刘刚, 杨西涛, 郝伟伟, 郑锐哲. 基于默认网络结构早期诊断创伤性颅脑损伤后注意障碍的临床研究[J]. 蚌埠医科大学学报, 2021, 46(7): 846-850. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.002
    引用本文: 刘刚, 杨西涛, 郝伟伟, 郑锐哲. 基于默认网络结构早期诊断创伤性颅脑损伤后注意障碍的临床研究[J]. 蚌埠医科大学学报, 2021, 46(7): 846-850. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.002
    LIU Gang, YANG Xi-tao, HAO Wei-wei, ZHENG Rui-zhe. Clinical study of the early diagnosis of attention disorder after traumatic brain injury based on default mode network[J]. Journal of Bengbu Medical University, 2021, 46(7): 846-850. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.002
    Citation: LIU Gang, YANG Xi-tao, HAO Wei-wei, ZHENG Rui-zhe. Clinical study of the early diagnosis of attention disorder after traumatic brain injury based on default mode network[J]. Journal of Bengbu Medical University, 2021, 46(7): 846-850. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.002

    基于默认网络结构早期诊断创伤性颅脑损伤后注意障碍的临床研究

    Clinical study of the early diagnosis of attention disorder after traumatic brain injury based on default mode network

    • 摘要:
      目的分析创伤性颅脑损伤(TBI)病人急性期默认网络(DMN)的结构变化,探讨其在早期诊断TBI后注意障碍的应用价值。
      方法纳入45例TBI病人作为TBI组,在急性期通过磁共振弥散张量成像技术评估DMN的结构完整性。在恢复期采用注意量表评估病人注意障碍。招募30名健康志愿者作为对照组。分析TBI病人磁共振相关参数,并与对照组进行比较,在此基础上,评估其与认知功能评分的相关性。
      结果与对照组相比,TBI病人急性期DMN结构内的各向异性分数(FA)降低(P < 0.01),胼胝体膝部(gCC)的表观弥散系数图(P < 0.01)。在恢复期,TBI病人注意量表评分较对照组均明显延长(P < 0.01)。急性期TBI病人DMN结构的变化与恢复期注意量表的评分显示,TBI病人DMN中扣带束、gCC、额枕上束(SFOF)的FA值之和与Stroop色词量表Victoria版本各部分耗时总和呈负相关关系(P < 0.05,R2=0.291);SFOF的FA值变化与VST中C部分的耗时呈负相关关系(P < 0.05,R2=0.396)。
      结论TBI引起纤维连接的中断是损伤后DMN结构破坏的主要因素,DMN结构的破坏可作为早期诊断TBI后注意障碍依据。

       

      Abstract:
      ObjectiveTo analyze the structural changes of default mode network(DMN) in patients with traumatic brain injury(TBI) in the acute phase, and explore the application value of DMN in the early diagnosis of attention disorder after TBI.
      MethodsForty-five patients with TBI were set as the TBI group, the structural integrity of DMN was evaluated using diffusion tensor imaging(DTI) during the acute phase, and the attention scale was used to evaluate the patient's attention disorder during convalescence.Thirty healthy volunteers were set as the control group.The MRI-related parameters of TBI patients were analyzed, and compared with the control group.The correlation between the parameters of DTI and cognitive function score was explored.
      ResultsCompared with the control group, the fractional anisotropy(FA) of brain region decreased(P < 0.01), and the apparent diffusion coefficient(ADC) of genitals of corpus callosum(gCC) increased in the acute phase(P < 0.01).In the convalescence period, the scores of attention scale in TBI patients were significantly longer than those in control group(P < 0.01).The results of the scores of DMN structure changes in the acute phase and scores of convalescence attention scale in the TBI patients showed that the sum of FA value of Cing, gCC and superior occipitofrontal fascicle(SFOF) were negatively correlated with the sumup time of each part of Stroop colour word scale Victoria version(P < 0.05, R2=0.291), and the FA value of SFOF was negatively correlated with the time of part C in VST(P < 0.05, R2=0.396).
      ConclusionsThe interruption of fiber connection in TBI patients is the key factor of damage of DMN structure.The damage of DMN structure can be used as a useful marker for the early diagnosis of attention disorder.

       

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