Hippocampal and Rostral Anterior Cingulate Blood Flow is Associated with Affective Symptoms in Chronic Traumatic Brain Injury,Brain Research

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Hippocampal and Rostral Anterior Cingulate Blood Flow is Associated with Affective Symptoms in Chronic Traumatic Brain Injury
Brain Research ( IF 2.7 ) Pub Date : 2021-08-28 , DOI: 10.1016/j.brainres.2021.147631
Binu P Thomas ₁ , Takashi Tarumi ₂ , Ciwen Wang ₃ , David C Zhu ₄ , Tsubasa Tomoto ₂ , C Munro Cullum ₅ , Marisara Dieppa ₃ , Ramon Diaz-Arrastia ₆ , Kathleen Bell ₇ , Christopher Madden ₄ , Rong Zhang ₂ , Kan Ding ₃

Affiliation

Advanced Imaging Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd., Arlington, TX 76010, USA.
Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 8200 Walnut Hill Ln, Dallas, TX 75231, USA.
Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA.
Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA.
Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Radiology and Cognitive Imaging Research Center, Michigan State University, 86 Service Road, East Lansing, MI 48824, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA; Department of Neurological Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA.
Department of Neurology, University of Pennsylvania Perelman School of Medicine, 51 North 39(th) St, Philadelphia, PA 19104, USA.
Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, TX 75390, USA.

Objective

The purpose of this study was to assess cerebral blood flow (CBF) and its association with self-reported symptoms in chronic traumatic brain injury (TBI).

Participants

Sixteen participants with mild to severe TBI and persistent self-reported neurological symptoms, 6 to 72 months post-injury were included. For comparison, 16 age- and gender-matched healthy normal control participants were also included.

Main Measures

Regional CBF and brain volume were assessed using pseudo-continuous Arterial Spin Labeling (PCASL) and T₁-weighted data respectively. Cognitive function and self-reported symptoms were assessed in TBI participants using the national institutes of health (NIH) Toolbox Cognition Battery and Patient-Reported Outcome Measurement Information System respectively. Associations between CBF and cognitive function, symptoms were assessed.

Results

Global CBF and regional brain volumes were similar between groups, but region of interest (ROI) analysis revealed lower CBF bilaterally in the thalamus, hippocampus, left caudate, and left amygdala in the TBI group. Voxel-wise analysis revealed that CBF in the hippocampus, parahippocampus, rostral anterior cingulate, inferior frontal gyrus, and other temporal regions were negatively associated with self-reported anger, anxiety, and depression symptoms. Furthermore, region of interest (ROI) analysis revealed that hippocampal and rostral anterior cingulate CBF were negatively associated with symptoms of fatigue, anxiety, depression, and sleep issues.

Conclusion

Regional CBF deficit was observed in the group with chronic TBI compared to the normal control (NC) group despite similar volume of cerebral structures. The observed negative correlation between regional CBF and affective symptoms suggests that CBF-targeted intervention may potentially improve affective symptoms and quality of life after TBI, which needs to be assessed in future studies.

中文翻译：

海马和头侧前扣带回血流与慢性创伤性脑损伤的情感症状相关

客观的

本研究的目的是评估脑血流量 (CBF) 及其与慢性创伤性脑损伤 (TBI) 患者自我报告症状的关联。

参加者

包括 16 名轻度至重度 TBI 和持续自我报告的神经系统症状的参与者，这些参与者在受伤后 6 至 72 个月内被纳入。为了进行比较，还包括 16 名年龄和性别匹配的健康正常对照参与者。

主要措施

区域 CBF 和脑容量分别使用伪连续动脉自旋标记 (PCASL) 和 T ₁加权数据进行评估。分别使用美国国立卫生研究院 (NIH) 工具箱认知电池和患者报告结果测量信息系统评估 TBI 参与者的认知功能和自我报告症状。评估了 CBF 与认知功能、症状之间的关联。

结果

各组之间的整体 CBF 和局部脑容量相似，但感兴趣区域 (ROI) 分析显示 TBI 组的双侧丘脑、海马、左侧尾状核和左侧杏仁核的 CBF 较低。体素分析显示，海马体、海马旁、头侧前扣带回、额下回和其他颞区的 CBF 与自我报告的愤怒、焦虑和抑郁症状呈负相关。此外，感兴趣区域 (ROI) 分析显示，海马体和头侧前扣带回 CBF 与疲劳、焦虑、抑郁和睡眠问题的症状呈负相关。