White Matter Abnormalities Associated With Prolonged Recovery in Adolescents Following Concussion.
White Matter Abnormalities Associated With Prolonged Recovery in Adolescents Following Concussion.
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白质异常与青少年脑震荡后长期恢复有关。
DOI：
10.3389/fneur.2021.681467
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发表时间：
2021
影响因子：
3.4
通讯作者：
Versace A
中科院分区：
文献类型：
--
作者：
Lima Santos JP;Kontos AP;Mailliard S;Eagle SR;Holland CL;Suss SJ Jr;Abdul-Waalee H;Stiffler RS;Bitzer HB;Blaney NA;Colorito AT;Santucci CG;Brown A;Kim T;Iyengar S;Skeba A;Diler RS;Ladouceur CD;Phillips ML;Brent D;Collins MW;Versace A
背景：青少年脑震荡症状通常在4周内消退。然而，20 - 30%的青少年经历了长时间的恢复。与视觉空间注意力和情绪调节有关的束异常（即，下纵束，ILF；下额枕束，IFOF；钩状束，UF）在脑震荡中一直被报道；然而，到目前为止，在青少年中还没有长期康复的客观标志。在这里，我们评估了扩散MRI在预后预测中的效用。42名青少年（12.1 - 17.9岁，女性占44.0%）在脑震荡后10天内接受了弥散磁共振成像（dMRI）检查。根据受伤至医疗许可的天数，将青少年分为短期（<28天，N = 21）和长期（>28天，N = 21）恢复时间。使用ILF、IFOF、UF和/或脑震荡症状的分数各向异性（FA）作为恢复时间（短、长）的预测因子。42名年龄和性别匹配的健康对照作为参考。较高的FA董继玲女士(左:调整后的优势比,AOR = 0.36, 95% CI = 0.15 - 0.91, P = 0.030;右:AOR = 0.28, 95% CI = 0.10 - 0.83, P = 0.021), IFOF(左:AOR = 0.21, 95% CI = 0.07 - 0.66, P = 0.008;右:AOR = 0.30, 95% CI = 0.11 - 0.83, P = 0.020),和佛罗里达大学(左:AOR = 0.26, 95% CI = 0.09 - 0.74, P = 0.011;右:AOR = 0.28, 95% CI = 0.10 - 0.73, P = 0.010)与短期复苏。在其他分析中，虽然短期恢复的青少年与HC没有差异，但长期恢复的青少年在ILF和IFOF中显示较低的FA （P < 0.014）。值得注意的是，纳入dMRI结果增加了仅包括临床变量（AUC = 0.75）的预测模型的敏感性和特异性（AUC = 0.93）。我们的研究结果表明，在长联合束（特别是ILF）中较高的FA可能为青少年脑震荡后的恢复时间提供更客观和准确的预测。
Background: Concussion symptoms in adolescents typically resolve within 4 weeks. However, 20 – 30% of adolescents experience a prolonged recovery. Abnormalities in tracts implicated in visuospatial attention and emotional regulation (i.e., inferior longitudinal fasciculus, ILF; inferior fronto-occipital fasciculus, IFOF; uncinate fasciculus; UF) have been consistently reported in concussion; yet, to date, there are no objective markers of prolonged recovery in adolescents. Here, we evaluated the utility of diffusion MRI in outcome prediction. Forty-two adolescents (12.1 – 17.9 years; female: 44.0%) underwent a diffusion Magnetic Resonance Imaging (dMRI) protocol within the first 10 days of concussion. Based on days of injury until medical clearance, adolescents were then categorized into SHORT (<28 days; N = 21) or LONG (>28 days; N = 21) recovery time. Fractional anisotropy (FA) in the ILF, IFOF, UF, and/or concussion symptoms were used as predictors of recovery time (SHORT, LONG). Forty-two age- and sex-matched healthy controls served as reference. Higher FA in the ILF (left: adjusted odds ratio; AOR = 0.36, 95% CI = 0.15 – 0.91, P = 0.030; right: AOR = 0.28, 95% CI = 0.10 – 0.83, P = 0.021), IFOF (left: AOR = 0.21, 95% CI = 0.07 – 0.66, P = 0.008; right: AOR = 0.30, 95% CI = 0.11 – 0.83, P = 0.020), and UF (left: AOR = 0.26, 95% CI = 0.09 – 0.74, P = 0.011; right: AOR = 0.28, 95% CI = 0.10 – 0.73, P = 0.010) was associated with SHORT recovery. In additional analyses, while adolescents with SHORT recovery did not differ from HC, those with LONG recovery showed lower FA in the ILF and IFOF (P < 0.014). Notably, inclusion of dMRI findings increased the sensitivity and specificity (AUC = 0.93) of a prediction model including clinical variables only (AUC = 0.75). Our findings indicate that higher FA in long associative tracts (especially ILF) might inform a more objective and accurate prognosis for recovery time in adolescents following concussion.
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影响因子：
4.2
作者：
Fong AK;Allen MD;Waltzman D;Sarmiento K;Yeates KO;Suskauer S;Wintermark M;Lindberg DM;Tate DF;Wilde EA;Loewen JL
通讯作者：
Loewen JL
影响因子：
8
作者：
Bryan, Mersine A.;Rowhani-Rahbar, Ali;Rivara, Frederick
通讯作者：
Rivara, Frederick
影响因子：
4.2
作者：
Kochunov, P.;Williamson, D. E.;Lancaster, J.;Fox, P.;Cornell, J.;Blangero, J.;Glahn, D. C.
通讯作者：
Glahn, D. C.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
8
作者：
Barlow, Karen Maria;Crawford, Susan;Dewey, Deborah
通讯作者：
Dewey, Deborah