Regional Volumes in Brain Stem and Cerebellum Are Associated With Postural Impairments in Young Brain-Injured Patients
Regional Volumes in Brain Stem and Cerebellum Are Associated With Postural Impairments in Young Brain-Injured Patients
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DOI：
10.1002/hbm.22958
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发表时间：
2015-12-01
影响因子：
4.8
通讯作者：
Swinnen, Stephan P.
中科院分区：
文献类型：
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作者：
Drijkoningen, David;Leunissen, Inge;Swinnen, Stephan P.
许多患有创伤性脑损伤（TBI）的患者患有姿势控制障碍，这可能会深刻影响日常生活。小脑和脑干对于姿势的神经控制至关重要，并且已被证明易受TBI的初级和二级结构后果的影响。本研究的目的是调查是否在脑干和小脑的形态测量差异可以解释损伤的静态和动态姿势控制在TBI。TBI患者（n=18）和健康对照组（n=30）在EquiTestV（R）系统（Neurocom）上完成了三项具有挑战性的姿势控制任务。使用空间无偏的幕下工具箱，使用小脑优化的基于体素的形态测量学分析了小脑灰质（GM）和白色物质（WM）体积。TBI患者的体积损失显示在全球小脑GM，全球幕下WM，小脑中脚，脑桥和中脑。在TBI组和两组中，较低的姿势控制性能与小叶I-IV，V和VI的蠕虫/蠕虫旁区域的GM体积减少相关。此外，在所有参与者中，更差的姿势控制表现与脑桥、延髓、中脑、小脑上级和中脚以及小脑的WM体积较低相关。这是第一项在TBI患者中进行的研究，证明了姿势障碍与特定幕下脑区体积减少之间的相关性。脑干和小脑的容积测量可能是慢性神经病理学的有价值的预后标志物，这使得TBI中姿势控制的康复变得复杂。(C)2015 Wiley Periodicals，Inc.
Many patients with traumatic brain injury (TBI) suffer from postural control impairments that can profoundly affect daily life. The cerebellum and brain stem are crucial for the neural control of posture and have been shown to be vulnerable to primary and secondary structural consequences of TBI. The aim of this study was to investigate whether morphometric differences in the brain stem and cerebellum can account for impairments in static and dynamic postural control in TBI. TBI patients (n=18) and healthy controls (n=30) completed three challenging postural control tasks on the EquiTestV (R) system (Neurocom). Infratentorial grey matter (GM) and white matter (WM) volumes were analyzed with cerebellum-optimized voxel-based morphometry using the spatially unbiased infratentorial toolbox. Volume loss in TBI patients was revealed in global cerebellar GM, global infratentorial WM, middle cerebellar peduncles, pons and midbrain. In the TBI group and across both groups, lower postural control performance was associated with reduced GM volume in the vermal/paravermal regions of lobules I-IV, V and VI. Moreover, across all participants, worse postural control performance was associated with lower WM volume in the pons, medulla, midbrain, superior and middle cerebellar peduncles and cerebellum. This is the first study in TBI patients to demonstrate an association between postural impairments and reduced volume in specific infratentorial brain areas. Volumetric measures of the brain stem and cerebellum may be valuable prognostic markers of the chronic neural pathology, which complicates rehabilitation of postural control in TBI. (C) 2015 Wiley Periodicals, Inc.