Diffuse and spatially variable white matter disruptions are associated with blast-related mild traumatic brain injury
Diffuse and spatially variable white matter disruptions are associated with blast-related mild traumatic brain injury
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DOI：
10.1016/j.neuroimage.2011.10.050
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发表时间：
2012-02-01
期刊：
影响因子：
5.7
通讯作者：
Sponheim, Scott R.
中科院分区：
文献类型：
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作者：
Davenport, Nicholas D.;Lim, Kelvin O.;Sponheim, Scott R.
爆炸性爆炸引起的轻度创伤性脑损伤（mTBI）在军人中很常见，通常与长期的心理和认知障碍有关。关于爆炸相关mTBI的神经影响以及它们是否与平民、非爆炸mTBI的神经影响不同，人们知之甚少。考虑到来自爆炸的脑损伤可能是弥漫性和异质性的，我们测试了爆炸mTBI与脑中细微的白色物质破坏相关的假设，这些破坏在个体之间是空间不一致的。我们使用扩散张量成像检查白色物质的完整性，量化的分数各向异性（FA），在一组美国军人（n = 25）或没有（n = 33）爆炸相关的rnTBI已部署作为伊拉克自由或持久自由行动的一部分。平民非爆炸性mTBI的病史在各组中同样常见，这使得能够测试爆炸性和非爆炸性mTBI对以下指标的影响：（1）集中的、空间一致的（感兴趣区域[ROI]内的平均FA），（2）集中的、空间可变的（具有低平均FA的ROI数量），和（3）弥漫的（具有低FA的体素数量）白色完整性破坏。爆炸性mTBI与弥漫性、全球性低白色物质完整性模式相关，并且该模式不受先前民用mTBI的影响。这两种类型的mTBI的措施更集中和空间一致的白色物质中断敏感的影响。此外，具有一次以上冲击波mTBI的个体倾向于比具有单一冲击波损伤的个体具有更多的低FA体素。这些结果表明，冲击波mTBI与几个白色物质束的破坏的完整性相关，并且这些破坏通过在ROI内的大量体素上进行平均而被稀释。报告的效应模式支持以下结论：原始细胞mTBI的神经学效应是弥漫性的、广泛的和空间可变的。(C)2011 Elsevier Inc. All rights reserved.
Mild traumatic brain injury (mTBI) due to explosive blast is common among military service members and often associated with long term psychological and cognitive disruptions. Little is known about the neurological effects of blast-related mTBI and whether they differ from those of civilian, non-blast mTBI. Given that brain damage from blasts may be diffuse and heterogeneous, we tested the hypothesis that blast mTBI is associated with subtle white matter disruptions in the brain that are spatially inconsistent across individuals. We used diffusion tensor imaging to examine white matter integrity, as quantified by fractional anisotropy (FA), in a group of American military service members with (n = 25) or without (n = 33) blast-related rnTBI who had been deployed as part of Operation Iraqi Freedom or Operation Enduring Freedom. History of civilian non-blast mTBI was equally common across groups, which enabled testing of both blast and non-blast mTBI effects on measures sensitive to (1) concentrated, spatially consistent (average FA within a region of interest [ROI]), (2) concentrated, spatially variable (number of ROIs with low average FA), and (3) diffuse (number of voxels with low FA) disruptions of white matter integrity. Blast mTBI was associated with a diffuse, global pattern of lower white matter integrity, and this pattern was not affected by previous civilian mTBI. Neither type of mTBI had an effect on the measures sensitive to more concentrated and spatially consistent white matter disruptions. Additionally, individuals with more than one blast mTBI tended to have a larger number of low FA voxels than individuals with a single blast injury. These results indicate that blast mTBI is associated with disrupted integrity of several white matter tracts, and that these disruptions are diluted by averaging across the large number of voxels within an ROI. The reported pattern of effects supports the conclusion that the neurological effects of blast mTBI are diffuse, widespread, and spatially variable. (C) 2011 Elsevier Inc. All rights reserved.