将眼球运动功能评估作为轻度脑外伤的生物标志物。

IF 1.8 Q3 CLINICAL NEUROLOGY
Neurotrauma reports Pub Date : 2024-07-03 eCollection Date: 2024-01-01 DOI:10.1089/neur.2024.0018
Ekaterina Lunkova, Jen-Kai Chen, Rajeet Singh Saluja, Alain Ptito
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引用次数: 0

摘要

轻度创伤性脑损伤(mTBI)或脑震荡是一个重大的公共卫生问题,其诊断仍然存在模糊性。虽然功能磁共振成像(fMRI)已被确定为脑震荡的有效筛查工具,但其在临床或现场环境中的可及性有限,因此需要一种更有效的替代方法。眼部运动功能障碍是 mTBI 中经常报告的一种病理现象。由于眼球运动回路与 mTBI 病理生理学之间存在神经解剖学上的重叠,因此预计会出现视觉障碍。在本研究中,我们探讨了使用眼球运动评估工具寻找脑震荡生物标志物的可能性。我们利用 fMRI 对眼球运动功能进行了评估:平滑追逐(SP)、眼球回转、反回转和视动眼震(OKN)。在扫描之前,受试者还使用了集成眼球和头部跟踪功能的虚拟现实护目镜系统进行测试,受试者完成的任务与在 fMRI 中使用的任务相同。29 名脑震荡后 1 个月内有症状的成人(CSA)和 29 名年龄和性别匹配的健康对照组(HCS)接受了测试,以检查与 mTBI 后眼球运动功能表现相关的血氧水平依赖性(BOLD)fMRI 改变,并评估眼球运动评估在检测 mTBI 后眼球运动和凝视缺陷方面的功效。CSA 组与 HCS 组相比,在反斜视和 OKN 表现方面存在显著差异。与 HCS 相比,CSA 组在每项任务中都表现出更高的 %BOLD 信号变化:平滑追逐时在额上回,眼球移动时在额下回,反斜视时在普坦门和背外侧前额叶皮层 (DLPFC),OKN 时在舌回和 IFG。主要研究结果如下(1) 与对照组相比,脑震荡受试者存在眼球运动障碍;(2) 与调节和控制眼球运动相关的区域存在异常激活模式,这表明脑震荡引起了眼球运动障碍;(3) 眼球运动评估有望成为 mTBI 生物标记的一种方法,其中反斜视和 OKN 被确定为最敏感的任务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Oculomotor Functions as a Biomarker in Mild Traumatic Brain Injury.

Mild traumatic brain injury (mTBI), or concussion, is a major public health problem, and ambiguity still exists regarding its diagnosis. While functional magnetic resonance imaging (fMRI) has been identified as a helpful screening tool for concussion, its limited accessibility in clinical or field settings necessitates a more efficient alternative. Oculomotor function deficit is an often-reported pathology in mTBI. Due to the neuroanatomical overlap between eye-movement circuitry and mTBI pathophysiology, visual deficits are expected. In this study, we investigate the possibility of using an oculomotor assessment tool for finding biomarkers in concussion. We used fMRI with tasks evaluating oculomotor functions: smooth pursuit (SP), saccades, anti-saccades, and optokinetic nystagmus (OKN). Before the scanning, the testing with a system of virtual reality goggles with integrated eye- and head-tracking was used where subjects performed the same tasks as those used in fMRI. Twenty-nine concussed symptomatic adults (CSA) within 1-month postconcussion and 29 age- and sex-matched healthy controls (HCS) were tested to examine blood oxygen level-dependent (BOLD) fMRI alterations associated with performances in oculomotor function after mTBI and evaluate the efficacy of the oculomotor assessment in detecting oculomotor and gaze deficits following mTBI. Comparing CSA with HCS, significant differences were observed in anti-saccades and OKN performance. CSA group exhibited elevated %BOLD signal change on each task compared with HCS: in the superior frontal gyrus during the smooth pursuit, inferior frontal gyrus during the saccades, putamen and dorsolateral prefrontal cortex (DLPFC) during the anti-saccades, and lingual gyrus and IFG during the OKN. Key findings include the following: (1) oculomotor deficits in concussed subjects compared with controls, (2) abnormal activation patterns in areas related to the regulation and control of oculomotor movements, suggesting concussion-induced disruptions, and (3) the potential of oculomotor assessment as a promising approach for mTBI biomarkers, with anti-saccades and OKN identified as the most sensitive tasks.

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CiteScore
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