Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients.
Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients.
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DOI：
10.1002/brb3.581
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发表时间：
2016-12
影响因子：
3.1
通讯作者：
Yurgelun-Todd, Deborah
中科院分区：
文献类型：
--
作者：
Epstein, Daniel J.;Legarreta, Margaret;Bueler, Elliot;King, Jace;McGlade, Erin;Yurgelun-Todd, Deborah
虽然轻度创伤性脑损伤（mTBI）占所有TBI的80%，但在严格的mTBI样本中，与临床症状（如攻击性、焦虑和抑郁）相关的眶额皮质（OFC）的形态学检查以前从未进行过。该研究的主要目的是确定mTBI患者是否会在OFC中显示形态学差异，以及该区域的形态学是否与临床症状相关。使用在3 T MRI机器中获得的结构图像，收集健康对照（N = 27）受试者和慢性mTBI（N = 55）患者损伤后至少一年的OFC的皮质厚度和皮质体积（针对总脑体积校正）。此外，在临床访谈期间，收集了量化临床症状严重程度的指标，包括攻击性、焦虑和抑郁。 MTBI受试者表现出增加的攻击性，焦虑和抑郁，焦虑和抑郁的措施表明与受试者失去意识的mTBI的数量的关系。mTBI组右侧OFC的皮质厚度显示变薄的证据;然而，在校正多重比较后，该差异不再显著。临床指标与眶额细胞形态计量学无显著相关性。这项研究发现mTBI组的攻击性、焦虑和抑郁增加，以及右侧OFC皮质变薄的证据。临床症状与意识丧失的mTBI数量之间的相关性表明mTBI的数量和严重程度可能会影响损伤后很长时间的临床症状。未来的研究将检查参与情感过程产生和调节的其他大脑区域，并纳入具有良好特征的情绪障碍的受试者，这可能进一步阐明mTBI，大脑形态学和临床症状之间的关系。
Although mild traumatic brain injury (mTBI) comprises 80% of all TBI, the morphological examination of the orbitofrontal cortex (OFC) in relation to clinical symptoms such as aggression, anxiety and depression in a strictly mTBI sample has never before been performed. The primary objective of the study was to determine if mTBI patients would show morphological differences in the OFC and if the morphology of this region would relate to clinical symptoms. Using structural images acquired in a 3T MRI machine, the cortical thickness and cortical volume (corrected for total brain volume) of the OFC was collected for healthy control (N = 27) subjects and chronic mTBI (N = 55) patients at least one year post injury. Also, during clinical interviews, measures quantifying the severity of clinical symptoms, including aggression, anxiety, and depression, were collected. MTBI subjects displayed increased aggression, anxiety, and depression, and anxiety and depression measures showed a relationship with the number of mTBI in which the subject lost consciousness. The cortical thickness of the right lateral OFC displayed evidence of thinning in the mTBI group; however, after correction for multiple comparisons, this difference was no longer significant. Clinical measures were not significantly related with OFC morphometry. This study found increased aggression, anxiety, and depression, in the mTBI group as well as evidence of cortical thinning in the right lateral OFC. The association between clinical symptoms and the number of mTBI with loss of consciousness suggests the number and severity of mTBI may influence clinical symptoms long after injury. Future studies examining other brain regions involved in the production and regulation of affective processes and inclusion of subjects with well‐characterized mood disorders could further elucidate the relationship between mTBI, brain morphology, and clinical symptoms.
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