Spatial patterns of progressive brain volume loss after moderate-severe traumatic brain injury.
Spatial patterns of progressive brain volume loss after moderate-severe traumatic brain injury.
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DOI：
10.1093/brain/awx354
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发表时间：
2018-03-01
期刊：
影响因子：
--
通讯作者：
Sharp DJ
中科院分区：
文献类型：
--
作者：
Cole JH;Jolly A;de Simoni S;Bourke N;Patel MC;Scott G;Sharp DJ
利用纵向神经成像，科尔等人表明，创伤性脑损伤（TBI）导致脑组织的进行性损失，这种损失在损伤后持续数年。组织损失主要发生在大脑白色物质和皮质沟。神经影像学检查可能是评价脑外伤后神经保护治疗的一种可行方法。创伤性脑损伤导致脑容量的显著损失，这持续到慢性阶段。这可以使用MRI的体积分析灵敏地测量。在这里，我们：（i）研究了脑萎缩的纵向模式;（ii）测试了脑沟皮层区域的萎缩是否最严重;（iii）显示了如何利用萎缩来为旨在减缓神经变性的干预试验提供动力。在61名中重度创伤性脑损伤患者（平均年龄= 41.55岁± 12.77岁）和32名健康对照者（平均年龄= 34.22岁± 10.29岁）中，使用基于体素的形态测量法在T1加权扫描上评估了横断面和纵向（1年随访）脑结构。纵向脑容量变化的特点是使用一种新的神经成像分析管道，产生雅可比行列式度量，反映基线和随访扫描之间的空间扭曲。对雅可比行列式值进行了区域总结，并与临床和神经心理学指标进行了比较。与对照组相比，创伤性脑损伤患者在基线时多个脑区的灰色和白色物质体积较低。创伤性脑损伤后明显萎缩超过1年。脑外伤患者平均每年损失灰质体积1.55% ± 2.19，白色体积1.49% ± 2.20，全脑体积1.51% ± 1.60。健康对照组灰质体积减少0.55% ± 1.13，白色体积增加0.26% ± 1.11，相当于全脑体积减少0.22% ± 0.83。萎缩在白色物质中最严重，其中大部分（84%）区域受到影响。这种影响是独立的，大大大于老化。与脑回相比，皮质沟萎缩也增加。萎缩与受伤后的时间或基线年龄之间没有关系。萎缩率与随访期结束时的记忆表现有关，也与多重比较校正前记忆表现的变化有关。总之，创伤性脑损伤导致脑组织体积的进行性损失，这种损失在损伤后持续多年。萎缩在白色物质中最明显，但与脑回相比，皮质沟中的萎缩也更明显。这些研究结果表明，雅可比行列式提供了一种量化创伤性脑损伤后脑萎缩的方法，并在确定损伤后的长期神经退行性影响方面提供了信息。功效计算表明，雅可比行列式图像是神经保护治疗临床试验中的有效替代标记。
Using longitudinal neuroimaging, Cole et al. show that traumatic brain injury (TBI) results in progressive loss of brain tissue that continues for years after an injury. Tissue loss occurs predominantly in cerebral white matter and cortical sulci. Neuroimaging may be a feasible method for evaluating neuroprotective therapies after TBI. Traumatic brain injury leads to significant loss of brain volume, which continues into the chronic stage. This can be sensitively measured using volumetric analysis of MRI. Here we: (i) investigated longitudinal patterns of brain atrophy; (ii) tested whether atrophy is greatest in sulcal cortical regions; and (iii) showed how atrophy could be used to power intervention trials aimed at slowing neurodegeneration. In 61 patients with moderate-severe traumatic brain injury (mean age = 41.55 years ± 12.77) and 32 healthy controls (mean age = 34.22 years ± 10.29), cross-sectional and longitudinal (1-year follow-up) brain structure was assessed using voxel-based morphometry on T1-weighted scans. Longitudinal brain volume changes were characterized using a novel neuroimaging analysis pipeline that generates a Jacobian determinant metric, reflecting spatial warping between baseline and follow-up scans. Jacobian determinant values were summarized regionally and compared with clinical and neuropsychological measures. Patients with traumatic brain injury showed lower grey and white matter volume in multiple brain regions compared to controls at baseline. Atrophy over 1 year was pronounced following traumatic brain injury. Patients with traumatic brain injury lost a mean (± standard deviation) of 1.55% ± 2.19 of grey matter volume per year, 1.49% ± 2.20 of white matter volume or 1.51% ± 1.60 of whole brain volume. Healthy controls lost 0.55% ± 1.13 of grey matter volume and gained 0.26% ± 1.11 of white matter volume; equating to a 0.22% ± 0.83 reduction in whole brain volume. Atrophy was greatest in white matter, where the majority (84%) of regions were affected. This effect was independent of and substantially greater than that of ageing. Increased atrophy was also seen in cortical sulci compared to gyri. There was no relationship between atrophy and time since injury or age at baseline. Atrophy rates were related to memory performance at the end of the follow-up period, as well as to changes in memory performance, prior to multiple comparison correction. In conclusion, traumatic brain injury results in progressive loss of brain tissue volume, which continues for many years post-injury. Atrophy is most prominent in the white matter, but is also more pronounced in cortical sulci compared to gyri. These findings suggest the Jacobian determinant provides a method of quantifying brain atrophy following a traumatic brain injury and is informative in determining the long-term neurodegenerative effects after injury. Power calculations indicate that Jacobian determinant images are an efficient surrogate marker in clinical trials of neuroprotective therapeutics.
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影响因子：
11.2
作者：
Cole, James H.;Leech, Robert;Sharp, David J.
通讯作者：
Sharp, David J.
影响因子：
4.2
作者：
Brezova, Veronika;Moen, Kent Goran;Haberg, Asta K.
通讯作者：
Haberg, Asta K.
影响因子：
17.1
作者：
Goldstein LE;Fisher AM;Tagge CA;Zhang XL;Velisek L;Sullivan JA;Upreti C;Kracht JM;Ericsson M;Wojnarowicz MW;Goletiani CJ;Maglakelidze GM;Casey N;Moncaster JA;Minaeva O;Moir RD;Nowinski CJ;Stern RA;Cantu RC;Geiling J;Blusztajn JK;Wolozin BL;Ikezu T;Stein TD;Budson AE;Kowall NW;Chargin D;Sharon A;Saman S;Hall GF;Moss WC;Cleveland RO;Tanzi RE;Stanton PK;McKee AC
通讯作者：
McKee AC
影响因子：
5.3
作者：
Bonnelle, Valerie;Leech, Robert;Sharp, David J.
通讯作者：
Sharp, David J.
DOI：
10.1017/s1355617713000507
发表时间：
2013-08
影响因子：
2.6
作者：
Bonner-Jackson, Aaron;Long, Jeffrey D.;Westervelt, Holly;Tremont, Geoffrey;Aylward, Elizabeth;Paulsen, Jane S.
通讯作者：
Paulsen, Jane S.