中国全科医学2017，Vol.20Issue(6)：731-735,5.DOI:10.3969/j.issn.1007-9572.2017.06.019
磁共振波谱成像、事件相关电位及脑震荡后综合征问卷评分在轻度创伤性脑损伤中的应用价值研究
Application Value of Magnetic Resonance Spectroscopy,Event Related Potential and Rivermead Post Concussion Syndrome Questionnaire Scores in Mild Traumatic Brain Injury
摘要
Abstract
Background It is common to see mild traumatic brain injury(mTBI)and emergence of post concussion syndrome seriously troubles the life of patients. Because of relatively subjective clinical manifestations and the not high relevant auxiliary examinations,its current clinical diagnosis remains controversial. It is important to explore the effective detection methods for early diagnosis and prognosis evaluation. Objective To explore the value of magnetic resonance spectroscopy (MRS), event related potentials ( P300 ) and rivermead post concussion symptoms questionnaire ( RPQ ) score in mTBI. Methods According to the inclusion criteria,30 mTBI patients and 30 healthy volunteers after physical examination in Dongguan Tung Wash Hospital from May 2012 to June 2015 were respectively selected as case group and control group. All the subjects were performed with MRI examination,P300 detection and RPQ scores. The levels of metabolites〔 N - acetylaspartate (NAA),creatine(Cr),choline(Cho)〕in the left and right side of basal ganglia,white matter of frontal lobe,semioval center,genu of corpus callosum,and splenium of corporis callosum were measured respectively. NAA/ Cr and Cho/ Cr of affected side and healthy side in the case group,and NAA/ Cr and Cho/ Cr of left side and right side in the control group,amplitude and latency period of P300 and RPQ score of all subjects were recorded. Results The routine MRI examination in the two groups showed no abnormalities. In case group,NAA peak in affected side of white matter of frontal lobe and semioval center declined and Cho peak increased compared with the healthy side. There was no significant difference in NAA/ Cr and Cho/ Cr between left side and right side of basal ganglia,white matter of frontal lobe,semioval center,genu of corpus callosum,splenium of corporis callosum in control group(P ﹥ 0. 05);there was no significant difference in NAA/ Cr and Cho/ Cr between affected side and healthy side of basal ganglia,genu of corpus callosum,splenium of corporis callosum in case group(P ﹥ 0. 05);in case group, NAA/ Cr and Cho/ Cr in affected side of white matter of frontal lobe and semioval center were lower than and higher than those in the healthy side respectively(P ﹤ 0. 05). Amplitude of P300 of case group was less than that of control group,while latency period of P300 and RPQ score were greater than those of control group(P ﹤ 0. 05). In case group,NAA/ Cr in affected side of white matter of frontal lobe and semioval center was positively correlated with amplitude of P300( r = 0. 874,P ﹤ 0. 001;r= 0. 883,P ﹤ 0. 001),while negatively correlated with latency period of P300(r = - 0. 813,P ﹤ 0. 001;r = - 0. 850,P ﹤0. 001)and RPQ score(r = - 0. 617,P ﹤ 0. 001;r = - 0. 627,P ﹤ 0. 001);in case group,Cho/ Cr in affected side of white matter of frontal lobe and semioval center was negatively correlated with amplitude of P300 ( r = - 0. 862,P ﹤ 0. 001;r= - 0. 749,P ﹤ 0. 001),while positively correlated with latency period of P300( r = 0. 607,P ﹤ 0. 001;r = 0. 552,P= 0. 002)and RPQ score(r = 0. 786,P ﹤ 0. 001;r = 0. 558,P = 0. 001). Conclusion MRS can reflect the changes of the biochemical and tissue metabolism of brain tissues of mTBI patients after trauma from the molecular level. P300 can objectively reflect the impaired condition of cognitive function of mTBI patients. RPQ score can objectively reflect the severity of post concussion syndrome of mTBI patients. The combination of the three is important significance in the early diagnosis,evaluation and prognosis of mTBI.关键词
脑损伤/磁共振成像/事件相关电位,P300/脑震荡后综合征Key words
Brain injuries/Magnetic resonance imaging/Event - related potentials, P300/Post -concussion syndrome分类
医药卫生引用本文复制引用
陶仅德,李秋雨,漆强,曾鹏,刘晓,吴贵平..磁共振波谱成像、事件相关电位及脑震荡后综合征问卷评分在轻度创伤性脑损伤中的应用价值研究[J].中国全科医学,2017,20(6):731-735,5.基金项目
东莞市医疗卫生科技计划一般项目 （）
