Tremblay, Desjardins, Bermudez, Iturria-Medina, Evans, Jolicoeur, De Beaumont (2019) Mild traumatic brain injury: The effect of age at trauma onset on brain structure integrity NeuroImage. Clinical 23() 101907
Mounting evidence suggests that mild traumatic brain injuries (mTBI) have long-term effects that interact with the aging process to precipitate cognitive decline. This line of research predicts that early exposure to brain trauma is particularly detrimental to long-term brain integrity. However, a second line of research into the effects of age at trauma onset predict that older brains are more vulnerable to the effects of mTBI than younger brains. We sought to determine whether patients who sustain a mTBI earlier in life fare better than patients who sustain a mTBI at an older age. We conducted a multi-cohort, case-control study, with participants randomly sampled from a population of patients with a history of mTBI. We recruited two cohorts of aging participants (N = 74, mean [SD] = 61.16 [6.41]) matched in age and education levels that differed in only one respect: age at mTBI onset. One cohort sustained their concussion in their early twenties (24.60 [6.34] y/o), the other in their early sixties (61.05 [4.90] y/o). Each mTBI cohort had its own matched control group. Participants underwent high-resolution MRI at 3 Tesla for T1 and diffusion-weighted images (DWI) acquisition. Images were processed and analyzed using Deformation-Based Morphometry and DWI Tract-Based Spatial Statistics to identify group differences in a 2 × 2 ANOVA design. Results showed a significant interaction on DWI measures of white matter integrity indicating larger anomalies in participants who sustained a mTBI at a younger age (F1,70, P < .05, FDR corrected). These findings suggest that mTBI initiates a lifelong neurodegeneration process that outweighs the risks associated with sustaining a mTBI at an older age. Implications are important for young athletes' populations exposed to the risk of mTBI in the practice of their sports and for retired athletes aging with a history of concussions sustained at a younger age. Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.
越来越多的证据表明，轻度创伤性脑损伤（mTBI）具有长期影响，与衰老过程相互作用，促使认知能力下降。这一研究预测，早期暴露于脑外伤对长期的大脑完整性尤其不利。然而，对创伤发病年龄影响的第二项研究预测，年龄较大的大脑比年轻的大脑更容易受到mTBI的影响。我们试图确定在生命早期维持mTBI的患者是否比在较大年龄维持mTBI的患者更好。我们进行了一项多队列病例对照研究，参与者从具有mTBI病史的患者群体中随机抽样。我们招募了两个年龄参与者群体（N = 74，平均[SD] = 61.16 [6.41]），其年龄和教育水平相匹配，仅在一个方面有所不同：mTBI发病年龄。一个队列在二十出头时（24.60 [6.34] y / o）持续震荡，另一个在六十年代初期（61.05 [4.90] y / o）。每个mTBI群组都有自己的匹配对照组。参与者在3特斯拉进行了高分辨率MRI，用于T1和扩散加权图像（DWI）采集。使用基于变形的形态测量和基于DWI轨迹的空间统计来处理和分析图像以识别2×2 ANOVA设计中的组差异。结果显示DWI测量白质完整性的显着相互作用表明在较年轻时维持mTBI的参与者的较大异常（F1,70，P <.05，FDR校正）。这些研究结果表明，mTBI启动了终生的神经变性过程，超过了与老年人维持mTBI相关的风险。对于年轻运动员在体育运动中暴露于mTBI风险的人群以及年龄较小且有脑震荡史的退役运动员来说，这一点很重要。版权所有©2019作者。由Elsevier Inc.出版。保留所有权利。