Widespread white matter aberrations are associated with phonemic verbal fluency impairment in chronic traumatic brain injury
Widespread white matter aberrations are associated with phonemic verbal fluency impairment in chronic traumatic brain injury
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广泛的白质畸变与慢性创伤性脑损伤中的音位语言流畅性损伤有关
DOI：
10.1089/neu.2019.6751
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发表时间：
2020
影响因子：
4.2
通讯作者：
Mimura M.
中科院分区：
文献类型：
--
作者：
57.Yamagata B;Ueda R;Tasato K;Aoki Y;Hotta S;Hirano J;Takamiya A;Nakaaki S;Tabuchi H;Mimura M.
微结构白色物质（WM）破坏和由此产生的异常结构连接形成了创伤性脑损伤（TBI）的潜在潜在病理学。在此，为了确定TBI认知功能恶化的潜在机制，我们研究了TBI患者特定WM束损伤与认知功能的相关性。我们招募了18名慢性期轻度至中度/重度TBI患者和17名年龄匹配的对照组。我们使用基于轨迹的空间统计学（TBSS）确定了TBI中WM畸变的模式，然后使用TBSS中的无阈值簇增强校正检查了认知障碍与WM损伤之间的关系。TBSS分析表明，TBI患者在广泛的脑区表现出WM畸变。在大多数这些地区，较低的分数各向异性（FA）在很大程度上与径向扩散率增加，但不与轴向扩散重叠。此外，在TBSS的体素方面的校正表明，较高的FA值与更好的表现在音位言语流畅性任务（VFT）在广泛的WM区域，但不与语义VFT。尽管个体病例之间脑损伤的程度和位置存在差异，但慢性TBI患者表现出广泛的WM畸变。我们证实了先前研究的发现，即与对照组相比，慢性受试者的脑外伤严重程度范围内的WM完整性较低。此外，与语义VFT相比，音位VFT可能是TBI中与WM畸变相关的执行功能障碍的更敏感的认知测量。
Microstructural white matter (WM) disruption and resulting abnormal structural connectivity form a potential underlying pathology in traumatic brain injury (TBI). Herein, to determine the potential mechanism of cognitive deterioration in TBI, we examined the association of damage to specific WM tracts with cognitive function in TBI patients. We recruited 18 individuals with mild-to-moderate/severe TBI in the chronic phase and 17 age-matched controls. We determined the pattern of WM aberrations in TBI using tract-based spatial statistics (TBSS) and then examined the relationship between cognitive impairment and WM damage using the threshold-free cluster enhancement correction in TBSS. TBSS analysis showed that TBI patients exhibited WM aberrations in a wide range of brain regions. In the majority of these regions, lower fractional anisotropy (FA) largely overlapped with increased radial diffusivity, but not with axial diffusivity. Further, voxel-wise correction in TBSS demonstrated that higher FA values were associated with better performance in the phonemic verbal fluency task (VFT) in widespread WM regions, but not with the semantic VFT. Despite variation in the magnitude and location of brain injury between individual cases, chronic TBI patients exhibited widespread WM aberrations. We confirmed the findings of previous studies that WM integrity is lower across the spectrum of TBI severity in chronic subjects compared to controls. Further, phonemic VFT may be a more sensitive cognitive measure of executive dysfunction associated with WM aberrations in TBI compared with semantic VFT.