Impaired Neurovascular Unit Function Contributes to Persistent Symptoms after Concussion: A Pilot Study
Impaired Neurovascular Unit Function Contributes to Persistent Symptoms after Concussion: A Pilot Study
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DOI：
10.1089/neu.2013.3213
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发表时间：
2014-09-01
影响因子：
4.2
通讯作者：
Ashwal, Stephen
中科院分区：
文献类型：
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作者：
Bartnik-Olson, Brenda L.;Holshouser, Barbara;Ashwal, Stephen
研究表明，大约14%患有轻度创伤性脑损伤（TBI）的学龄儿童，包括运动相关脑震荡（SRC），在受伤后三个月仍有症状。损伤后早期的先进成像研究显示，轻度TBI患者存在轴突损伤、N-乙酰天冬氨酸（NAA）减少和脑血流量（CBF）受损的证据。本研究旨在确定这些技术是否可以为具有持续性脑震荡后症状的儿童SRC患者提供有价值的信息。15名年龄在8 - 17岁的儿童受试者在SRC后3 - 12个月使用灌注加权成像（PWI）、三维（3D）磁共振波谱成像和扩散张量成像（DTI）进行了评价，这些受试者具有持续的脑震荡后症状。将数据与15个人口统计学相似（年龄，性别和体重指数）的对照组进行比较。与对照组相比，SRC患者的双侧丘脑CBF（p=0.02和p=0.02）和相对脑血容量（CBV; p=0.05和p=0.03）降低。在胼胝体（p=0.003; p=0.05）和顶叶白色物质（p= 0.005）中，NAA/肌酸（Cr）和NAA/胆碱（Cho）比值降低。
Research shows that approximately 14% of school age children with mild traumatic brain injury (TBI) including sports-related concussions (SRCs) remain symptomatic three months after injury. Advanced imaging studies early after injury have shown evidence of axonal damage, reduced N-acetyl aspartate (NAA) and impaired cerebral blood flow (CBF) in individuals with mild TBI. This study was undertaken to determine whether these techniques can provide valuable information in pediatric SRC patients with persistent post-concussive symptoms. Fifteen pediatric subjects ages 8 to 17 years with persistent post-concussive symptoms were evaluated using perfusion-weighted imaging (PWI), three-dimensional (3D) magnetic resonance spectroscopic imaging, and diffusion tensor imaging (DTI) three to 12 months post-SRC. Data were compared with 15 demographically similar (age, gender, and body mass index) controls. In the bilateral thalami, SRC patients showed reduced CBF (p=0.02 and p=0.02) and relative cerebral blood volume (CBV; p=0.05 and p=0.03), compared with controls. NAA/creatine (Cr) and NAA/choline (Cho) ratios were reduced in the corpus callosum (p=0.003; p=0.05) and parietal white matter (p