中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (3): 587-593.doi: 10.4103/1673-5374.320995

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

急性轻度创伤性脑损伤后大脑皮质的形态变化

  

  • 出版日期:2022-03-15 发布日期:2021-10-15

Morphometric changes in the cortex following acute mild traumatic brain injury

Meng-Jun Li, Si-Hong Huang, Chu-Xin Huang, Jun Liu*   

  1. Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
  • Online:2022-03-15 Published:2021-10-15
  • Contact: Jun Liu, MD, PhD, junliu123@csu.edu.cn.
  • Supported by:
    This study was supported by the National Natural Science Foundation of China, No. 81671671 (to JL).

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摘要：

基于表面形态学测量得到的大脑皮质厚度、表面积和体积可反映急性轻度创伤性脑损伤后的病理变化。既往研究多关注亚急性或慢性期轻度创伤性脑损伤患者的大脑皮质厚度、表面积和体积，少见急性期的变化。同时，由于轻度创伤性脑损伤患者在急性期存在短暂的认知缺陷，也未见有研究评估急性创伤性脑损伤患者签署大脑皮质形态变化与认知功能之间的关系。此次前瞻性队列研究于2019年9至12月从中南大学湘雅二医院招募了30例急性轻度创伤性脑损伤患者（男15例，女15例，年龄33.7岁）和27例健康对照（男12例，女性15岁，年龄37.7岁）。（1）在轻度创伤性脑损伤后7d内行高分辨率T1成像，并以FreeSurfer软件分析结果显示，（1）与健康对照相比，急性期轻度创伤性脑损伤患者右侧枕外侧回皮质表面积和皮质体积增加，而皮质厚度没有明显变化；（2）急性期轻度创伤性脑损伤患者执行功能和处理速度（数字符号替代测试结果）降低，而认知灵活性（连线测试B结果）下降；（3）患者右侧枕外侧回皮质表面积和体积增加均与评估运动和视觉搜索速度的连线测试A结果呈负相关，而与数字符号替代测试结果呈正相关；（4）结果表明，急性期轻度创伤性脑损伤患者可见皮质厚度、表面积和体积以及认知功能障碍的变化，且其右侧枕外侧回皮质表面积和体积增加可能是认知功能障碍的代偿。试验于2019年2月9日经中南大学湘雅二医院伦理委员会批准（批准号086）。

https://orcid.org/0000-0002-7851-6782 (Jun Liu)

Abstract: Morphometric changes in cortical thickness (CT), cortical surface area (CSA), and cortical volume (CV) can reflect pathological changes after acute mild traumatic brain injury (mTBI). Most previous studies focused on changes in CT, CSA, and CV in subacute or chronic mTBI, and few studies have examined changes in CT, CSA, and CV in acute mTBI. Furthermore, acute mTBI patients typically show transient cognitive impairment, and few studies have reported on the relationship between cerebral morphological changes and cognitive function in patients with mTBI. This prospective cohort study included 30 patients with acute mTBI (15 males, 15 females, mean age 33.7 years) and 27 matched healthy controls (12 males, 15 females, mean age 37.7 years) who were recruited from the Second Xiangya Hospital of Central South University between September and December 2019. High-resolution T1-weighted images were acquired within 7 days after the onset of mTBI. The results of analyses using FreeSurfer software revealed significantly increased CSA and CV in the right lateral occipital gyrus of acute-stage mTBI patients compared with healthy controls, but no significant changes in CT. The acute-stage mTBI patients also showed reduced executive function and processing speed indicated by a lower score in the Digital Symbol Substitution Test, and reduced cognitive ability indicated by a longer time to complete the Trail Making Test-B. Both increased CSA and CV in the right lateral occipital gyrus were negatively correlated with performance in the Trail Making Test part A. These findings suggest that cognitive deficits and cortical alterations in CSA and CV can be detected in the acute stage of mTBI, and that increased CSA and CV in the right lateral occipital gyrus may be a compensatory mechanism for cognitive dysfunction in acute-stage mTBI patients. This study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University, China (approval No. 086) on February 9, 2019.

Key words: acute mild brain trauma injury, Alzheimer’s disease, cognitive function, cortical surface area, cortical thickness, cortical volume, FreeSurfer, surface-based morphometry

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