Neuroimaging Biomarkers of New-Onset Psychiatric Disorders Following Traumatic Brain Injury.

Neuroimaging Biomarkers of New-Onset Psychiatric Disorders Following Traumatic Brain Injury.
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创伤性脑损伤后新发精神疾病的神经影像学生物标志物

DOI:
10.1016/j.biopsych.2021.06.005
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发表时间:
2022-03-01
影响因子:
10.6
通讯作者:
Quinn DK
Quinn DK
中科院分区:
医学1区
文献类型:
--
作者:
Mayer AR;Quinn DK

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创伤性脑损伤(TBI)传统上与急性和慢性损伤阶段的认知和行为变化有关。由于其非侵入性的性质,神经影像学有可能提供潜在的宏观和微观生物学机制,可能作为这些神经精神后遗症的病原体的独特信息。目前的广泛范围的审查确定了TBI和新发精神疾病之间存在的至少四种常见的宏观途径,以及神经影像学目前如何用于临床研究的几个例子。然后,审查严格审查的优势和局限性,神经影像学阐明TBI相关的微观病理学,如微观结构的变化,神经炎症,蛋白质病变,血脑屏障损伤和细胞信号中断。然后提供了一个总结,神经影像学是如何被用来调查TBI相关的病理在新发神经认知障碍,抑郁症和创伤后应激障碍。在文献中确定的差距包括缺乏前瞻性研究,以明确相关的影像学表现与新发精神疾病的发展,以及随后证实的尸检相关性在同一研究队列中的死前影像学研究。虽然成像生物标志物的空间分辨率和特异性在过去的二十年中有了很大的提高,我们得出结论,神经影像学生物标志物还不存在明确的,在体内诊断细胞病理学。这是进一步阐明创伤性脑损伤和新发精神疾病之间因果关系的必要的下一步。
Traumatic brain injury (TBI) has traditionally been associated with cognitive and behavioral changes during both the acute and chronic phases of injury. Due to its non-invasive nature, neuroimaging has the potential to provide unique information on underlying macroscopic and microscopic biological mechanisms that may serve as causative agents for these neuropsychiatric sequelae. The current broad scoping review identifies at least four common macroscopic pathways that exist between TBI and new-onset psychiatric disorders, as well as several examples of how neuroimaging is currently being utilized in clinical research. The review then critically examines the strengths and limitations of neuroimaging for elucidating TBI-related microscopic pathology such as microstructural changes, neuroinflammation, proteinopathies, blood brain barrier damage and disruptions in cellular signaling. A summary is then provided for how neuroimaging is currently being used to investigate TBI-related pathology in new-onset neurocognitive disorders, depression and post-traumatic stress disorder. Identified gaps in the literature include a lack of prospective studies to definitively associate imaging findings with the development of new-onset psychiatric disorders, as well as ante-mortem imaging studies subsequently confirmed with post-mortem correlates in the same study cohort. Although the spatial resolution and specificity of imaging biomarkers has greatly improved over the last two decades, we conclude that neuroimaging biomarkers do not yet exist for the definitive, in vivo diagnosis of cellular pathology. This represents a necessary next step for further elucidating causal relationships between TBI and new-onset psychiatric disorders.
脑血管功能障碍伴有压力和抑郁。
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