对抗相关的大脑网络的保存预测了创伤性脑损伤后的恢复
Samuel B Snider1,2,3, Hui Shi1,3, Yelena G Bodien4,5,6
1Division of Neurocritical Care, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115.
概括
在创伤性脑损伤 (TBI) 后不久,通过静止状态功能性MRI (rs-fMRI) 测量功能性脑连接,可以预测长期康复. 特定大脑区域之间的抗相关性是TBI患者神经恢复的关键指标.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 中度至重度创伤性脑损伤 (TBI) 后的预后有很大差异,影响治疗决策.
- 终止维持生命治疗是创伤后死亡的主要原因,这凸显了准确预后的必要性.
- 休息状态功能性MRI (rs-fMRI) 测量同步的大脑活动,可能与神经恢复有关.
研究的目的:
- 识别关键的功能连接,以便在TBI后恢复.
- 为了确定早期的rs-fMRI连接能否预测长期的神经结果.
- 调查功能性抗对应物在TBI恢复中的作用.
主要方法:
- 分析了来自三个潜在队列的rs-fMRI数据 (N=116名TBI患者,134名对照),这些数据是在受伤后不久获得的.
- 机器学习模型 (交叉验证AUC) 用于评估功能连接在6个月后的预测能力.
- 统计分析以控制诸如镇静和意识水平等混因素.
主要成果:
- 包括两个抗相关区域在内的三个特定脑区域对之间的功能连接是6个月功能结果最强的预测因素 (训练AUC0.94,测试AUC0.78).
- 在控制镇静和意识水平 (P=0.02) 之后,这些发现仍然很强大.
- 结合保存的抗相对应物改善了已确定的预后得分的准确性 (AUC 0.90对比0.80,P=0.02).
结论:
- 在TBI后急性阶段保留的功能性反相对应物作为恢复所需的神经基质的生物标志物.
- 这种基于rs-fMRI的生物标志物可以帮助TBI患者的预后决策,可能减少维持生命治疗的过早停止.
- 对特定功能性大脑连接模式的早期评估为TBI恢复轨迹提供了有价值的见解.
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