Abnormal White Matter Blood-Oxygen-Level-Dependent Signals in Chronic Mild Traumatic Brain Injury
Abnormal White Matter Blood-Oxygen-Level-Dependent Signals in Chronic Mild Traumatic Brain Injury
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DOI：
10.1089/neu.2014.3547
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发表时间：
2015-08-15
影响因子：
4.2
通讯作者：
Corbetta, Maurizio
中科院分区：
文献类型：
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作者：
Astafiev, Serguei V.;Shulman, Gordon L.;Corbetta, Maurizio
脑震荡或轻度创伤性脑损伤（mTBI）可导致持续的行为症状和认知障碍，但目前尚不清楚这种情况是否与可检测的结构或功能性大脑变化有关。在两个地点，具有持续性脑震荡后症状（受伤后三个月至五年）的慢性mTBI人类受试者和年龄和教育程度匹配的健康人类对照受试者进行了广泛的神经心理学和视觉跟踪眼球运动测试。在一个研究中心，患者和对照组也进行了视觉跟踪任务，而血氧水平依赖（BOLD）信号与功能磁共振成像测量。虽然无论是神经心理学还是视觉跟踪措施区分患者与对照组在个体受试者的水平，异常BOLD信号可靠地检测到患者。最一致的变化局限于白色物质区域：前内囊和上级纵束。相比之下，BOLD信号在皮层区域是正常的，如额叶眼区和顶内沟，介导视觉跟踪所需的眼球和注意力功能。异常的BOLD信号在单个受试者水平上准确地区分了慢性mTBI患者和健康对照，尽管它们与症状或神经心理学表现无关。我们的结论是，持续性脑震荡后症状的受试者，可以确定他们的TBI使用功能磁共振成像和眼球运动任务后，尽管显示正常的结构MRI和DTI年。
Concussion, or mild traumatic brain injury (mTBI), can cause persistent behavioral symptoms and cognitive impairment, but it is unclear if this condition is associated with detectable structural or functional brain changes. At two sites, chronic mTBI human subjects with persistent post-concussive symptoms (three months to five years after injury) and age- and education-matched healthy human control subjects underwent extensive neuropsychological and visual tracking eye movement tests. At one site, patients and controls also performed the visual tracking tasks while blood-oxygen-level-dependent (BOLD) signals were measured with functional magnetic resonance imaging. Although neither neuropsychological nor visual tracking measures distinguished patients from controls at the level of individual subjects, abnormal BOLD signals were reliably detected in patients. The most consistent changes were localized in white matter regions: anterior internal capsule and superior longitudinal fasciculus. In contrast, BOLD signals were normal in cortical regions, such as the frontal eye field and intraparietal sulcus, that mediate oculomotor and attention functions necessary for visual tracking. The abnormal BOLD signals accurately differentiated chronic mTBI patients from healthy controls at the single-subject level, although they did not correlate with symptoms or neuropsychological performance. We conclude that subjects with persistent post-concussive symptoms can be identified years after their TBI using fMRI and an eye movement task despite showing normal structural MRI and DTI.