Compensatory cortical activation during performance of an attention task by patients with diffuse axonal injury: a functional magnetic resonance imaging study
Compensatory cortical activation during performance of an attention task by patients with diffuse axonal injury: a functional magnetic resonance imaging study
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DOI：
10.1136/jnnp.2006.097345
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发表时间：
2007-02-01
影响因子：
11
通讯作者：
Muranaka, H.
中科院分区：
文献类型：
--
作者：
Maruishi, M.;Miyatani, M.;Muranaka, H.
目的：探讨脑弥漫性轴索损伤（DAI）后恢复期高级认知系统的皮层代偿机制。设计：确定了12名右利手患者，其磁共振成像（MRI）病变模式与纯DAI兼容。单纯DAI定义为在T2* 加权梯度回波图像上发现创伤性微出血，而无其他创伤性或非创伤性MRI异常。还招募了12名匹配的健康对照。使用功能性磁共振成像（fMRI）来评估工作记忆测试（起搏视觉序列注意力测试（PVSAT））期间的大脑激活。结果：在PVSAT的反应时间方面没有观察到显著的组间差异。尽管单纯DAI患者在PVSAT期间犯了一些错误，但对照组对每个探头的反应都正确。对照组显示左侧额回、左侧顶回和右侧顶下回激活。单纯DAI患者左侧额下回、右侧额下回和右侧额中回激活。PVSAT任务的组间分析显示，与对照组相比，单纯DAI患者的右侧额下回（BA 45）和右侧额中回（BA 9）的激活显著更高。结论：单纯DAI患者需要对侧（右侧）前额叶区域的代偿性激活来进行与健康对照组相似的活动。这些发现为DAI恢复阶段神经系统的适应能力和脑可塑性提供了进一步的证据。
Objective: To determine how cortical compensation occurs in higher cognitive systems during the recovery phase of diffuse axonal injury (DAI). Design: 12 right-handed patients with a magnetic resonance imaging (MRI) lesion pattern compatible with pure DAI were identified. Pure DAI was defined as finding of traumatic microbleeds on T2*-weighted gradient-echo images in the absence of otherwise traumatic or non-traumatic MRI abnormalities. 12 matched healthy controls were also enrolled. Functional magnetic resonance imaging (fMRI) was used to assess brain activation during a working memory test (Paced Visual Serial Attention Test (PVSAT)). Results: No significant group differences were observed in reaction times for the PVSAT. Although patients with pure DAI committed a few errors during the PVSAT, controls respond correctly to each probe. Controls showed activations in the left frontal gyrus, left parietal gyrus and right inferior parietal gyrus. Patients with pure DAI showed activations in the left inferior frontal gyrus, right inferior frontal gyrus and right middle frontal gyrus. Between-group analysis of the PVSAT task showed significantly greater activation of the right inferior frontal gyrus (BA 45) and right middle frontal gyrus (BA 9) in patient with pure DAI versus controls. Conclusions: Patients with pure DAI require compensatory activation of the contralateral (right) prefrontal region to carry out activities similar to healthy controls. These findings provide further evidence for the adaptive capacity of neuronal systems and brain plasticity during the recovery stages of DAI.