Deficits in Visual System Functional Connectivity after Blast-Related Mild TBI are Associated with Injury Severity and Executive Dysfunction.
Deficits in Visual System Functional Connectivity after Blast-Related Mild TBI are Associated with Injury Severity and Executive Dysfunction.
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DOI：
10.1002/brb3.454
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发表时间：
2016-05
影响因子：
3.1
通讯作者：
Sponheim SR
中科院分区：
文献类型：
--
作者：
Gilmore CS;Camchong J;Davenport ND;Nelson NW;Kardon RH;Lim KO;Sponheim SR
大约275,000名被派往伊拉克或阿富汗的美国军人遭受了轻度创伤性脑损伤，其中75%涉及爆炸性爆炸。视觉处理问题和认知功能障碍是冲击波相关mTBI后常见的主诉。在127名退伍军人中，我们检测了视觉系统中四个关键结点的静息fMRI功能连接性(FC)：外侧膝状核(LGN)、初级视觉皮质(V1)、枕外侧回(LO)和梭状回(FG)。进行回归分析(I)以获得来自每个种子的时间序列与脑中所有体素之间的相关性，以及(Ii)识别FC变异性与冲击性mTBI严重程度相关的脑区。爆炸相关mTBI的严重程度被量化为受试者自我报告的三个最显著的爆炸相关损伤的严重程度分数的总和。使用可获得的行为数据在参与者之间进行了FC和执行功能任务绩效之间的相关性(n=994)。冲击性mTBI严重程度评分越高，FC值越低：(A)LGN种子和(I)额内侧回、(II)舌回和(III)丘脑右腹前核；(B)V1种子和楔前核；(C)LO种子和额中上回；(D)FG种子和(I)额上和内侧回，(Ii)左额中回。最后，视觉网络区域和额叶皮质区域之间较低的FC预示着在WAIS数字符号编码任务中表现较差。这些是首次发表的结果，直接说明了爆炸相关的mTBI严重程度、视觉通路神经网络和执行功能障碍之间的关系--这些结果突出了爆炸相关的脑损伤与视觉感觉输入和执行过程的整合之间的有害关系。
Approximately, 275,000 American service members deployed to Iraq or Afghanistan have sustained a mild traumatic brain injury (mTBI), with 75% of these incidents involving an explosive blast. Visual processing problems and cognitive dysfunction are common complaints following blast‐related mTBI. In 127 veterans, we examined resting fMRI functional connectivity (FC) of four key nodes within the visual system: lateral geniculate nucleus (LGN), primary visual cortex (V1), lateral occipital gyrus (LO), and fusiform gyrus (FG). Regression analyses were performed (i) to obtain correlations between time‐series from each seed and all voxels in the brain, and (ii) to identify brain regions in which FC variability was related to blast mTBI severity. Blast‐related mTBI severity was quantified as the sum of the severity scores assigned to each of the three most significant blast‐related injuries self‐reported by subjects. Correlations between FC and performance on executive functioning tasks were performed across participants with available behavioral data (n = 94). Greater blast mTBI severity scores were associated with lower FC between: (A) LGN seed and (i) medial frontal gyrus, (ii) lingual gyrus, and (iii) right ventral anterior nucleus of thalamus; (B) V1 seed and precuneus; (C) LO seed and middle and superior frontal gyri; (D) FG seed and (i) superior and medial frontal gyrus, and (ii) left middle frontal gyrus. Finally, lower FC between visual network regions and frontal cortical regions predicted worse performance on the WAIS digit‐symbol coding task. These are the first published results that directly illustrate the relationship between blast‐related mTBI severity, visual pathway neural networks, and executive dysfunction – results that highlight the detrimental relationship between blast‐related brain injury and the integration of visual sensory input and executive processes.