptoms after concussion and the extent to which this predates the onset of subsequent psychiatric morbidity after injury remains challenging. Although advanced neuroimaging techniques, such as functional magnetic resonance imaging and diffusion magnetic resonance imaging, have been used to detect and monitor concussion-related brain abnormalities in research settings, their clinical utility remains limited. In this narrative review, we have performed a comprehensive search of the available literature regarding emotional regulation, adolescent concussion, and advanced neuroimaging techniques in electronic databases (PubMed, Scopus, and Google Scholar). We highlight clinical evidence showing the heightened susceptibility of adolescents to experiencing emotional dysregulation symptoms following a concussion. Furthermore, we describe and provide empirical support for widely used magnetic resonance imaging modalities (i.e., functional and diffusion imaging), which are utilized to detect abnormalities in circuits responsible for emotional regulation. Additionally, we assess how these abnormalities relate to the emotional dysregulation symptoms often reported by adolescents post-injury. Yet, it remains to be determined if a progression of concussion-related abnormalities exists, especially in brain regions that undergo significant developmental changes during adolescence. We conclude that neuroimaging techniques hold potential as clinically useful tools for predicting and, ultimately, monitoring the treatment response to emotional dysregulation in adolescents following a concussion.