Masif Travmanın Beyin Yapıları Üzerindeki Etkisi: 6 Şubat Depremi Sonrası MR Volümetrik Analizi

Öz

Amaç: Bu çalışma, 6 Şubat depremi sonrası beyin yapıları üzerindeki etkileri, özellikle duygu durumla ilişkili merkezleri Manyetik Rezonans Görüntüleme (MRG) volümetrik analizi kullanarak incelemeyi amaçlamakta-dır. Materyal ve Metod: Bu retrospektif çalışma, nöroloji kliniğinde takip edilen ve beyin MRG’i hem deprem öncesinde hem de sonrasında çekilmiş 20 hastayı (2022-2023) içermektedir. MRG taramaları, felaketten önceki ve sonraki bir yıl içinde analiz edilmiştir. Çalışmaya dahil edilen hastaların yaşı, cinsiyeti, MRG endi-kasyonları ve tıbbi öyküsü kaydedilmiştir. Dahil edilme kriterleri baş ağrısı öyküsü bulunan bireyleri kapsar-ken, nörodejeneratif hastalıkları, kafa travması veya diğer yapısal beyin patolojileri olan hastalar çalışmadan dışlanmıştır. Beyin hacminin volümetrik analizi için volBrain yöntemi kullanılmıştır. 3T MRG T1-ağırlıklı sekanslar ile toplam beyin hacmi, beyaz madde, gri madde, beyin omurilik sıvısı (BOS) ve limbik sistem (hipokampus, parahipokampal girus, amigdala, hipotalamus, singulat girus, entorinal korteks), prefrontal korteks, beyincik ve talamus gibi belirli beyin bölgeleri değerlendirilmiştir. Çalışmaya katılan tüm hastalar deprem nedeniyle birinci derece yakın kaybı yaşamış veya evleri yıkılmış bireylerden oluşmaktadır. Bulgular: Çalışma grubunun %65’i kadın, %35’i erkek olup, yaş ortalaması 42,15 ± 8,41 yıldır. Deprem sonrası birçok beyin bölgesinde anlamlı volümetrik değişiklikler gözlemlenmiştir. Beyaz madde hacmi belir-gin şekilde azalırken (p=0,011), BOS hacmi artmıştır (p=0,017). Toplam beyin hacminde anlamlı bir azalma saptanmıştır (p=0,025). Beyincik toplam hacmi (p=0,023) ile sağ (p=0,021) ve sol hemisferleri (p=0,029) anlamlı küçülme göstermiştir. Benzer şekilde, talamus toplam hacmi (p=0,008), sağ (p=0,009) ve sol hemis-ferleri (p=0,010) anlamlı olarak azalmıştır. Buna karşın, posterior singulat girus (PCgG) toplam (p=0,007), sağ (p=0,023) ve sol (p=0,012) hemisferlerinde belirgin hacim artışı göstermiştir. Sonuç: Elde edilen bulgular, akut stres veya travmanın nörobiyolojik etkilerini yansıtan belirgin beyin hacmi değişikliklerine işaret etmektedir. Bu değişimler, deprem gibi travmatik olayların uzun vadeli etkilerini anlamak ve bu etkileri azaltmaya yönelik müdahaleler geliştirmek için ileri çalışmalara duyulan ihtiyacı ortaya koymaktadır. Anahtar Kelimeler: Deprem kaynaklı travma, MRG volümetrik analiz, Limbik sistem, Deprem, Nörogörüntü-leme

Anahtar Kelimeler

• deprem ilişkili travma
• mr volumetrik analiz
• limbik sistem
• deprem
• nörogörüntüleme

Impact of Massive Trauma on Brain Structures: MRI Volumetric Analysis Post-February 6 Earthquake

Öz

Background: This study aims to investigate the impact of the February 6 earthquake on brain structures, particularly mood centers, using MRI volumetric analysis. Materials and Methods: In this retrospective study, 20 neurology clinic patients who were treated at a neurology clinic and underwent brain MRI both before and after the earthquake (2022–2023). MRI scans were analyzed within one year prior to and after the disaster. Patient data included age, gender, MRI indications and medical history. Inclusion criteria required participants to have experienced headaches but excluded those with neurodegenerative diseases, head trauma, or other structural brain pathologies. The volBrain method was used to assess total brain, white and grey matter, cerebrospinal fluid, limbic system (hippocampus, parahippocampal gyrus, amygdala, hypothalamus, cingulate gyrus, entorhinal cortex), pref-rontal cortex, cerebellum, and thalamus via 3T MRI T1 sequences. All participants had experienced first-degree relative loss or home destruction. Results: The study group comprised 65% women and 35% men, with a mean age of 42.15 ± 8.41 years. Significant volumetric changes were observed in several brain regions post-earthquake. White matter volume decreased significantly (p=0.011), while CSF volume increased (p=0.017), and total brain volume showed a significant reduction (p=0.025). The cerebellum exhibited significant volume reductions, inclu-ding total volume (p=0.023), as well as the right (p=0.021) and left hemispheres (p=0.029). Similarly, the thalamus demonstrated significant reductions in total volume (p=0.008), right hemisphere (p=0.009), and left hemisphere (p=0.010). Conversely, the posterior cingulate gyrus (PCgG) showed significant volume increases in total (p=0.007), right (p=0.023), and left hemispheres (p=0.012). Conclusions: The findings reveal significant volumetric changes in specific brain regions suggesting neurobi-ological effects of acute stressor trauma caused by the earthquake. These changes highlight the need for further studies to understand the mechanisms underlying these alterations and to develop interventions aimed at mitigating the long-term effects of such traumatic events. Keywords: Limbic system, Mrı volumetric analysis, Earthquake, Disaster, Massive trauma, Neuroimaging

Anahtar Kelimeler

• earthquake related trauma
• mrı volumetric analysis
• limbic system
• earthquake
• neuroimaging

Kaynakça

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