Cerebrovascular Responses to O2-CO2 Exchange Ratio under Brief Breath-Hold Challenge in Patients with Chronic Mild Traumatic Brain Injury.
Cerebrovascular Responses to O2-CO2 Exchange Ratio under Brief Breath-Hold Challenge in Patients with Chronic Mild Traumatic Brain Injury.
复制标题
慢性轻度创伤性脑损伤患者短暂屏气挑战下的脑血管对 O2-CO2 交换比的反应。
DOI：
10.1089/neu.2021.0166
复制
发表时间：
2021
影响因子：
4.2
通讯作者：
Kwong,KennethK
中科院分区：
文献类型：
--
作者：
Chan,Suk-Tak;Ordway,Cora;Calvanio,RonaldJ;Buonanno,FerdinandoS;Rosen,BruceR;Kwong,KennethK
呼吸-呼吸氧-二氧化碳（O2-CO2）交换率（bER）是一种呼吸气体交换（RGE）指标，它是吸气末和呼气末之间O2（Δ PO 2）与CO2（Δ PCO 2）的变化之比，已被证明可以表征健康个体对屏气挑战的脑血管反应。我们的目的是探讨bER是否可以表征慢性轻度创伤性脑损伤（mTBI）患者在屏气挑战下的脑血管反应。我们还调查了bER和脑震荡后症状严重程度之间的相关性。使用功能磁共振成像（fMRI）对10例慢性mTBI患者和10例无脑损伤史的对照组进行屏气任务时采集血氧水平依赖（BOLD）图像。计算Δ PO 2、Δ PCO 2和bER的RGE指标的时间序列，并计算其与BOLD区域变化（ΔBOLD）的互相关。使用Rivermead脑震荡后问卷（RPQ）评估症状负担，并测量其与RGE变化的相关性。与对照组相比，mTBI患者脑内局部ΔBOLD与bER之间的相关性呈弥漫性降低（pfdr< 0.05）。患者组和对照组的局部ΔBOLD与Δ PO 2和Δ PCO 2的相关性无显著性差异。在屏气期，随着bER（ρ= 0.79，p = 0.01）和Δ PO 2（ρ= 0.70，p = 0.03）平均变化的减少，RPQ评分所指示的症状严重程度增加。我们的影像学和症状严重程度研究结果表明，bER可用于表征mTBI患者屏气时的脑血管反应。RGE可能有助于脑震荡后症状的严重程度。
Breath-by-breath oxygen-carbon dioxide (O2-CO2)exchange ratio (bER) is a respiratory gas exchange (RGE) metric, which is the ratio of the changes in the partial pressure of O2(ΔPO2) to CO2(ΔPCO2) between end-inspiration and end-expiration, has been demonstrated to characterize the cerebrovascular responses to breath-hold challenge in healthy individuals. We aimed to explore whether bER could characterize cerebrovascular responses in patients with chronic mild traumatic brain injury (mTBI) under breath-hold challenge. We also investigated the correlation between bER and the severity of post-concussion symptoms. Blood-oxygenation-level-dependent (BOLD) images were acquired using functional magnetic resonance imaging (fMRI) on 10 patients with chronic mTBI and 10 controls without brain injury history when performing a breath-hold task. Time series of RGE metrics of ΔPO2, ΔPCO2, and bER were computed, and their cross-correlation with regional change in BOLD (ΔBOLD) was calculated. Symptom burden was assessed using the Rivermead Post Concussion Questionnaire (RPQ), and its correlation with RGE changes was also measured. Compared with controls, a diffuse decrease in the correlation between regional ΔBOLD and bER was found in the brain of patients with mTBI (pfdr< 0.05). No significant difference was found between patients and controls for the correlation of regional ΔBOLD with ΔPO2and ΔPCO2. Symptom severity indicated by RPQ scores increased with a decrease in the averaged changes of bER (ρ= 0.79,p= 0.01) and ΔPO2(ρ= 0.70,p= 0.03) in breath-hold epochs. Our imaging and symptom severity findings suggest that bER can be used to characterize cerebrovascular responses to breath hold in patients with mTBI. The RGE may contribute to the post-concussive symptom severity.