CAJ | 학술논문

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。
목적：탐토경도뇌외상（mild traumatic brain injury，mTBI）환자뇌백질미산장량성상（diffusion ten?sor imaging，DTI）적특점급기여인지공능적관계。방법대36례mTBI환자（환자조）36례건강수시자（대조조）진행전뇌DTI소묘화인지공능측사，채용기우체소적전뇌분석법비교환자조화대조조전뇌백질각향이성（fractional anisotropy , FA）도상；채용t검험비교량조FA치적차이；제취환자조차이뇌구FA치，여P300파폭、잠복기，몽특리이인지평고량표（Montreal cognitive assessment ，MoCA）평분，한밀돈억욱량표(Hamilton depres?sion scale，HDRS)평분，한밀돈초필량표（Hamilton anxiey scale，HAMA）평분，년령급수교육정도진행상관분석。결과여대조조비교，환자조FA강저적뇌구분포재우액내측회，쌍측중앙후회、좌설전협，좌후구대회화우섭상회（P＜0.01，FDR교정）；미발현유FA증고적뇌구。Pearson상관분석미발현각이상뇌구FA치여환자각림상특정인자존재상관（P＞0.05）。결론 mTBI환자존재인지공능손해화다개뇌구백질미세결구적손해。
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.