Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.
Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.
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DOI：
10.1002/hbm.22117
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发表时间：
2013-11
影响因子：
4.8
通讯作者：
McCarthy, Gregory
中科院分区：
文献类型：
--
作者：
Morey, Rajendra A.;Haswell, Courtney C.;Selgrade, Elizabeth S.;Massoglia, Dino;Liu, Chunlei;Weiner, Jonathan;Marx, Christine E.;Cernak, Ibolja;McCarthy, Gregory
关键词：
轻度创伤性脑损伤（TBI）是伊拉克和阿富汗战争中常见的发病原因。由于结构MRI上没有明显病变，退伍军人慢性轻度TBI的诊断依赖于获得准确的病史和行为症状评估，这些症状也与频繁的共病障碍相关，特别是创伤后应激障碍（PTSD）和抑郁症。来自伊拉克和阿富汗的轻度TBI退伍军人（n=30）与共病PTSD和抑郁症和非TBI参与者从主要（n=42）和验证（n=28）对照组进行了评估与高角分辨率扩散成像（HARDI）。白色物质特异性配准，然后对交叉纤维进行全脑体素分析，提供了反映初级纤维和次级（交叉）纤维完整性的单独部分体积分数。初级纤维中白色物质完整性的丧失（p <0.05;校正）与慢性轻度TBI相关，主要纤维束和较小的外周束广泛分布，包括胼胝体（胼胝体、体、压部）、小钳、大钳、上级和后放射冠、内囊、上级纵束等。分布性白色物质完整性丧失与意识丧失的持续时间相关，最明显的是与“感到头晕或困惑”相关，但与创伤后应激障碍或抑郁症状的诊断无关。白色物质损伤的这种广泛的空间范围通常在中度至重度TBI中报道。白色物质完整性的弥漫性丧失似乎与爆炸和撞击相关的轻度TBI所共有的损伤的全身机制一致，其涉及炎症和神经化学事件的级联反应。
Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of behavioral symptoms that are also associated with frequent comorbid disorders, particularly posttraumatic stress disorder (PTSD) and depression. Military veterans from Iraq and Afghanistan with mild TBI (n=30) with comorbid PTSD and depression and non-TBI participants from primary (n=42) and confirmatory (n=28) control groups were assessed with high angular resolution diffusion imaging (HARDI). White matter-specific registration followed by whole-brain voxelwise analysis of crossing fibers provided separate partial volume fractions reflecting the integrity of primary fibers and secondary (crossing) fibers. Loss of white matter integrity in primary fibers (p < .05; corrected) was associated with chronic mild TBI in a widely distributed pattern of major fiber bundles and smaller peripheral tracts including the corpus callosum (genu, body, splenium), forceps minor, forceps major, superior and posterior corona radiata, internal capsule, superior longitudinal fasciculus, and others. Distributed loss of white matter integrity correlated with duration of loss of consciousness and most notably with “feeling dazed or confused,” but not diagnosis of PTSD or depressive symptoms. This widespread spatial extent of white matter damage has typically been reported in moderate to severe TBI. The diffuse loss of white matter integrity appears consistent with systemic mechanisms of damage shared by blast- and impact-related mild TBI that involves a cascade of inflammatory and neurochemical events.
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影响因子：
4.2
作者：
Cubon, Valerie A.;Putukian, Margot;Dettwiler, Annegret
通讯作者：
Dettwiler, Annegret
DOI：
10.1038/jcbfm.2009.203
发表时间：
2010-02
期刊：
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
影响因子：
--
作者：
通讯作者：
--
影响因子：
1.2
作者：
Gondusky, JS;Reiter, MP
通讯作者：
Reiter, MP
影响因子：
3.4
作者：
Cernak, Ibolja
通讯作者：
Cernak, Ibolja
影响因子：
4.8
作者：
Dedert, Eric A.;Green, Kimberly T.;Beckham, Jean C.
通讯作者：
Beckham, Jean C.