Cognitive and Behavioral Neurology最新文献_第9页

Clinical Correlates of Depression and Suicidality in Huntington Disease: An Analysis of the Enroll-HD Observational Study 亨廷顿病患者抑郁和自杀的临床相关性:一项入组观察性研究分析

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-04-22 DOI: 10.1097/WNN.0000000000000301

N. Rocha, Madison R Tuazon, Jorge Patino, E. Furr Stimming, A. L. Teixeira

Background: Depression and suicidality are commonly experienced by Huntington disease (HD) gene carriers. Research on these behavioral symptoms is imperative, not only to increase our understanding of the symptoms and how they relate to HD, but also to contribute to improving patients’ care and quality of life. Objective: To identify clinical variables associated with a history of depression and suicidality in HD gene carriers. Method: We conducted a cross-sectional study of HD gene carriers from the Enroll-HD database PDS4 (periodic data set 4; N = 11,582). Data from baseline visits were obtained, and binary logistic regression models were used to ascertain the effects of clinical variables on the likelihood that HD gene carriers would have previous depression and suicidal ideation/attempts. Results: Approximately 65% (n = 7526) of the HD gene carriers had a history of depression, and ~27% (n = 3152) had previous suicidal ideation/attempts. Female sex; diagnosis of manifest HD; history of perseverative/obsessive behavior, apathy, and psychosis; and previous suicidal ideation/attempts were significantly associated with a history of depression in the HD gene carriers. Medical history of apathy, psychosis, and depression, as well as worse scores on the Total Functional Capacity and Irritability Scales, were significantly associated with previous suicidal ideation/attempts in the HD gene carriers. Conclusion: The prevalence of depression and suicidality is high among HD gene carriers. An improved understanding of the risk factors for depression and suicide in HD gene carriers can assist providers in recognizing at-risk individuals and allow providers to implement therapeutic strategies.

背景:抑郁症和自杀是亨廷顿病(HD)基因携带者的常见症状。对这些行为症状的研究是必要的，不仅可以增加我们对这些症状及其与HD的关系的理解，而且有助于改善患者的护理和生活质量。目的:确定与HD基因携带者抑郁和自杀史相关的临床变量。方法:我们对来自Enroll-HD数据库PDS4 (periodic data set 4;N = 11582)。从基线访问中获得数据，并使用二元逻辑回归模型来确定临床变量对HD基因携带者既往抑郁和自杀意念/企图可能性的影响。结果:约65% (n = 7526)的HD基因携带者有抑郁史，约27% (n = 3152)有自杀意念/企图。女性性;显性HD的诊断;有持续性/强迫性行为、冷漠和精神病病史;既往的自杀意念/企图与HD基因携带者的抑郁史显著相关。在HD基因携带者中，冷漠、精神病和抑郁的病史，以及在总功能容量和易怒量表上的较差得分，与先前的自杀意念/企图显著相关。结论:HD基因携带者抑郁和自杀率较高。加深对HD基因携带者抑郁和自杀风险因素的了解可以帮助提供者识别高危个体，并允许提供者实施治疗策略。

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引用次数: 2

Eye-gaze Strategies During Facial Emotion Recognition in Neurodegenerative Diseases and Links With Neuropsychiatric Disorders. 神经退行性疾病面部情绪识别过程中的凝视策略及其与神经精神疾病的联系。

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-03 DOI: 10.1097/WNN.0000000000000288

Kévin Polet, Solange Hesse, Adeline Morisot, Benoît Kullmann, Sandrine Louchart de la Chapelle, Alain Pesce, Galina Iakimova

Background: Facial emotion recognition (FER) is primarily and severely impaired in individuals with the behavioral variant of frontotemporal dementia (bvFTD) and is often mildy impaired in individuals with Alzheimer disease (AD) or Parkinson disease (PD). Such impairment is associated with inappropriate social behaviors.

Objective: To determine whether FER impairment is linked to the use of inappropriate eye-gaze strategies to decode facial emotions, leading to misinterpretation of others' intentions and then to behavioral disorders.

Method: We assessed FER in 9 individuals with bvFTD, 23 with AD, and 20 with PD, as well as 22 healthy controls (HC), using the Reading the Mind in the Eyes (RME) Test and the Ekman Faces Test. Eye movements (number and duration of fixations) were recorded with an eye-tracking device. Behavior was assessed using the Neuropsychiatric Inventory.

Results: FER was mildly impaired in the AD and PD groups and severely impaired in the bvFTD group. FER impairment was accompanied by an increase in the number of fixations and a more attracted gaze toward the lower part of one's face. FER impairment and an increase in the number of fixations were positively correlated with behavioral disorders.

Conclusion: Our study demonstrated a link between FER impairment, modification of eye-gaze strategies during the observation of emotional faces, and behavioral disorders in individuals with bvFTD and those with AD or PD. These results suggest that an eye-gaze strategy rehabilitation program could have beneficial effects on emotion recognition and behavioral disorders in individuals with these diseases.

背景：面部情绪识别（FER）在额颞叶痴呆（bvFTD）行为变体患者中主要严重受损，在阿尔茨海默病（AD）或帕金森病（PD）患者中通常轻度受损。这种损害与不恰当的社会行为有关。目的：确定FER损伤是否与使用不恰当的凝视策略来解码面部情绪有关，从而导致对他人意图的误解，进而导致行为障碍。方法：我们使用阅读眼睛中的思想（RME）测试和Ekman面孔测试评估了9名bvFTD患者、23名AD患者和20名PD患者以及22名健康对照（HC）的FER。用眼动仪记录眼球运动（注视次数和持续时间）。结果：AD和PD组FER轻度受损，bvFTD组FER重度受损。FER损伤伴随着注视次数的增加和对面部下部更吸引的凝视。FER损伤和注视次数的增加与行为障碍呈正相关。结论：我们的研究证明了bvFTD患者和AD或PD患者的FER损伤、在观察情绪面孔时眼睛凝视策略的改变与行为障碍之间的联系。这些结果表明，凝视策略康复计划可以对这些疾病患者的情绪识别和行为障碍产生有益影响。

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引用次数: 6

Sustained Long-term Improvement in Neuropsychiatric Symptoms of an Individual With Initial bvFTD Diagnosis: A Case Report 最初诊断为bvFTD的个体的神经精神症状持续长期改善:一例报告

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000298

E. Kim, N. Pliskin, M. Caserta

The behavioral variant of frontotemporal dementia (bvFTD) is a neurodegenerative disease that is diagnosed by progressive neuropsychiatric changes and supportive neuroimaging. Making an accurate diagnosis of bvFTD is a challenging process that can be complicated by the presence of a subset of nonprogressive, or phenocopy, cases whose symptoms remain stable. Our patient, who presented with neuropsychiatric symptoms that are characteristic of bvFTD, improved and stabilized after thorough neuropsychiatric and neuropsychological evaluation and treatment. Our case illustrates that, despite diagnostic uncertainties, appropriate evaluation and treatment can lead to improvement and stabilization of neuropsychiatric symptoms in individuals presumed to have bvFTD.

额颞叶痴呆(bvFTD)是一种神经退行性疾病，通过进行性神经精神改变和支持性神经影像学来诊断。准确诊断bvFTD是一个具有挑战性的过程，由于存在症状保持稳定的非进展性或表现性病例，可能会使诊断变得复杂。本例患者表现为bvFTD特有的神经精神症状，经过彻底的神经精神和神经心理学评估和治疗后，病情好转并稳定下来。我们的病例表明，尽管诊断不确定，适当的评估和治疗可以改善和稳定被认为患有bvFTD的个体的神经精神症状。

引用次数: 0

Diagnostic Utility of Hippocampal Volumetric Data in a Memory Disorder Clinic Setting 海马体积数据在记忆障碍临床诊断中的应用

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000295

R. Ruchinskas, Trung Nguyen, K. Womack, Alka Khera, F. Yu, B. Kelley

Background: Hippocampal volumetric data are widely used in research but are rarely examined in clinical populations in regard to aiding diagnosis or correlating with objective memory test scores. Objective: To replicate and expand on the few prior clinical examinations of the utility of hippocampal volumetric data. We evaluated MRI volumetric data to determine (a) the degree of hippocampal loss across diagnostic groups compared with a cognitively intact group, (b) if total or lateralized hippocampal volumes predict diagnostic group membership, and (c) how total and lateralized volumes correlate with memory tests. Method: We retrospectively examined hippocampal volumetric data and memory test scores for 294 individuals referred to a memory clinic. Results: Individuals with mild cognitive impairment or Alzheimer disease had smaller hippocampal volumes compared with cognitively intact individuals. The raw and normalized total and lateralized hippocampal volumes were essentially equal for predicting diagnostic group membership, and notably low hippocampal volumes evidenced greater specificity than sensitivity. All of the volumetric data correlated with the memory test scores, with the total and left hippocampal volumes accounting for the slightly more variance in the diagnostic groups. Conclusion: The diagnostic groups exhibited hippocampal volume loss, which can be a potential biomarker for neurodegenerative disease in clinical practice. However, solely using hippocampal volumetric data to predict diagnostic group membership or memory test failure was not supported. While extreme hippocampal volume loss was rare in the cognitively intact group, the sensitivity of these volumetric data suggests a need for supplementation by other tools when making a diagnosis.

背景：海马体积数据在研究中被广泛使用，但很少在临床人群中进行检查，以帮助诊断或与客观记忆测试分数相关。目的：复制和扩展先前为数不多的临床检查海马体积数据的实用性。我们评估了MRI体积数据，以确定（a）与认知完整组相比，诊断组的海马损失程度，（b）海马总体积或侧化体积是否预测诊断组成员，以及（c）总体积和侧化体积与记忆测试的相关性。方法：我们回顾性检查了294名被转诊到记忆诊所的患者的海马体积数据和记忆测试分数。结果：与认知完整的个体相比，轻度认知障碍或阿尔茨海默病患者的海马体积较小。原始和标准化的总海马体积和侧化海马体积在预测诊断组成员方面基本相等，显著的低海马体积显示出比灵敏度更高的特异性。所有体积数据都与记忆测试分数相关，诊断组的总海马体积和左海马体积的差异略大。结论：诊断组表现出海马体积损失，这可能是临床上神经退行性疾病的潜在生物标志物。然而，仅使用海马体积数据来预测诊断组成员或记忆测试失败是不受支持的。虽然在认知完整的组中，极端的海马体积损失是罕见的，但这些体积数据的敏感性表明，在进行诊断时，需要通过其他工具进行补充。

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引用次数: 2

Verbal and Nonverbal Memory in Neurodegenerative and Stroke Aphasia: Evidence From the Turkish Version of the Three Words Three Shapes Test 神经退行性和中风失语症的言语和非言语记忆:来自土耳其语三词三形测验的证据

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000294

M. Seckin, Begüm Özbek, Ilayda Demir, E. Kurt, Ulaş Ay, D. Yildirim, N. Yesilot, O. Çoban, Öget Öktem, H. Gürvit

Background: Although language impairment is the most salient feature of cognitive impairment in both primary progressive aphasia (PPA) and stroke aphasia (SA), memory can also be impaired in both patient populations. Objective: To identify distinctive features of verbal and nonverbal memory processing in individuals with PPA and those with SA. Method: We gave individuals with PPA (n = 14), those with SA (n = 8), and healthy controls (HC; n = 13) a comprehensive neuropsychological test battery and the Turkish version of the Three Words Three Shapes Test (3W3S–Turkish). The 3W3S–Turkish Test includes five subtests: Copy, Incidental Recall, Acquisition, Delayed Recall, and Recognition. High-resolution brain scans were performed in a subset of individuals with PPA and those with SA. Lesion distribution was limited to the dorsal language areas in the SA group, whereas peak atrophy areas in the PPA group extended beyond the language network, including the medial temporal lobe, precuneus, and posterior/medial portions of the cingulate cortex. Results: Both the PPA and SA groups showed impairment in incidental recall, and the PPA group showed additional impairment in delayed recall. Greater impairment for verbal stimuli suggestive of material-specific memory impairment was evident in the PPA group’s scores on the Incidental Recall and Delayed Recall subtests. Both aphasia groups retained the acquired information regardless of material type. Conclusion: Although both aphasia groups shared similarities in the involvement of the dorsal prefrontal working memory/attention network, the PPA group showed greater impairment in delayed recall compared with the SA group.

背景:虽然语言障碍是原发性进行性失语症(PPA)和卒中性失语症(SA)中认知障碍的最显著特征，但在这两种患者群体中，记忆也可能受损。目的:探讨PPA患者和SA患者言语和非言语记忆加工的特点。方法:选取PPA患者(n = 14)、SA患者(n = 8)和健康对照(HC;n = 13)综合神经心理测试组和土耳其版的三字三形测试(3w3s -土耳其语)。3w3s -土耳其测试包括五个子测试:复制、附带回忆、习得、延迟回忆和识别。对PPA患者和SA患者进行了高分辨率脑部扫描。SA组的病变分布仅限于背侧语言区，而PPA组的峰值萎缩区域延伸到语言网络之外，包括内侧颞叶、楔前叶和扣带皮层的后/内侧部分。结果:PPA组和SA组在偶然回忆中均表现出障碍，PPA组在延迟回忆中表现出额外的障碍。PPA组在附带回忆和延迟回忆子测试中的得分明显显示，言语刺激对物质特异性记忆障碍的损害更大。两组失语症患者均保留了习得的信息，与材料类型无关。结论:尽管两组失语症患者在背侧前额叶工作记忆/注意网络的参与上有相似之处，但PPA组在延迟回忆上的损害大于SA组。

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引用次数: 0

The Code Breaker, Jennifer Doudna, Gene Editing, and the Future of the Human Race. 《密码破译者》，詹妮弗·杜德纳，《基因编辑与人类的未来》。

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000291

Howard S Kirshner

引用次数: 3

Hemodialyzed Individuals’ Left Spatial Attentional Bias Is Normalized Following Successful Kidney Transplantation 肾移植成功后血液透析患者的左空间注意偏差正常化

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000290

Aleksandra Mańkowska, K. Heilman, J. Williamson, B. Biedunkiewicz, A. Dębska-Ślizień, M. Harciarek

Background: Healthy people have a leftward spatial attentional bias, called pseudoneglect. Individuals with end-stage renal disease (ESRD) who are receiving hemodialysis often demonstrate an increase in their leftward spatial attentional bias. Whereas a successful kidney transplant often improves the cognitive functions of individuals who previously received hemodialysis, the effect of a kidney transplant on this abnormal allocation of spatial attention has not been investigated. Objective: To investigate the effects of kidney transplant on individuals who were being treated with dialysis and had an increase in their left spatial attentional bias. Method: The performance of 20 hemodialyzed individuals with ESRD on the line bisection test was compared to that of 17 demographically matched individuals with ESRD, who had received a kidney transplant, and 23 demographically matched healthy controls (HC). Results: All of the participants exhibited a left spatial bias on the line bisection task. When compared with the HC, the hemodialyzed individuals demonstrated a significantly greater left spatial bias. There was, however, no difference in spatial bias between the HC and the individuals who had received a kidney transplant. Conclusion: A successful kidney transplant can improve patients’ abnormal leftward allocation of spatial attention. However, future studies are needed to better understand the mechanisms of this spatial attentional bias in hemodialyzed individuals and the normalization of bias following transplantation.

背景：健康人有一种向左的空间注意偏向，称为伪忽视。接受血液透析的终末期肾病（ESRD）患者通常表现出向左空间注意偏差的增加。尽管成功的肾移植通常能改善先前接受血液透析的个体的认知功能，但肾移植对这种空间注意力异常分配的影响尚未得到研究。目的：研究肾移植对接受透析治疗且左空间注意偏向增加的患者的影响。方法：将20名血液透析的ESRD患者与17名接受过肾移植的ESRD人口统计学匹配患者和23名人口统计学匹配的健康对照组（HC）在平分线测试中的表现进行比较。结果：所有参与者在直线平分任务中都表现出左空间偏向。与HC相比，血液透析的个体表现出明显更大的左空间偏差。然而，HC和接受肾移植的个体之间的空间偏差没有差异。结论：成功的肾移植可以改善患者空间注意力的异常向左分配。然而，需要未来的研究来更好地了解血液透析患者这种空间注意偏差的机制，以及移植后偏差的正常化。

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引用次数: 0

The Attention Network Test in Parkinson and Lewy Body Disease: A Systematic Review 帕金森和路易体病的注意网络测试:系统回顾

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000292

Jihyun Yang, Dana Pourzinal, T. Rheinberger, D. Copland, K. Mcmahon, G. Byrne, N. Dissanayaka

Background: The Attention Network Test (ANT) is a well-established measure of efficiency for the alerting, orienting, and executive attentional networks. However, its novel application in Parkinson disease (PD) and Lewy body dementia (LBD) research more broadly has yet to be evaluated systematically. Objective: To compare and consolidate the outcomes of studies reporting use of the ANT in PD and LBD groups and to identify the methodological considerations for the conduct of such studies. Method: We performed a systematic literature search for articles exploring attention in PD and LBD groups using the ANT. We excluded articles on the basis of irrelevant scope, non-English, and groups other than PD and LBD. Once the full text articles were identified, we extracted the data and assessed the studies’ quality. Results: The final sample included 16 articles ranging from low to moderate quality. Behavioral findings suggested a general slowing of responses yet preserved accuracy from the PD group compared with controls. Overall, the evidence was inconclusive regarding the state of the alerting network in the PD and LBD groups, mostly supportive of an intact orienting network, and strongly suggestive of an impaired executive network. Differences in sample stratification, patient symptomatology, and dopaminergic medication levels were identified as influential factors in the attentional results across studies. Conclusion: Although sparse, the existing evidence indicates that the ANT is a viable option for measuring attention in PD; it can also be harnessed to explore the impact of symptoms and medications on attentional networks in PD and LBD groups.

背景：注意力网络测试（ANT）是一种公认的衡量警报、定向和执行注意力网络效率的方法。然而，它在帕金森病（PD）和路易体痴呆（LBD）研究中的新应用尚待系统评估。目的：比较和巩固报告在帕金森病和LBD组中使用ANT的研究结果，并确定进行此类研究的方法考虑因素。方法：我们使用ANT对PD和LBD组的注意力进行了系统的文献检索。我们根据不相关的范围、非英语以及PD和LBD以外的群体排除了文章。一旦全文文章被确定，我们提取数据并评估研究的质量。结果：最终样本包括16篇质量从低到中等的文章。行为研究结果表明，与对照组相比，PD组的反应普遍放缓，但仍保持了准确性。总的来说，关于PD和LBD组的警报网络状态的证据是不确定的，主要支持完整的定向网络，并强烈暗示执行网络受损。样本分层、患者症状和多巴胺能药物水平的差异被确定为研究中注意力结果的影响因素。结论：虽然稀少，但现有证据表明，ANT是测量PD注意力的可行选择；它还可以用来探索症状和药物对PD和LBD组注意力网络的影响。

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引用次数: 1

Anosognosia and Memory Encoding in Huntington Disease 亨廷顿病的病感失认和记忆编码

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2022-03-01 DOI: 10.1097/WNN.0000000000000293

Ciaran M. Considine, Shelby B. Hughes, Jessie Sellers Gibson, David Isaacs, Katherine E McDonell, R. Darby, D. Claassen

Background: Anosognosia can manifest as an unawareness of neurobehavioral symptoms in individuals with Huntington disease (HD). Measurement of anosognosia is challenging, but the Anosognosia Scale (AS) represents a brief option with promising findings in small samples. Objective: To replicate application of the AS in a larger HD sample than previous studies in order to assess psychometrics and demographic correlates and to investigate the genetic, motor, and neuropsychological correlates of the AS in individuals with HD. Method: We retrospectively reviewed the AS ratings of 74 genetically confirmed Huntington gene carriers, nearly all early motor manifest, who had been referred for clinical neuropsychological assessment. Concurrent clinical neurologic examination and neuropsychometric assessment data were compiled, where available (ns = 35–74). The severity of the anosognosia per AS ratings was characterized for the HD sample. Results: The AS ratings did not correlate with demographic variables, genetic markers, or motor dysfunction severity. Correlation analyses revealed that higher AS ratings correlated with worse recognition–discrimination memory performance (r = 0.38, P < 0.05) but not cognitive control on executive functioning performance or on collateral-reported frontal–behavioral symptoms. Higher AS ratings also correlated with fewer patient-reported depressive symptoms (r = –0.38, P < 0.01) and diurnal hypersomnia symptoms (r = –0.44, P < 0.01). Conclusion: Anosognosia (per AS) is associated with recognition–discrimination deficits and fewer self-reported neuropsychiatric symptoms in individuals with pre-to-early manifest HD, though not with HD severity per genetic or motor markers, nor to executive dysfunction or collateral-reported frontal–behavioral symptoms.

背景：在亨廷顿舞蹈症（HD）患者中，认知障碍可表现为对神经行为症状的不了解。嗅觉缺失的测量具有挑战性，但嗅觉缺失量表（AS）是一个简短的选择，在小样本中有很好的发现。目的：在比以往研究更大的HD样本中复制AS的应用，以评估心理测量学和人口学相关性，并研究HD患者AS的遗传、运动和神经心理学相关性。方法：我们回顾性地回顾了74名遗传确认的亨廷顿舞蹈症基因携带者的AS评分，这些携带者几乎都是早期运动表现，他们被转诊进行临床神经心理评估。在可用的情况下，同时汇编临床神经检查和神经计量评估数据（n=35-74）。根据AS评分对HD样本的嗅觉缺失严重程度进行了表征。结果：AS评分与人口统计学变量、遗传标志物或运动功能障碍严重程度无关。相关分析显示，较高的AS评分与较差的识别-辨别记忆表现相关（r=0.38，P<0.05），但与执行功能表现或附带报告的额叶行为症状的认知控制无关。较高的AS评分也与较少的患者报告的抑郁症状（r=-0.38，P<0.01）和昼夜嗜睡症状（r=0.44，P<0.01）相关，尽管没有遗传或运动标志物的HD严重程度，也没有执行功能障碍或附带报告的额叶行为症状。

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引用次数: 1

Diffusion Tensor Imaging Correlates of Resilience Following Adolescent Traumatic Brain Injury. 青少年颅脑损伤后弥散张量成像与恢复力的相关性。

IF 1.4 4区医学 Q3 Medicine

Cognitive and Behavioral Neurology

Pub Date : 2021-12-02 DOI: 10.1097/WNN.0000000000000283

Adam T Schmidt, Hannah M Lindsey, Emily Dennis, Elisabeth A Wilde, Brian D Biekman, Zili D Chu, Gerri R Hanten, Dana L Formon, Matthew S Spruiell, Jill V Hunter, Harvey S Levin

Background: Traumatic brain injury (TBI) is associated with considerable mortality and morbidity in adolescents, but positive outcomes are possible. Resilience is the concept that some individuals flourish despite significant adversity.

Objective: To determine if there is a relationship between resilience-promoting factors that are known to promote resilience and white matter (WM) microstructure 1 year after complicated mild TBI or moderate or severe TBI that is sustained by adolescents.

Method: We examined the relationship between performance on a self-report measure of resilience-promoting factors and WM integrity assessed by diffusion tensor imaging in a group of adolescents who had sustained either a TBI (n = 38) or an orthopedic injury (OI) (n = 23).

Results: Immediately following injury, the individuals with TBI and the OI controls had comparable levels of resilience-promoting factors; however, at 1 year post injury, the TBI group endorsed fewer resilience-promoting factors and exhibited WM disruption compared with the OI controls. The individuals with TBI who had more resilience-promoting factors at 1 year post injury exhibited increased WM integrity, but the OI controls did not. Findings were particularly strong for the following structures: anterior corona radiata, anterior limb of the internal capsule, and genu of the corpus callosum-structures that are implicated in social cognition and are frequently disrupted after TBI. Relationships were notable for caregiver and community-level resilience-promoting factors.

Conclusion: The current findings are some of the first to indicate neurobiological evidence of previously noted buffering effects of resilience-promoting factors in individuals with TBI.

背景：创伤性脑损伤（TBI）与青少年的相当大的死亡率和发病率有关，但积极的结果是可能的。韧性是指一些人在重大逆境中仍能茁壮成长的概念。目的：确定已知促进恢复力的恢复力促进因素与青少年并发轻度或中度或重度TBI后1年的白质（WM）微观结构之间是否存在关系。方法：我们研究了一组青少年的自我报告恢复力促进因素的表现与通过扩散张量成像评估的WM完整性之间的关系 = 38）或矫形损伤（OI）（n = 23）.结果：受伤后，TBI患者和OI对照组的恢复力促进因子水平相当；然而，在损伤后1年，与OI对照组相比，TBI组支持较少的恢复力促进因素，并表现出WM中断。在损伤后1年具有更多恢复力促进因素的TBI患者表现出WM完整性增加，但OI对照组没有。以下结构的研究结果尤其强烈：前放射冠、内囊前肢和胼胝体膝部结构，这些结构与社会认知有关，在TBI后经常被破坏。人际关系在照顾者和社区层面的恢复力促进因素方面显著。结论：目前的研究结果首次表明了先前注意到的恢复力促进因子对TBI患者的缓冲作用的神经生物学证据。

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引用次数: 3