Subject-specific changes in brain white matter on diffusion tensor imaging after sports-related concussion.
Subject-specific changes in brain white matter on diffusion tensor imaging after sports-related concussion.
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DOI：
10.1016/j.mri.2011.10.001
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发表时间：
2012-02
影响因子：
2.5
通讯作者：
Zhong, Jianhui
中科院分区：
文献类型：
--
作者：
Bazarian, Jeffrey J.;Zhu, Tong;Blyth, Brian;Borrino, Allyson;Zhong, Jianhui
目前的扩散张量成像（DTI）分析方法不允许识别DTI指数的个人水平变化。我们研究了野启动分析检测运动相关脑震荡前后脑白质（WM）特异性变化的能力。一项前瞻性队列研究在9名从事曲棍球或足球的高中运动员和6名对照组中进行。受试者在3个月的时间间隔内进行了DTI术前和术后检查。一名运动员被诊断为脑震荡（在72小时内扫描），8名运动员遭受了26至399次次震荡性头部撞击。在每个白质体素中测量分数各向异性（FA）和平均扩散率（MD）。生成Bootstrap样本，并使用排列t检验来比较每个受试者在赛季前和赛季后的体素FA/MD变化。脑损伤前后WM体素变化显著（p<0.05）的比例在脑震荡组最高（3.2%），次脑震荡组居中（平均1.05±0.05）。15%)，对照组最低（平均0.28±0.01%）。同样，有显著MD变化的WM体素百分比在脑震荡受试者中最高（3.44%），次脑震荡头部打击的WM体素百分比居中(平均1.48±。17%)，对照组最低（平均0.48±0.05%）。右放射状冠和右下纵束损伤显著改变了FA和MD体素的共定位。Wild bootstrap分析在单个脑震荡运动员中检测到显著改变的WM。遭受多次次脑震荡头部打击的运动员，其WM百分比发生了显著变化，比对照组高出3倍以上。努力理解这些WM变化的重要性，以及它们与头部冲击力的关系似乎是有必要的。
Current approaches to diffusion tensor imaging (DTI) analysis do not permit identification of individual-level changes in DTI indices. We investigated the ability of wild bootstrapping analysis to detect subject-specific changes in brain white matter (WM) before and after sports-related concussion. A prospective cohort study was performed in 9 high school athletes engaged in hockey or football, and 6 controls. Subjects underwent DTI pre- and post-season within a 3-month interval. One athlete was diagnosed with concussion (scanned within 72 hours) and 8 suffered between 26 and 399 sub-concussive head blows. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in each white matter voxel. Bootstrap samples were generated and a permuted t test used to compare voxel-wise FA/MD changes in each subject pre- vs. post-season. The percentage of WM voxels with significant (p<0.05) pre-post FA changes was highest for the concussion subject (3.2%), intermediary for those with sub-concussive head blows (mean 1.05±.15%) and lowest for controls (mean 0.28±.01%). Similarly, the percentage of WM voxels with significant MD changes was highest for the concussion subject (3.44%), intermediary for those with sub-concussive head blows (mean 1.48±.17%) and lowest for controls (mean 0.48±.05%). Significantly changed FA and MD voxels co-localized in the concussion subject to the right corona radiata and right inferior longitudinal fasciculus. Wild bootstrap analysis detected significantly changed WM in a single concussed athlete. Athletes with multiple sub-concussive head blows had significant changes in a percentage of their WM that was over 3 times higher than controls. Efforts to understand the significance of these WM changes, and their relationship to head impact forces appear warranted.
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