White Matter Deficits Underlying the Impaired Consciousness Level in Patients with Disorders of Consciousness / 神经科学通报·英文版

In this study, we aimed to (1) identify white matter (WM) deficits underlying the consciousness level in patients with disorders of consciousness (DOCs) using diffusion tensor imaging (DTI), and (2) evaluate the relationship between DTI metrics and clinical measures of the consciousness level in DOC patients. With a cohort of 8 comatose, 8 unresponsive wakefulness syndrome/vegetative state, and 14 minimally conscious state patients and 25 patient controls, we performed group comparisons of the DTI metrics in 48 core WM regions of interest (ROIs), and examined the clinical relevance using correlation analysis. We identified multiple abnormal WM ROIs in DOC patients compared with normal controls, and the DTI metrics in these ROIs were significantly correlated with clinical measures of the consciousness level. Therefore, our findings suggested that multiple WM tracts are involved in the impaired consciousness levels in DOC patients and demonstrated the clinical relevance of DTI for DOC patients.

Comparison of gray matter among children with different karyotype of Turner syndrome: voxel-based morphometry analysis / 中华放射学杂志

Objective To detect the difference of cerebral gray matter change in children with different karyotype Turner Syndrome (TS) by using voxel-based morphometry (VBM).Methods Nineteen children with 45XO karyotype TS,21 children with heterozygous TS and 20 age-matched control girls were recruited in this study.Wechsler intelligence scale for children was used to obtain their intelligence quotients (IQ).High-resolution magnetic MR imaging was performed in TS children and control girls to collect the whole brain structural data.The data was analyzed by VBM based on SPM8 to compare the volume of gray matter among the monosomy TS children,heterozygous TS children and normal controls by using covariance analysis.Alphasim method in the software of analysis of functional neuroimages(AFNI) was used for clusterlevel multiple comparison.Results The IQ was 89 ± 16 for the monosomy TS children,and it was 91 ± 13 for heterozygous TS children and 109 ± 15 for the controls.Statistical analysis revealed significant difference of IQ among them (F =10.75,P ＜ 0.05).Compared with normal controls,both monosomy TS children and heterozygous TS children showed significantly decreased volume (voxel numbers in clusters were 4117,1392,1085,t =5.75,5.33 and 5.02 for monosomy TS; voxel numbers in clusters were 4501,2437,591,t =5.40,5.11 and 4.95 for heterozygous TS respectively,P ＜ 0.01,FWE-corrected) in the gray matter of bilateral precuneus lobule,postcentral gyrus,and cingulum cortex.However,the volume of the orbitofrontal lobe,parahippocampal gyrus,cerebellum,temporal pole,corpus striatum and posterior midbrain were increased in the monosomy and heterozygous TS children compared to the controls (voxel numbers in clusters were 1444,1188,791,725,695,431,386,t =5.01,5.96,5.67,5.23,4.85,4.43,4.94 for monosomy TS; voxel numbers in clusters were 6988,2709,2510,2380,1987,1709,1185,t =6.50,7.06,7.26,5.27,5.71,6.02,4.56 for heterozygous TS,P ＜ 0.01,FWE-corrected).Compared with monosomy TS,heterozygous TS showed increased gray matter volume in the left parahippocampal gyrus and corpus striatum (voxel numbers were 1014 and 496,t =4.75,4.53,P ＜0.01,FWE-eorreeted),while they had decreased gray matter volume in the right supramarginal gyrus (voxel number was 350,t =4.28,P ＜ 0.01,FWE-corrected).Conclusions Both monosomy and heterozygous TS show brain atrophy in the parietooccipital lobe,indicating similar abnormality of gray matter development.However,heterozygous TS shows more increased gray matter volume in the prefrontal lobes and the cerebellum than monosomy TS,which may be the compensatory mechanism in this condition.