Impaired clearance of perivascular waste in the brain may play a critical role in morbidity after mild traumatic brain injury (mTBI). We aimed to determine the effect of mTBI on the burden of magnetic resonance imaging (MRI)-visible perivascular spaces (PVSs) in a cohort of U.S. military veterans and whether sleep modulates this effect. We also investigated the correlation between PVS burden and severity of persistent post-concussive symptoms. Fifty-six Iraq/Afghanistan veterans received 3 Tesla MRI as part of a prospective cohort study on military blast mTBI. White matter PVS burden (i.e., number and volume) was calculated using an established automated segmentation algorithm. Multi-variate regression was used to establish the association between mTBIs sustained in the military and PVS burden. Covariates included age, blood pressure, number of impact mTBIs outside the military, and blast exposures. Correlation coefficients were calculated between PVS burden and severity of persistent post-concussive symptoms. There was a significant positive relationship between the number of mTBIs sustained in the military and both PVS number and volume (p = 0.04). A significant interaction was found between mTBI and poor sleep on PVS volume (p = 0.04). A correlation was found between PVS number and volume, as well as severity of postconcussive symptoms (p = 0.03). Further analysis revealed a moderate correlation between PVS number and volume, as well as balance problems (p < 0.001). In Iraq/Afghanistan veterans, mTBI is associated with an increase in PVS burden. Further, an interaction exists between mTBI and poor sleep on PVS burden. Increased PVS burden, which may indicate waste clearance dysfunction, is associated with persistent post-concussive symptom severity.

中文翻译：

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轻度创伤性脑损伤、睡眠不良和磁共振成像之间的联系：退伍军人的可见血管周围空间

大脑中血管周围废物的清除受损可能在轻度创伤性脑损伤（mTBI）后的发病中发挥关键作用。我们的目的是确定 mTBI 对一组美国退伍军人的磁共振成像 (MRI) 可见血管周围空间 (PVS) 负担的影响，以及睡眠是否调节这种影响。我们还研究了 PVS 负担与持续性脑震荡后症状严重程度之间的相关性。作为军事爆炸 mTBI 前瞻性队列研究的一部分，56 名伊拉克/阿富汗退伍军人接受了 3 特斯拉 MRI。使用已建立的自动分割算法计算白质 PVS 负担（即数量和体积）。使用多变量回归来建立军队中持续的 mTBIs 与 PVS 负担之间的关联。协变量包括年龄、血压、军队以外的影响 mTBI 的数量，以及爆炸暴露。计算 PVS 负担与持续性脑震荡后症状严重程度之间的相关系数。军队中持续存在的 mTBI 数量与 PVS 数量和数量之间存在显着的正相关关系（p  = 0.04）。研究发现 mTBI 和睡眠质量差对 PVS 容量有显着的交互作用 ( p  = 0.04)。PVS 数量和体积以及脑震荡后症状的严重程度之间存在相关性 ( p  = 0.03)。进一步的分析显示 PVS 数量和体积之间存在中等相关性，以及平衡问题 ( p  < 0.001)。在伊拉克/阿富汗退伍军人中，mTBI 与 PVS 负担的增加有关。此外，mTBI 和睡眠不佳对 PVS 负担之间存在相互作用。PVS 负担增加可能表明废物清除功能障碍，与持续的脑震荡后症状严重程度相关。