Neuroplasticity following non-penetrating traumatic brain injury
Neuroplasticity following non-penetrating traumatic brain injury
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DOI：
10.1080/0269905031000107151
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发表时间：
2003-08-01
期刊：
影响因子：
1.9
通讯作者：
Levin, HS
中科院分区：
文献类型：
--
作者：
Levin, HS
本综述的主要目的是研究创伤性脑损伤（TBI）恢复中神经可塑性手术的方法和证据，并与先前围产期和婴儿局灶性血管病变患者的研究结果进行比较。迄今为止的证据表明，早期局灶性脑损伤后功能重组增强的传统观点可能适用于早期局灶性脑损伤，但不符合早期严重弥漫性脑损伤的研究。与早期局灶性血管病变相比，年轻在严重弥漫性脑损伤的预后中没有优势。髓鞘形成的破坏可能会潜在地改变连通性，这一建议可以通过扩散张量成像（DTI）证实。TBI患者的DTI的初步报告支持这种技术可以显示白质连接的改变的可能性，这种改变在传统的磁共振成像（MRI）上是看不到的，并且可能随着时间或干预而改变。TBI患者的初步功能性MRI研究表明，大脑激活模式发生了改变，这表明需要招募更广泛的皮质区域来执行需要计算资源的任务。功能性MRI，结合DTI和可能的其他成像方式，有望阐明脑外伤后神经可塑性和修复的机制。
The primary objective of this review is to examine the methodology and evidence for neuroplasticity operating in recovery from traumatic brain injury (TBI), as compared with previous findings in patients sustaining perinatal and infantile focal vascular lesions. The evidence to date indicates that the traditional view of enhanced reorganization of function after early focal brain lesions might apply to early focal brain lesions, but does not conform with studies of early severe diffuse brain injury. In contrast to early focal vascular lesions, young age confers no advantage in the outcome of severe diffuse brain injury. Disruption of myelination could potentially alter connectivity, a suggestion which could be confirmed through diffusion tensor imaging (DTI). Initial reports of DTI in TBI patients support the possibility that this technique can demonstrate alterations in white matter connections which are not seen on conventional magnetic resonance imaging (MRI) and might change over time or with interventions. Preliminary functional MRI studies of TBI patients indicate alterations in the pattern of brain activation, suggesting recruitment of more extensive cortical regions to perform tasks which stress computational resources. Functional MRI, coupled with DTI and possibly other imaging modalities holds the promise of elucidating mechanisms of neuroplasticity and repair following TBI.