Sex Differences in White Matter Abnormalities after Mild Traumatic Brain Injury: Localization and Correlation with Outcome-猫眼课题宝

DOI：

10.1148/radiol.14132512

发表时间：

2014-09-01

期刊：

RADIOLOGY

影响因子：

19.7

通讯作者：

中科院分区：

医学1区

文献类型：

作者：

Fakhran, Saeed;Yaeger, Karl;Alhilali, Lea

目的：使用基于脑束的空间统计学方法(TBSS)评估轻度颅脑损伤(MTBI)后脑白质弥散张量成像(DTI)白质异常的性别差异，并比较相关的临床结果。材料和方法：机构审查委员会批准了这项研究，但放弃知情同意。对69例常规磁共振(MR)正常的脑外伤患者(男47例，女22例)和对照组21例(男10例，女11例)的弥散张量成像进行了回顾性分析。生成分数各向异性(FA)图作为衡量白质完整性的指标。对mTBI患者进行了一系列神经认知测试，包括即时震荡后评估和认知测试(IMPACT)。对性别、脑白质FA值、冲击评分和症状缓解时间(TSR)进行多因素分析和TBSS分析。结果：男性和女性在年龄上没有显著差异(对照组，P=.3；mTBI患者，P=.34)。男性和女性mTBI患者的初始碰撞症状评分没有显著差异(P=.33)。男性患者双侧钩带束(UF)的FA值显著低于女性患者和对照组(P&lt；0.05)(平均FA值为0.425；95%可信区间为0.375、0.476)，TSR显著延长(P=0.04)。多因素分析显示，性别和UF FA值与3个月以上的TSR独立相关(调整后优势比分别为2.27和2.38；P=0.04和P&lt；.001)，但初始症状严重度无相关性(调整后优势比为1.15；P=.35)。结论：女性患者在mTBI后相对较男性患者有相对较少的UF，性别和UF FA值比初始症状严重度更能预测TSR。(C)RSNA，2014年

Purpose: To evaluate sex differences in diffusion-tensor imaging (DTI) white matter abnormalities after mild traumatic brain injury (mTBI) using tract-based spatial statistics (TBSS) and to compare associated clinical outcomes.Materials and Methods: The institutional review board approved this study, with waiver of informed consent. DTI in 69 patients with mTBI (47 male and 22 female patients) and 21 control subjects (10 male and 11 female subjects) with normal conventional magnetic resonance (MR) images were retrospectively reviewed. Fractional anisotropy (FA) maps were generated as a measure of white matter integrity. Patients with mTBI underwent serial neurocognitive testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Correlation between sex, white matter FA values, ImPACT scores, and time to symptom resolution (TSR) were analyzed with multivariate analysis and TBSS.Results: No significant difference in age was seen between males and females (control subjects, P = .3; patients with mTBI, P = .34). No significant difference was seen in initial ImPACT symptom scores (P = .33) between male and female patients with mTBI. Male patients with mTBI had significantly decreased FA values in the uncinate fasciculus (UF) bilaterally (mean FA, 0.425; 95% confidence interval: 0.375, 0.476) compared with female patients with mTBI and control subjects (P < .05), with a significantly longer TSR (P = .04). Multivariate analysis showed sex and UF FA values independently correlated with TSR longer than 3 months (adjusted odds ratios, 2.27 and 2.38; P = .04 and P < .001, respectively), but initial symptom severity did not (adjusted odds ratio, 1.15; P = .35).Conclusion: Relative sparing of the UF is seen in female compared with male patients after mTBI, with sex and UF FA values as stronger predictors of TSR than initial symptom severity. (C) RSNA, 2014

Sex Differences in White Matter Abnormalities after Mild Traumatic Brain Injury: Localization and Correlation with Outcome

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