Voxel-based moprhometry in the differential diagnosis of posttraumatic cognitive impairments

Brain injury (BI) is a major cause of cognitive impairments (CI) in young people. However, many aspects of their development remain unstudied. In particular, the role of neurodegenerative and vascular processes in the occurrence of posttraumatic disorders of higher cortical functions is still unclear. Voxel-based morphometry is one of the current neuroimaging techniques. Objective: to comprehensively study a change in the volume indicators of a number of brain structures in patients with posttraumatic, vascular, and amnestic CI.

Patients and methods. The investigation enrolled 123 patients who were divided into 5 groups: 1) 20 examinees without CI (a control group); 2) 22 patients with mild and moderate CI and a history of mild recurrent CI; 3) 19 patients with moderate posttraumatic CI after severe brain contusion; 4) 41 patients with moderate vascular CI; 5) 21 patients with moderate amnestic CI. Before divided into the groups, all the patients underwent comprehensive neuropsychological testing, which enabled different aspects of cognitive performance to be assessed.

Results. Atrophic changes were ascertained to be uncharacteristic for the patients who had sustained mild recurrent BI. At the same time, the patients with severe consequences of BI showed a significant decrease in the volume of brain regions, primarily in that of frontal and temporal lobes. A combined comprehensive assessment of the results obtained in the group analysis using SPM8 and calculating absolute volume values using MRICroN allowed one to more accurately understand the nature of neurodegenerative changes. Comparative assessment of the data obtained in the posttraumatic, vascular, and amnestic CI groups identified a number of differences in both the distribution of atrophic changes and their level, which can be of great importance for the differential diagnosis of these conditions.

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