Predictive Utility of Diffusion MRI After Mild Traumatic Brain Injury in Civilian Populations: A Systematic Review.

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuropsychiatry and Clinical Neurosciences Pub Date : 2024-01-01 Epub Date: 2024-03-26 DOI:10.1176/appi.neuropsych.20230122

Sanne van Rhijn, Maria Teixeira-Dias, Nick Medford, Timothy Nicholson, David Okai, Paul Shotbolt, Quinton Deeley

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引用次数: 0

Abstract

Objective: A considerable number of people experience persisting symptoms and functional limitations after mild traumatic brain injury (mTBI). It is unclear whether subtle white matter changes contribute to this phenomenon. In this systematic review, the authors evaluated whether microstructural white matter indices on advanced MRI are related to clinical dysfunction among patients without abnormalities on standard brain computed tomography (CT) or MRI (uncomplicated mTBI).

Methods: A search of multiple databases was performed. Studies with individuals who experienced blast-related, sports-related, or multiple mTBIs were excluded. Diffusion tensor imaging (DTI) and susceptibility-weighted imaging (SWI) metrics and cognitive, neuropsychiatric, or functional outcome measures were extracted from each study.

Results: Thirteen studies were selected (participants with mTBI, N=553; healthy control group, N=438). Seven DTI studies evaluated cognitive function, with five reporting significant correlations between reduced white matter integrity and deficits in attention, processing speed, and executive function at 6-12 months after injury (three studies included only individuals with uncomplicated mTBI). Four studies found significant correlations between DTI metrics and persistent postconcussive symptoms after 3-12 months (one study included only individuals with uncomplicated mTBI). Two SWI studies reported conflicting findings regarding the relationship between the presence of microbleeds and postconcussive symptoms.

Conclusions: The results revealed that indices of microstructural white matter integrity may relate to clinical presentation 3-12 months after injury in uncomplicated mTBI. However, analysis methods and brain regions studied varied across studies. Further research is needed to identify relationships between white matter indices in specific brain regions and symptom persistence beyond 12 months.

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平民轻度脑外伤后弥散核磁共振成像的预测效用：系统回顾

目的：相当多的人在轻度创伤性脑损伤（mTBI）后会出现持续症状和功能限制。目前尚不清楚细微的白质变化是否会导致这一现象。在这篇系统性综述中，作者评估了在标准脑计算机断层扫描（CT）或核磁共振成像（无并发症的 mTBI）上无异常的患者中，高级核磁共振成像上的微结构白质指数是否与临床功能障碍有关：方法：对多个数据库进行了检索。方法：对多个数据库进行了检索，排除了与爆炸相关、与运动相关或多重 mTBIs 患者的研究。从每项研究中提取弥散张量成像（DTI）和感度加权成像（SWI）指标以及认知、神经精神或功能结果测量指标：结果：共选取了 13 项研究（mTBI 参与者，N=553；健康对照组，N=438）。七项 DTI 研究对认知功能进行了评估，其中五项研究报告了白质完整性降低与伤后 6-12 个月时注意力、处理速度和执行功能缺陷之间的显著相关性（三项研究仅包括无并发症的 mTBI 患者）。四项研究发现，DTI 指标与 3-12 个月后的持续性脑震荡后症状之间存在明显的相关性（一项研究仅包括无并发症的 mTBI 患者）。两项SWI研究报告的微出血与撞击后症状之间的关系结果相互矛盾：结论：研究结果表明，微结构白质完整性指数可能与无并发症的 mTBI 患者伤后 3-12 个月的临床表现有关。然而，不同研究的分析方法和研究的大脑区域各不相同。需要进一步研究以确定特定脑区的白质指数与12个月后症状持续存在之间的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuropsychiatry and Clinical Neurosciences 医学-精神病学

CiteScore

5.30

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.