中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (9): 1556-1561.doi: 10.4103/1673-5374.255977

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

扣带结构完整性而不是弥散张量纤维束成像参数在预测慢性轻度颅脑损伤患者认知功能方面更有价值？

  

  • 出版日期:2019-09-15 发布日期:2019-09-15
  • 基金资助:

    医学研究中心计划（2015R1A5A2009124）的支持，该计划由韩国科学，ICT和未来规划部国家研究基金会（NRF）资助

Traumatic axonal injury of the cingulum in patients with mild traumatic brain injury: a diffusion tensor tractography study

Sung Ho Jang 1 , Seong Ho Kim 2 , Han Do Lee 1   

  1. 1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea
    2 Department of Neurosurgery, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea
  • Online:2019-09-15 Published:2019-09-15
  • Contact: Han Do Lee, MS, lhd890221@hanmail.net.
  • Supported by:

    This work was supported by the Medical Research Center Program (2015R1A5A2009124) through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (to SHJ and SHK).

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摘要：

大脑扣带涉及多种认知功能，包括注意力、记忆力和动机。为了解慢性轻度创伤性脑损伤（MTBI）患者的扣带损伤与认知障碍之间的关系，应用弥散张量纤维束成像对73例慢性轻度创伤性脑损伤患者（39名男性，34名女性，年龄43.29±11.42岁）和健康对照受试者40名（22名男性，18名女性，年龄40.11±16.81岁）前扣带和基底前脑之间的完整性进行评估。轻度创伤性脑损伤患者被分为3个亚组：A组19例，两侧前扣带完整；B组36例，单侧前扣带完整，C组18例，两侧前扣带均不完整。总记忆评估量表评分在亚组A和亚组B之间以及亚组A和亚组C之间存在显著差异。但弥散张量纤维束成像参数--分数各向异性、表观扩散系数和纤维体积在患者与健康对照组之间无明显差异。从而提示前扣带的结构完整性，而不是弥散张量纤维束成像参数可用于预测慢性轻度创伤性脑损伤患者的认知功能。研究于2017年8月16日经岭南大学伦理委员会批准(YUMC-2014-01-425-010)，所有参与者或患者监护人均签署知情同意书。

orcid: 0000-0002-1668-2187 (Han Do Lee)

关键词: 轻度创伤性脑损伤, 脑创伤, 弥散张量纤维束成像, 弥散张量成像, 认知障碍, 扣带, 记忆, 格拉斯哥昏迷量表

Abstract:

The cingulum, connecting the orbitofrontal cortex to the medial temporal lobe, involves in diverse cognition functions including attention, memory, and motivation. To investigate the relationship between the cingulum injury and cognitive impairment in patients with chronic mild traumatic brain injury, we evaluated the integrity between the anterior cingulum and the basal forebrain using diffusion tensor tractography in 73 patients with chronic mild traumatic brain injury (39 males, 34 females, age 43.29 ± 11.42 years) and 40 healthy controls (22 males, 18 females, age 40.11 ± 16.81 years). The patients were divided into three subgroups based on the integrity between the anterior cingulum and the basal forebrain on diffusion tensor tractography: subgroup A (n = 19 patients) – both sides of the anterior cingulum were intact; subgroup B (n = 36 patients) – either side of the anterior cingulum was intact; and subgroup C (18 patients) – both sides of the anterior cingulum were discontinued. There were significant differences in total Memory Assessment Scale score between subgroups A and B and between subgroups A and C. There were no significant differences in diffusion tensor tractography parameters (fractional anisotropy, apparent diffusion coefficient, and fiber volume) between patients and controls. These findings suggest that the integrity between the anterior cingulum and the basal forebrain, but not diffusion tensor tractography parameter, can be used to predict the cognitive function of patients with chronic mild traumatic brain injury. This study was approved by Yeungnam University Hospital Institutional Review Board (approval No. YUMC-2014-01-425-010) on August 16, 2017.

Key words: mild traumatic brain injury, brain trauma, diffusion tensor tractography, diffusion tensor imaging, cognitive impairment, cingulum, memory, Glasgow Coma Scale, neural regeneration