Structural neuroimaging in sport-related concussion
Structural neuroimaging in sport-related concussion
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DOI：
10.1016/j.ijpsycho.2017.09.006
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发表时间：
2018-10-01
影响因子：
3
通讯作者：
Bigler, Erin D.
中科院分区：
文献类型：
--
作者：
Bigler, Erin D.
对运动相关脑震荡（SRC）运动员的结构神经成像可以被视为标准的临床成像，也可以被视为定量评估大脑结构的先进神经成像方法。常规计算机断层扫描（CT）或磁共振成像（MRI）的阴性结果是SRC的标准。尽管如此，这些传统措施仍然是运动员神经成像的第一线，因为它们确实可以检测到临床上显着的病理（如果存在），例如血肿、挫伤和微出血形式的出血性异常沿着局灶性脑软化区域或其他信号异常，其中CT最能检测颅骨骨折。然而，先进的神经影像学技术在检测运动员的细微神经病理学方面有着特殊的前景，而这是标准的临床神经影像学所不能做到的。为了更好地了解常规和定量神经影像学方法在SRC中的检测，本文首先介绍了与轻度创伤性脑损伤（mTBI）相关的基本神经解剖学原理以及最容易受到SRC损伤的脑区，因为这些区域定义了高级神经影像学方法最有可能检测到异常的区域。先进的MRI技术结合了定量指标，包括体积、形状、厚度沿着以及扩散参数，提供了对大脑结构的更细粒度的分析。随着图像分析的进步，现在可以利用多种定量神经成像指标来评估SRC。这种多模态方法对于评估损伤后大脑的白色物质和网络完整性特别相关和重要，包括SRC。这篇综述只关注SRC的神经影像学结构方面，但这些技术也正在与功能性神经影像学相结合，这两种方法的结合可能提供评估SRC病理效应的上级方法。
Structural neuroimaging of athletes who have sustained a sports-related concussion (SRC) can be viewed as either standard clinical imaging or with advanced neuroimaging methods that quantitatively assess brain structure. Negative findings from conventional computed tomography (CT) or magnetic resonance imaging (MRI) are the norm in SRC. Nonetheless, these conventional measures remain the first line of neuroimaging of the athlete as they do detect clinically significant pathologies, when present, such as hemorrhagic abnormalities in the form of hematomas, contusions and mircobleeds along with regions of focal encephalomalacia or other signal abnormalities, with CT best capable of detecting skull fractures. However, advanced neuroimaging techniques hold particular promise in detecting subtle neuropathology in the athlete which standard clinical neuroimaging cannot. To best understand what conventional as well as quantitative neuroimaging methods are detecting in SRC, this review begins by covering basic neuroanatomical principles associated with mild traumatic brain injury (mTBI) and the brain regions most vulnerable to injury from SRC, as these regions define where advanced neuroimaging methods most likely detect abnormalities. Advanced MRI techniques incorporate quantitative metrics that include volume, shape, thickness along with diffusion parameters that provide a more fine-grained analysis of brain structure. With advancements in image analysis, multiple quantitative neuroimaging metrics now can be utilized in assessing SRC. Such multimodality approaches are particularly relevant and important for assessing white matter and network integrity of the brain following injury, including SRC. This review focuses just on the structural side of neuroimaging in SRC, but these techniques also are being integrated with functional neuroimaging, where the combination of the two approaches may provide superior methods in assessing the pathological effects of SRC.