轻度脑外伤患者弥散张量成像与认知功能

摘要

目的：探讨轻度脑外伤（mild traumatic brain injury，mTBI）患者脑白质弥散张量成像（diffusion ten⁃sor imaging，DTI）的特点及其与认知功能的关系。方法对36例mTBI患者（患者组）36例健康受试者（对照组）进行全脑DTI扫描和认知功能测查，采用基于体素的全脑分析法比较患者组和对照组全脑白质各向异性（fractional anisotropy , FA）图像；采用t检验比较两组FA值的差异；提取患者组差异脑区FA值，与P300波幅、潜伏期，蒙特利尔认知评估量表（Montreal cognitive assessment ，MoCA）评分，汉密顿抑郁量表(Hamilton depres⁃sion scale，HDRS)评分，汉密顿焦虑量表（Hamilton anxiey scale，HAMA）评分，年龄及受教育程度进行相关分析。结果与对照组比较，患者组FA降低的脑区分布在右额内侧回，双侧中央后回、左楔前叶，左后扣带回和右颞上回（P＜0.01，FDR校正）；未发现有FA增高的脑区。Pearson相关分析未发现各异常脑区FA值与患者各临床特征因子存在相关（P＞0.05）。结论 mTBI患者存在认知功能损害和多个脑区白质微细结构的损害。%Objective To explore the features of white matter in DTI in patients with asymptomatic mild traumat⁃ic brain injury(mTBI)and their correlation with the cognitive features. Methods The DTI data and cognitive function data were obtained from 36 mTBI patients and 36 health controls. The fractional anisotropy (FA) pictures were ana⁃lyzed by voxel-based analysis. The FA value differences of the two groups were analyzed by using t test. The values of FA were extracted from the abnormal regions of mTBI patients. Correlation analyses were performed on the association of extracted FA value with P300 latency,P300 amplitude,the scores of Montreal Cognitive Assessment (MoCA) Scale, Hamilton Depression Scale, Hamilton Anxiey Scale,age and education(P>0.05). Results Compared with controls, mTBI patients had significant reduction of FA in the right medial frontal gyrus, bilateral postcentral gyrus, left precune⁃us, right posterior cingutate and right superior temporal gyrus(P<0.01,FDR correction). There were no significant correlations between extracted FA value and all clinical characteristics in mTBI patients. Conclusions Patients with mTBI have white matter microstructural damage and cognitive impairment.