Recovery from mild head injury in sports: Evidence from serial functional magnetic resonance imaging studies in male athletes
Recovery from mild head injury in sports: Evidence from serial functional magnetic resonance imaging studies in male athletes
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DOI：
10.1097/jsm.0b013e318170b59d
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发表时间：
2008-05-01
影响因子：
2.7
通讯作者：
Ptito, Alain
中科院分区：
文献类型：
--
作者：
Chen, Jen-Kai;Johnston, Karen M.;Ptito, Alain
目的：检查脑震荡后症状 (PCS) 消退前后的功能性大脑激活模式。设计：使用功能磁共振成像 (fMRI) 对男性运动员进行前瞻性系列研究。设置：医院实验室和成像设施。参与者：9 名在受伤后至少 1 个月经历持续性 PCS 的有症状的脑震荡运动员和 6 名健康运动员。干预措施：所有运动员填写 PCS 检查表并接受 fMRI 治疗，期间执行工作记忆任务。结果测量：行为结果是在功能磁共振成像会话期间执行的工作记忆任务的响应速度和准确性。功能成像结果是与工作记忆任务相关的血氧水平依赖性功能磁共振成像激活模式。结果：各组之间的行为表现没有差异。尽管结构 MRI 结果正常，但所有有症状的脑震荡运动员最初都在背外侧前额皮质 (DLPC) 中表现出非典型的大脑激活模式。与最初的伤后评估相比，那些 PCS 得到解决的运动员在随访中表现出左侧 DLPC 的激活显着增加。 PCS 状态在随访中保持不变的脑震荡运动员继续表现出 DLPC 的非典型激活。健康运动员在 DLPC 中最初和后续都表现出非常清晰和一致的大脑激活，突出了 fMRI 的重测可靠性。结论：结果证明了使用 fMRI 检测具有正常结构成像结果的有症状的脑震荡运动员的潜在病理的可行性及其记录恢复的潜力。这些信息对于临床判断和患者管理可能具有相当大的价值。
Objective: To examine functional brain activation patterns before and after postconcussive symptoms (PCS) resolution.Design: Prospective serial study with male athletes using functional magnetic resonance imaging (fMRI).Setting: Hospital laboratory and imaging facility.Participants: 9 symptomatic concussed athletes who experienced persisting PCS at least I month postinjury and 6 healthy athletes.Interventions: All athletes filled out a PCS checklist and underwent an fMRI session during which they performed a working-memory task.Main outcome measurements: Behavioral outcomes were response speed and accuracy on the working memory tasks performed during the fMRI session. Functional imaging outcomes were blood oxygen level-dependent fMRI activation patterns associated with a working memory task.Results: There was no difference in behavioral performance between the groups. Despite normal structural MRI findings, all symptomatic concussed athletes initially showed atypical brain activation patterns in the dorsolateral prefrontal cortex (DLPC). Compared to the initial postinjury evaluation, those athletes at follow-up with PCS resolved showed significant increases in activation in the left DLPC. Concussed athletes whose PCS status remained unchanged at follow-up continued to show atypical activation in DLPC. Healthy athletes showed remarkably clear and consistent brain activations in DLPC initially as well as in follow-up, highlighting the test-retest reliability of fMRI.Conclusions: The results demonstrate the feasibility of using fMRI to detect an underlying pathology in symptomatic concussed athletes with normal structural imaging results and its potential to document recovery. Such information may be of considerable value for clinical judgment and patient management.