Hyper-connectivity of the thalamus during early stages following mild traumatic brain injury.
Hyper-connectivity of the thalamus during early stages following mild traumatic brain injury.
复制标题
轻度创伤性脑损伤后，丘脑在丘脑的高度连接性。
DOI：
10.1007/s11682-015-9424-2
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发表时间：
2015-09
影响因子：
3.2
通讯作者：
Gullapalli RP
中科院分区：
文献类型：
--
作者：
Sours C;George EO;Zhuo J;Roys S;Gullapalli RP
在前瞻性招募的77名急性轻度TBI（mTBI）患者（平均6±3天）的前10天内，以及35名神经功能完好的对照受试者中，使用Oxford丘脑连接图谱检查了7个丘脑下区域的丘脑-皮质静息状态功能连接。使用自动神经心理学评估工具（ANAM）进行神经心理学评估。一部分参与者接受了磁共振波谱（MRS）检查，以确定丘脑和后扣带皮层中的代谢物浓度。结果显示，患者在ANAM的各种子测试和加权吞吐量评分上的表现比对照组差，这表明在损伤的早期阶段认知能力降低。静息状态fMRI数据的基于体素和感兴趣区域的分析表明，急性mTBI患者与感觉处理和默认模式网络（DMN）相关的各种丘脑下区域和皮质区域之间的功能连接增加。此外，在mTBI患者的丘脑中观察到NAA/Cr的显著降低。此外，与没有自我报告的感觉症状的患者相比，观察到具有自我报告的感觉症状的mTBI患者的Cho/Cr比率增加。这些结果为与内部反刍和唤醒相关的大脑状态的神经机制提供了新的见解，这对具有持续症状的mTBI患者的新干预措施具有重要意义。此外，在损伤的早期阶段，对感觉相关输入的高度敏感性的理解可能有助于增强对安全返回工作的预测。
The thalamo-cortical resting state functional connectivity of 7 sub-thalamic regions were examined in a prospectively recruited population of 77 acute mild TBI (mTBI) patients within the first 10 days (mean 6±3 days) of injury and 35 neurologically intact control subjects using the Oxford thalamic connectivity atlas. Neuropsychological assessments were conducted using the Automated Neuropsychological Assessment Metrics (ANAM). A subset of participants received a magentic resonance spectroscopy (MRS) exam to determine metabolite concentrations in the thalamus and posterior cingulate cortex. Results show that patients performed worse than the control group on various subtests of ANAM and the weighted throughput score, suggesting reduced cognitive performance at this early stage of injury. Both voxel and region of interest based analysis of the resting state fMRI data demonstrated that acute mTBI patients have increased functional connectivity between the various sub-thalamic regions and cortical regions associated with sensory processing and the default mode network (DMN). In addition, a significant reduction in NAA/Cr was observed in the thalamus in the mTBI patients. Furthermore, an increase in Cho/Cr ratio specific to mTBI patients with self-reported sensory symptoms was observed compared to those without self-reported sensory symptoms. These results provide novel insights into the neural mechanisms of the brain state related to internal rumination and arousal, which have implications for new interventions for mTBI patients with persistent symptoms. Furthermore, an understanding of heightened sensitivity to sensory related inputs during early stages of injury may facilitate enhanced prediction of safe return to work.