Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results

외상에 노출된 소방관들의 뇌 구조 및 휴식기 뇌기능 변화: 예비 결과

  • Yae Won Park (Department of Radiology, Ewha Womans University College of Medicine) ;
  • Suhnyoung Jun (Department of Psychology, Yonsei University College of Medicine) ;
  • Juwhan Noh (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Seok Jong Chung (Department of Neurology, Brain Research Institute, Yonsei University College of Medicine) ;
  • Sanghoon Han (Department of Psychology, Yonsei University College of Medicine) ;
  • Phil Hyu Lee (Department of Neurology, Brain Research Institute, Yonsei University College of Medicine) ;
  • Changsoo Kim (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Seung-Koo Lee (Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine)
  • 박예원 (이화여자대학교 의과대학 영상의학교실) ;
  • 전선영 (연세대학교 의과대학 심리학교실) ;
  • 노주환 (연세대학교 의과대학 예방의학교실) ;
  • 정석종 (연세대학교 의과대학 뇌연구소 신경과) ;
  • 한상훈 (연세대학교 의과대학 심리학교실) ;
  • 이필휴 (연세대학교 의과대학 뇌연구소 신경과) ;
  • 김창수 (연세대학교 의과대학 예방의학교실) ;
  • 이승구 (연세대학교 의과대학 방사선의과학연구소 영상의학교실)
  • Received : 2019.08.19
  • Accepted : 2019.10.14
  • Published : 2020.05.01
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Abstract

Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.

목적 외상 후 스트레스 장애(posttraumatic stress disorder; 이하 PTSD)가 없는 외상에 노출된 소방관들에서 뇌 구조의 변화와 휴식기 뇌기능 변화를 연구하고자 한다. 대상과 방법 모든 피험자는 휴식기 기능 뇌자기공명영상(resting-state functional MRI; 이하 rsfMRI) 검사를 시행하였다. PTSD가 없는 40세 이상의 31명의 소방관(31명, 평균 연령, 49.8 ± 4.7세)이 포함되었다. 26명의 외상을 받지 않은 건강한 대조군(26명, 평균 연령, 65.3 ±7.84세)도 포함되었다. Voxel-based morphometry 분석을 시행하여 뇌 해부학상의 국소적 차이를 조사하였으며, 휴식기 뇌기능의 차이를 조사하기 위해 seed-based functional connectivity analysis 분석을 시행하였다. 결과 서울언어학습결과(Seoul Verbal Learning Test)의 평균 z 값을 비교했을때 소방관은 건강한 대조군에 비해 즉각회상(immediate recall), 지연 회상(delayed recall), 통제단어연상검사(Controlled Oral Word Association Test; 이하 COWAT)의 동물(animal)과 음소(phonemic) 항목에서 점수가 유의하게 낮았으며, 신경인지 기능이 감소한 것으로 나타났다. 소방관은 좌위마루이랑(left superior parietal gyrus)과 좌하관자이랑(left inferior temporal gyrus)의 회색질 부피가 건강한 대조군에 비해 감소되어 있었다. 소방관은 방추향이랑(fusiform gyrus)과 소뇌(cerebellum) 등을 포함한 여러 부위에서 rsfMRI 값의 변화를 보였다. 결론 구조적 뇌 및 휴식 상태 기능 이상은 외상에 노출된 소방관의 변화를 확인하는 데 유용한 이미징 바이오 마커일 수 있다.

Keywords

Acknowledgement

This research was supported by the Fire Fighting Safety & 119 Rescue Technology Research and Development Program funded by National Fire Agency ("MPSS-Firesafety-2015-80").

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