Blast-Exposed Veterans With Mild Traumatic Brain Injury Show Greater Frontal Cortical Thinning and Poorer Executive Functioning.
Blast-Exposed Veterans With Mild Traumatic Brain Injury Show Greater Frontal Cortical Thinning and Poorer Executive Functioning.
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DOI：
10.3389/fneur.2018.00873
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发表时间：
2018
影响因子：
3.4
通讯作者：
Delano-Wood L
中科院分区：
文献类型：
--
作者：
Clark AL;Merritt VC;Bigler ED;Bangen KJ;Werhane M;Sorg SF;Bondi MW;Schiehser DM;Delano-Wood L
目的：爆炸暴露（BE）和轻度创伤性脑损伤（mTBI）已独立地与病理性脑变化相关。然而，BE和mTBI对脑结构的综合影响尚未被表征。因此，我们研究了在部署时，有和没有BE的mTBI退伍军人之间是否存在皮质厚度的区域差异。我们还检查了皮质厚度（CT）和认知能力是否在具有低水平与高水平累积BE的mTBI退伍军人之间存在差异。方法：对80例mTBI患者进行神经影像学检查，并完成神经心理学测试和症状自评量表。协方差分析（ANCOVA）用于比较爆炸暴露退伍军人（mTBI+BE，n = 51）与无BE的退伍军人（mTBI-BE，n = 29）的额叶和颞叶先验感兴趣区（ROI）CT。接下来，使用多元回归分析来检查在具有低（mTBI+BE低，n = 22）与高（mTBI +BE高，n = 26）累积BE水平的mTBI退伍军人之间CT和执行功能复合物的表现是否不同。结果：调整年龄、TBI数量和PTSD症状后，mTBI+BE组在额叶区域显示出显著的皮质变薄（即，左眶额皮质[p = 0.045]、左额中回[p = 0.023]和右额下回[p = 0.034]）。颞区CT无显著组间差异（p> 0.05）。多元回归分析显示，左眶额皮质（p = 0.001）和左额中回（p = 0.020）的BE × CT累积交互作用显著;在mTBI+BE高组中，CT降低与认知表现较差相关，但在mTBI+BE低组中则无关。结论：研究结果表明，mTBI和BE的退伍军人可能存在部署后皮质变薄的风险。此外，我们的研究结果表明，CT的减少与高水平累积BE的退伍军人的执行功能较差有关。未来的纵向研究需要确定是否BE加剧mTBI相关的皮质变薄或独立的负面影响灰质结构。
Objective: Blast exposure (BE) and mild traumatic brain injury (mTBI) have been independently linked to pathological brain changes. However, the combined effects of BE and mTBI on brain structure have yet to be characterized. Therefore, we investigated whether regional differences in cortical thickness exist between mTBI Veterans with and without BE while on deployment. We also examined whether cortical thickness (CT) and cognitive performance differed among mTBI Veterans with low vs. high levels of cumulative BE. Methods: 80 Veterans with mTBI underwent neuroimaging and completed neuropsychological testing and self-report symptom rating scales. Analyses of covariance (ANCOVA) were used to compare blast-exposed Veterans (mTBI+BE, n = 51) to those without BE (mTBI-BE, n = 29) on CT of frontal and temporal a priori regions of interest (ROIs). Next, multiple regression analyses were used to examine whether CT and performance on an executive functions composite differed among mTBI Veterans with low (mTBI+BE Low, n = 22) vs. high (mTBI+BE High, n = 26) levels of cumulative BE. Results: Adjusting for age, numer of TBIs, and PTSD symptoms, the mTBI+BE group showed significant cortical thinning in frontal regions (i.e., left orbitofrontal cortex [p = 0.045], left middle frontal gyrus [p = 0.023], and right inferior frontal gyrus [p = 0.034]) compared to the mTBI-BE group. No significant group differences in CT were observed for temporal regions (p's > 0.05). Multiple regression analyses revealed a significant cumulative BE × CT interaction for the left orbitofrontal cortex (p = 0.001) and left middle frontal gyrus (p = 0.020); reduced CT was associated with worse cognitive performance in the mTBI+BE High group but not the mTBI+BE Low group. Conclusions: Findings show that Veterans with mTBI and BE may be at risk for cortical thinning post-deployment. Moreover, our results demonstrate that reductions in CT are associated with worse executive functioning among Veterans with high levels of cumulative BE. Future longitudinal studies are needed to determine whether BE exacerbates mTBI-related cortical thinning or independently negatively influences gray matter structure.
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战斗暴露的严重程度与战斗退伍军人的皮质厚度降低有关：初步报告。
DOI：
10.1177/2470547017724714
发表时间：
2017-01
期刊：
Chronic stress (Thousand Oaks, Calif.)
影响因子：
--
作者：
Averill LA;Abdallah CG;Pietrzak RH;Averill CL;Southwick SM;Krystal JH;Harpaz-Rotem I
通讯作者：
Harpaz-Rotem I
影响因子：
17.1
作者：
Goldstein LE;Fisher AM;Tagge CA;Zhang XL;Velisek L;Sullivan JA;Upreti C;Kracht JM;Ericsson M;Wojnarowicz MW;Goletiani CJ;Maglakelidze GM;Casey N;Moncaster JA;Minaeva O;Moir RD;Nowinski CJ;Stern RA;Cantu RC;Geiling J;Blusztajn JK;Wolozin BL;Ikezu T;Stein TD;Budson AE;Kowall NW;Chargin D;Sharon A;Saman S;Hall GF;Moss WC;Cleveland RO;Tanzi RE;Stanton PK;McKee AC
通讯作者：
McKee AC
影响因子：
2.4
作者：
Bazarian, Jeffrey J.;Donnelly, Kerry;Zhong, Jianhui
通讯作者：
Zhong, Jianhui
影响因子：
0.8
作者：
Hayes, Jasmeet Pannu;Morey, Rajendra A.;Tupler, Larry A.
通讯作者：
Tupler, Larry A.
影响因子：
3.4
作者：
Heldt SA;Elberger AJ;Deng Y;Guley NH;Del Mar N;Rogers J;Choi GW;Ferrell J;Rex TS;Honig MG;Reiner A
通讯作者：
Reiner A