Elevated Intraindividual Variability in Executive Functions and Associations with White Matter Microstructure in Veterans with Mild Traumatic Brain Injury.
Elevated Intraindividual Variability in Executive Functions and Associations with White Matter Microstructure in Veterans with Mild Traumatic Brain Injury.
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DOI：
10.1017/s1355617720000879
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Delano-Wood L
中科院分区：
文献类型：
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作者：
Sorg SF;Merritt VC;Clark AL;Werhane ML;Holiday KA;Schiehser DM;Bondi M;Delano-Wood L
我们研究了是否在执行功能测试（EF-IIV）的个体内变异性（IIV）是升高的退伍军人与历史的轻度创伤性脑损伤（mTBI）相对于军事控制（MC）没有mTBI的历史。我们还探讨了EF-IIV，白色物质微观结构，创伤后应激障碍（PTSD）症状之间的关系。77名退伍军人（mTBI=43，MCs=34）完成了神经心理学测试，弥散张量成像（DTI）和PTSD症状评级。EF-IIV计算为EF的6次检验的标准差，沿着EF-平均值复合。根据广义分数各向异性（GFA），DSI Studio连接测量分析确定了与EF-IIV显著相关的白色物质束。在调整EF均值和PTSD症状后，mTBI组的EF IIV显著高于MC组。在调整PTSD症状后，各组的EF均值没有差异。在各组中，PTSD症状与EF-Mean显著负相关，但与EF-IIV无关。EF-IIV与连接额叶和更后部区域的多个白色通路中的GFA显著负相关。与MCs相比，mTBI退伍军人在EF测试中表现出更大的IIV，即使在调整了这些措施的平均组差异以及PTSD严重程度之后。研究结果表明，在对比分析，探索跨测试的平均性能的影响，差异分析可能会捕捉独特的差异，神经心理学性能和更敏感地捕捉认知中断的退伍军人与mTBI的历史。重要的是，研究结果表明，EF-IIV是负相关的微观结构的白色物质通路互连皮层区域，介导执行功能和注意力的过程。
We examined whether intra-individual variability (IIV) across tests of executive functions (EF-IIV) is elevated in Veterans with a history of mild traumatic brain injury (mTBI) relative to military controls (MCs) without a history of mTBI. We also explored relationships among EF-IIV, white matter microstructure, and post-traumatic stress disorder (PTSD) symptoms. 77 Veterans (mTBI=43, MCs=34) completed neuropsychological testing, diffusion tensor imaging (DTI), and PTSD symptom ratings. EF-IIV was calculated as the standard deviation across six tests of EF, along with an EF-Mean composite. DSI Studio connectometry analysis identified white matter tracts significantly associated with EF-IIV according to generalized fractional anisotropy (GFA). After adjusting for EF-Mean and PTSD symptoms, the mTBI group showed significantly higher EF-IIV than MCs. Groups did not differ on EF-Mean after adjusting for PTSD symptoms. Across groups, PTSD symptoms significantly negatively correlated with EF-Mean, but not with EF-IIV. EF-IIV significantly negatively correlated with GFA in multiple white matter pathways connecting frontal and more posterior regions. Veterans with mTBI demonstrated significantly greater IIV across EF tests compared to MCs, even after adjusting for mean group differences on those measures as well as PTSD severity. Findings suggest that, in contrast to analyses that explore effects of mean performance across tests, discrepancy analyses may capture unique variance in neuropsychological performance and more sensitively capture cognitive disruption in Veterans with mTBI histories. Importantly, findings show that EF-IIV is negatively associated with the microstructure of white matter pathways interconnecting cortical regions that mediate executive function and attentional processes.