Cortical and Subcortical Alterations and Clinical Correlates after Traumatic Brain Injury

被引:9
作者
Xue, Qiang [1 ]
Wang, Linbo [2 ]
Zhao, Yuanyu [3 ]
Tong, Wusong [4 ]
Wang, Jiancun [1 ]
Li, Gaoyi [5 ]
Cheng, Wei [2 ]
Gao, Liang [6 ]
Dong, Yan [6 ]
机构
[1] Navy Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Neurosurg, Shanghai 200433, Peoples R China
[2] Fudan Univ, Inst Sci & Technol Brain Inspired Intelligence, Shanghai 210023, Peoples R China
[3] Navy Med Univ, Changzheng Hosp, Dept Organ Transplantat, Shanghai 200070, Peoples R China
[4] Shanghai Pudong New Area Peoples Hosp, Dept Neurosurg, Shanghai 201299, Peoples R China
[5] Tongji Univ, Peoples Hosp Putuo Dist, Dept Neurosurg, Sch Med, Shanghai 200061, Peoples R China
[6] Tongji Univ, Shanghai Peoples Hosp 10, Dept Neurosurg, Sch Med, Shanghai 200072, Peoples R China
基金
中国国家自然科学基金;
关键词
traumatic brain injury; gray matter volume; white matter track; prognosis;
D O I
10.3390/jcm11154421
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Traumatic brain injury (TBI) often results in persistent cognitive impairment and psychiatric symptoms, while lesion location and severity are not consistent with its clinical complaints. Previous studies found cognitive deficits and psychiatric disorders following TBI are considered to be associated with prefrontal and medial temporal lobe lesions, however, the location and extent of contusions often cannot fully explain the patient ' s impairments. Thus, we try to find the structural changes of gray matter (GM) and white matter (WM), clarify their correlation with psychiatric symptoms and memory following TBI, and determine the brain regions that primary correlate with clinical measurements. Methods: Overall, 32 TBI individuals and 23 healthy controls were recruited in the study. Cognitive impairment and psychiatric symptoms were examined by Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), and Wechsler Memory Scale-Chinese Revision (WMS-CR). All MRI data were scanned using a Siemens Prisma 3.0 Tesla MRI system. T1 MRI data and diffusion tensor imaging (DTI) data were processed to analyze GM volume and WM microstructure separately. Results: In the present study, TBI patients underwent widespread decrease of GM volume in both cortical and subcortical regions. Among these regions, four brain areas including the left inferior temporal gyrus and medial temporal lobe, supplementary motor area, thalamus, and anterior cingulate cortex (ACC) were highly implicated in the post-traumatic cognitive impairment and psychiatric complaints. TBI patients also underwent changes of WM microstructure, involving decreased fractional anisotropy (FA) value in widespread WM tracts and increased mean diffusivity (MD) value in the forceps minor. The changes of WM microstructure were significantly correlated with the decrease of GM volume. Conclusions: TBI causes widespread cortical and subcortical alterations including a reduction in GM volume and change in WM microstructure related to clinical manifestation. Lesions in temporal lobe may lead to more serious cognitive and emotional dysfunction, which should attract our high clinical attention.
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页数:11
相关论文
共 41 条
[1]   A prospective examination of Axis I psychiatric disorders in the first 5 years following moderate to severe traumatic brain injury [J].
Alway, Y. ;
Gould, K. R. ;
Johnston, L. ;
McKenzie, D. ;
Ponsford, J. .
PSYCHOLOGICAL MEDICINE, 2016, 46 (06) :1331-1341
[2]  
Bigler ED, 2001, ARCH CLIN NEUROPSYCH, V16, P95
[3]   Rates of Major Depressive Disorder and Clinical Outcomes Following Traumatic Brain Injury [J].
Bombardier, Charles H. ;
Fann, Jesse R. ;
Temkin, Nancy R. ;
Esselman, Peter C. ;
Barber, Jason ;
Dikmen, Sureyya S. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 303 (19) :1938-1945
[4]   Role of innate inflammation in traumatic brain injury [J].
Bourgeois-Tardif, Sandrine ;
De Beaumont, Louis ;
Rivera, Jose Carlos ;
Chemtob, Sylvain ;
Weil, Alexander G. .
NEUROLOGICAL SCIENCES, 2021, 42 (04) :1287-1299
[5]   Alterations of connectivity patterns in functional brain networks in patients with mild traumatic brain injury: A longitudinal resting-state functional magnetic resonance imaging study [J].
D'Souza, Maria M. ;
Kumar, Mukesh ;
Choudhary, Ajay ;
Kaur, Prabhjot ;
Kumar, Pawan ;
Rana, Poonam ;
Trivedi, Richa ;
Sekhri, Tarun ;
Singh, Ajay K. .
NEURORADIOLOGY JOURNAL, 2020, 33 (02) :186-197
[6]   Asymmetry of the Brain: Development and Implications [J].
Duboc, Veronique ;
Dufourcq, Pascale ;
Blader, Patrick ;
Roussigne, Myriam .
ANNUAL REVIEW OF GENETICS, VOL 49, 2015, 49 :647-672
[7]   Disconnection of network hubs and cognitive impairment after traumatic brain injury [J].
Fagerholm, Erik D. ;
Hellyer, Peter J. ;
Scott, Gregory ;
Leech, Robert ;
Sharp, David J. .
BRAIN, 2015, 138 :1696-1709
[8]   Suicide, Fatal Injuries, and Other Causes of Premature Mortality in Patients With Traumatic Brain Injury A 41-Year Swedish Population Study [J].
Fazel, Seena ;
Wolf, Achim ;
Pillas, Demetris ;
Lichtenstein, Paul ;
Langstrom, Niklas .
JAMA PSYCHIATRY, 2014, 71 (03) :326-333
[9]  
GENTRY LR, 1988, AM J ROENTGENOL, V150, P663, DOI 10.2214/ajr.150.3.663
[10]   Understanding neurodegeneration after traumatic brain injury: from mechanisms to clinical trials in dementia [J].
Graham, Neil S. N. ;
Sharp, David J. .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2019, 90 (11) :1221-1233