The Study Of Functional Magnetic Resonance Imaing In The Rehabilitation Mechanism Of Traumatic Brain Injury With Hyperbaric Oxygen Therapy

Objective To explore the changes of the resting state brain function in patients with traumatic brain injury(TBI) before and after hyperbaric oxygen therapy(HBOT) by the method of Amplitude of Low Frequency Fluctuation(ALFF) and precuneus based functional connectivity of resting-state functional MRI(f MRI), for further illustrate the rehabilitation mechanism of traumatic brain injury.Materials and Methods The resting state f MRI data,T1-weighted 3D imaging and general MRI including T2-weighted imaging and T2-FLAIR imaging of fifteen case of TBI(twelve patients received hyperbaric oxygen therapy) and fifteen healthy subjects, which are matched with TBI patients in age, gender and educational background, were recorded by a Siemens 3.0 T Skyra MRI scanner. The resting-state BOLD-f MRI data preprocessing were performed by using DPARSF2.2(data processing assistant for resting state f MRI) and REST1.8 software based on the platform of Matlab 2012 b. Then ALFF value was calculated and analyzed statistically by SPSS 18.0 packages. The cognitive level of the TBI patients before and after receiving HBOT were assessed by Mo CA(Montreal Cognitive Assessment).Results(1) Compared with controls(p < 0.05), TBI patients showed significant decrease of ALFF values in left lingual gyrus, bilateral precuneus, right middle temporal gyrus, right angular gyrus and right inferior temporal gyrus, and significant increase of ALFF values mainly in left inferior temporal gyrus, left fusiform gyrus, bilateral precentral gyrus and bilateral paracentral lobule.(2) Compared with pre-HBOT(p < 0.05), the group of the post-HBIO showed significant increase of ALFF value in bilateral precuneus, bilateral medial cingulate, bilateral superior parietal lobule.(3) Compared with controls(p < 0.05), TBI patients showed significant decrease of functional connectivity between Pru and some regions, including the right Hippocampi, right Insula, right superior temporal gyrus and right temporal pole, and increase of functional connectivity between Pru and right calcarine, right lingual gyrus.(4) Compared with the group of pre-HBOT(p < 0.05), the group of post-HBOT showed significant increase of functional connectivity between Pru and right hippocampus, right parahippocampal gyrus, right fusiform gyrus, right left inferior temporal gyrus and the pole of right temporal.Conclusion(1) In addition to the structure damage region indicated by the conventional MRI in TBI patients, there are also multiple functional damage encephalic regions and which can be reveled by rs-f MRI.(2) HBOT can promote the recovery of neural functional in TBI patients, which can be used as one of intervention treatment for an early stage of TBI patients.(3) The rehabilitation mechanism of Traumatic brain injury with hyperbaric oxygen therapy is mainly to facilitated the compansation of different encephalic regions with the same functions and completed the reconstruction of neurological function in TBI patients.