急性轻度创伤性脑损伤患者的个体形态学脑网络研究

Individual-based morphological brain network and its association with acute mild traumatic brain injury

目的探究急性轻度创伤性脑损伤(mild traumatic brain injury,mTBI)患者个体形态学脑网络的拓扑属性改变。材料与方法共纳入43例mTBI患者和37例健康对照(health control,HC),采集所有受试者高分辨率T1WI的图像,使用Freesurfer软件对数据进行预处理得到5个形态学指标(皮层厚度、灰质体积、脑表面积、脑沟深度、平均曲率)脑图并构建个体形态学脑网络,使用图论分析的方法计算网络拓扑属性,通过双样本t检验比较组间差异,并采用错误发生率(false discovery rate,FDR)对结果进行多重比较校正。结果与HC组相比,mTBI组左侧额极横回(t=-2.186,P=0.032)、中央沟(t=-2.617,P=0.011)、外侧沟水平支(t=-2.456,P=0.016)和右侧枕极(t=-2.013,P=0.048)的节点度中心性(degree centrality,DC)增高,左侧额极横回(t=-2.182,P=0.032)、中央沟(t=-2.226,P=0.029)、外侧沟水平支(t=-2.440,P=0.017)和右侧楔前叶(t=-2.207,P=0.030)的节点效率(nodal efficiency,N_(e))增高,与认知和执行功能相关;左侧楔叶(t=2.173,P=0.033)、角回(t=2.498,P=0.015)、海马旁回(t=4.009,P<0.001)的节点DC下降,左侧颞上回极平面(t=2.394,P=0.019)、角回(t=2.668,P=0.009)、海马旁回(t=4.671,P<0.001)、胼胝体沟(t=2.189,P=0.032)的N_(e)下降,与记忆和情绪调节相关。对于全局拓扑属性,二者差异无统计学意义(P>0.05)。结论急性期mTBI的个体形态学脑网络仍保持了小世界属性。mTBI异常增高的节点DC和N_(e),主要集中在与认知和执行功能相关的脑区,反映了大脑对认知功能的应激性代偿;异常减低的节点DC和N_(e),主要集中在与记忆、情绪调节相关的脑区,揭示了急性期的认知和情绪变化。这为急性期mTBI的研究提供了新的角度,对其大脑网络改变机制的探索提供了进一步线索。

Objective:To explore the changes of individual-based morphological brain network topological properties in patients with mild traumatic brain injury(mTBI).Materials and Methods:A sample of 43 mTBI patients and 37 healthy controls(HC)were included.After T1WI data of all subjects were collected,using the Freesurfer to do data preprocessing and geting severals morphological indices(cortical thickness,gray matter volume,brain surface area,sulcus depth,mean curvature),which construct the individual-based morphological brain network,and then Graph Theoretical Network Analysis(GRETNA)was utilized to calculate the network topological properties.The last,differences between the two groups were compared based on two-samples t-test,with false discovery rate(FDR)corrections for multiple comparisons.Results:Compared with the HC group,the mTBI group showed approximately differences in nodal degree centrality(DC),the brain regions of left frontal pole transverse gyrus(t=−2.186,P=0.032),central sulcus(t=−2.617,P=0.011),horizontal anterior segment of lateral fissure(t=−2.456,P=0.016)and right pole occipital(t=−2.013,P=0.048)were increased,and nodal efficiency(N_(e))of left frontal pole transverse gyrus(t=−2.182,P=0.032;),central sulcus(t=−2.226,P=0.029),horizontal anterior segment of lateral fissure(t=−2.440,P=0.017)and right precuneus(t=−2.207,P=0.030)were increased,which were related to cognitive and executive functions;in addition,the memory and emotional regulation cortexs suffered biggest drop,the DC of the nodes in the left cuneus(t=2.173,P=0.033),angular return(t=2.498,P=0.015)and parahippocampal gyrus(t=4.009,P<0.001)were dropped,and N_(e) in the left planum polare of the superior temporal gyrus(t=2.394,P=0.019),angular return(t=2.668,P=0.009),parahippocampal gyrus(t=4.671,P<0.001),callosal sulcus(t=2.189,P=0.032)were dropped.The global topological properties differences were not statistically significant(P>0.05).Conclusions:The individual morphological brain network of mTBI in the acute phase still retains the small-world attribute.The abnormally elevated nodes DC and N_(e) of mTBI are mainly concentrated in brain regions related to cognitive and executive functions,reflecting the brain's stress compensation for cognitive functions.The abnormally reduced nodes DC and N_(e),mainly concentrated in brain regions related to memory and emotion regulation,revealed cognitive and emotional changes in the acute phase.This provides a new perspective for the study of mTBI in the acute phase and provides further clues for the exploration of the mechanism of brain network alteration.