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Yang L, Peng J, Zhang L, Zhang F, Wu J, Zhang X, Pang J, Jiang Y. Advanced Diffusion Tensor Imaging in White Matter Injury After Subarachnoid Hemorrhage. World Neurosurg 2024; 189:77-88. [PMID: 38789033 DOI: 10.1016/j.wneu.2024.05.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Subarachnoid hemorrhage (SAH) is recognized as an especially severe stroke variant, notorious for its high mortality and long-term disability rates, in addition to a range of both immediate and enduring neurologic impacts. Over half of the SAH survivors experience varying degrees of neurologic disorders, with many enduring chronic neuropsychiatric conditions. Due to the limitations of traditional imaging techniques in depicting subtle changes within brain tissues posthemorrhage, the accurate detection and diagnosis of white matter (WM) injuries are complicated. Against this backdrop, diffusion tensor imaging (DTI) has emerged as a promising biomarker for structural imaging, renowned for its enhanced sensitivity in identifying axonal damage. This capability positions DTI as an invaluable tool for forming precise and expedient prognoses for SAH survivors. This study synthesizes an assessment of DTI for the diagnosis and prognosis of neurologic dysfunctions in patients with SAH, emphasizing the notable changes observed in DTI metrics and their association with potential pathophysiological processes. Despite challenges associated with scanning technology differences and data processing, DTI demonstrates significant clinical potential for early diagnosis of cognitive impairments following SAH and monitoring therapeutic effects. Future research requires the development of highly standardized imaging paradigms to enhance diagnostic accuracy and devise targeted therapeutic strategies for SAH patients. In sum, DTI technology not only augments our understanding of the impact of SAH but also may offer new avenues for improving patient prognoses.
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Affiliation(s)
- Lei Yang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jianhua Peng
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lifang Zhang
- Institute of Brain Science, Southwest Medical University, Luzhou, China; Sichuan Clinical Research Center for Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fan Zhang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jinpeng Wu
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xianhui Zhang
- Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jinwei Pang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yong Jiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Institute of Brain Science, Southwest Medical University, Luzhou, China; Sichuan Clinical Research Center for Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
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Fesharaki-Zadeh A, Datta D. An overview of preclinical models of traumatic brain injury (TBI): relevance to pathophysiological mechanisms. Front Cell Neurosci 2024; 18:1371213. [PMID: 38682091 PMCID: PMC11045909 DOI: 10.3389/fncel.2024.1371213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
Background Traumatic brain injury (TBI) is a major cause of morbidity and mortality, affecting millions annually worldwide. Although the majority of TBI patients return to premorbid baseline, a subset of patient can develop persistent and often debilitating neurocognitive and behavioral changes. The etiology of TBI within the clinical setting is inherently heterogenous, ranging from sport related injuries, fall related injuries and motor vehicle accidents in the civilian setting, to blast injuries in the military setting. Objective Animal models of TBI, offer the distinct advantage of controlling for injury modality, duration and severity. Furthermore, preclinical models of TBI have provided the necessary temporal opportunity to study the chronic neuropathological sequelae of TBI, including neurodegenerative sequelae such as tauopathy and neuroinflammation within the finite experimental timeline. Despite the high prevalence of TBI, there are currently no disease modifying regimen for TBI, and the current clinical treatments remain largely symptom based. The preclinical models have provided the necessary biological substrate to examine the disease modifying effect of various pharmacological agents and have imperative translational value. Methods The current review will include a comprehensive survey of well-established preclinical models, including classic preclinical models including weight drop, blast injury, fluid percussion injury, controlled cortical impact injury, as well as more novel injury models including closed-head impact model of engineered rotational acceleration (CHIMERA) models and closed-head projectile concussive impact model (PCI). In addition to rodent preclinical models, the review will include an overview of other species including large animal models and Drosophila. Results There are major neuropathological perturbations post TBI captured in various preclinical models, which include neuroinflammation, calcium dysregulation, tauopathy, mitochondrial dysfunction and oxidative stress, axonopathy, as well as glymphatic system disruption. Conclusion The preclinical models of TBI continue to offer valuable translational insight, as well as essential neurobiological basis to examine specific disease modifying therapeutic regimen.
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Affiliation(s)
- Arman Fesharaki-Zadeh
- Department of Neurology and Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Dibyadeep Datta
- Division of Aging and Geriatric Psychiatry, Alzheimer’s Disease Research Unit, Department of Psychiatry, New Haven, CT, United States
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Lima Santos JP, Jia-Richards M, Kontos AP, Collins MW, Versace A. Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6274. [PMID: 37444121 PMCID: PMC10341732 DOI: 10.3390/ijerph20136274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
Emotional dysregulation symptoms following a concussion are associated with an increased risk for emotional dysregulation disorders (e.g., depression and anxiety), especially in adolescents. However, predicting the emergence or worsening of emotional dysregulation symptoms after concussion and the extent to which this predates the onset of subsequent psychiatric morbidity after injury remains challenging. Although advanced neuroimaging techniques, such as functional magnetic resonance imaging and diffusion magnetic resonance imaging, have been used to detect and monitor concussion-related brain abnormalities in research settings, their clinical utility remains limited. In this narrative review, we have performed a comprehensive search of the available literature regarding emotional regulation, adolescent concussion, and advanced neuroimaging techniques in electronic databases (PubMed, Scopus, and Google Scholar). We highlight clinical evidence showing the heightened susceptibility of adolescents to experiencing emotional dysregulation symptoms following a concussion. Furthermore, we describe and provide empirical support for widely used magnetic resonance imaging modalities (i.e., functional and diffusion imaging), which are utilized to detect abnormalities in circuits responsible for emotional regulation. Additionally, we assess how these abnormalities relate to the emotional dysregulation symptoms often reported by adolescents post-injury. Yet, it remains to be determined if a progression of concussion-related abnormalities exists, especially in brain regions that undergo significant developmental changes during adolescence. We conclude that neuroimaging techniques hold potential as clinically useful tools for predicting and, ultimately, monitoring the treatment response to emotional dysregulation in adolescents following a concussion.
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Affiliation(s)
- João Paulo Lima Santos
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (M.J.-R.); (A.V.)
| | - Meilin Jia-Richards
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (M.J.-R.); (A.V.)
| | - Anthony P. Kontos
- Department of Orthopaedic Surgery, UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.P.K.); (M.W.C.)
| | - Michael W. Collins
- Department of Orthopaedic Surgery, UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA; (A.P.K.); (M.W.C.)
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (M.J.-R.); (A.V.)
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Kato H, Nakagawara J, Hachisuka K, Hatazawa J, Ikoma K, Suehiro E, Iida H, Ogasawara K, Iizuka O, Ishiai S, Ichikawa T, Nariai T, Okazaki T, Shiga T, Mori E. Impaired neuronal integrity in traumatic brain injury detected by 123I-iomazenil single photon emission computed tomography and MRI. J Cereb Blood Flow Metab 2022; 42:2245-2254. [PMID: 35796498 PMCID: PMC9670011 DOI: 10.1177/0271678x221113001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study was aiming at investigating the extent of neuronal damage in cases of traumatic brain injury (TBI) with diffuse axonal injury (DAI) using 123I-iomazenil(IMZ) SPECT and MRI. We compared the findings in 31 patients with TBI without any major focal brain lesions and 25 age-matched normal controls. Subjects underwent 123I-IMZ SPECT and MRI, and also assessment by cognitive function tests. The partial volume effect of 123I-IMZ SPECT was corrected using MRI. In the patients with TBI, decreased spatial concentration of 123I-IMZ binding was detected in the medial frontal/orbitofrontal cortex, posterior cingulate gyrus, cuneus, precuneus, and superior region of the cerebellum. ROC analysis of 123I-IMZ SPECT for the detection of neuronal injury showed a high diagnostic ability of 123I-IMZ binding density for TBI in these areas. The decreased 123I-IMZ uptake density in the cuneus and precuneus was associated with cognitive decline after the injury. In the patients with TBI, brain atrophy was detected in the frontal lobe, anterior temporal and parietal cortex, corpus callosum, and posterior part of the cerebellum. Evaluation of the neuronal integrity by 123I-IMZ SPECT and MRI provides important information for the diagnosis and pathological interpretation in cases of TBI with DAI.
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Affiliation(s)
- Hiroki Kato
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jyoji Nakagawara
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Kenji Hachisuka
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Katsunori Ikoma
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Eiichi Suehiro
- Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan
| | - Hidehiko Iida
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
| | - Osamu Iizuka
- Department of Behavioral Neurology & Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sumio Ishiai
- Department of Rehabilitation Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tadashi Ichikawa
- Department of Neurology, Saitama Rehabilitation Center, Ageo, Japan
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Okazaki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tohru Shiga
- Department of Diagnostic Imaging, Hokkaido University, Sapporo, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology & Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
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Huang W, Hu W, Zhang P, Wang J, Jiang Y, Ma L, Zheng Y, Zhang J. Early Changes in the White Matter Microstructure and Connectome Underlie Cognitive Deficit and Depression Symptoms After Mild Traumatic Brain Injury. Front Neurol 2022; 13:880902. [PMID: 35847204 PMCID: PMC9279564 DOI: 10.3389/fneur.2022.880902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Abstract
Cognitive and emotional impairments are frequent among patients with mild traumatic brain injury (mTBI) and may reflect alterations in the brain structural properties. The relationship between microstructural changes and cognitive and emotional deficits remains unclear in patients with mTBI at the acute stage. The purpose of this study was to analyze the alterations in white matter microstructure and connectome of patients with mTBI within 7 days after injury and investigate whether they are related to the clinical questionnaires. A total of 79 subjects (42 mTBI and 37 healthy controls) underwent neuropsychological assessment and diffusion-tensor MRI scan. The microstructure and connectome of white matter were characterized by tract-based spatial statistics (TBSSs) and graph theory approaches, respectively. Mini-mental state examination (MMSE) and self-rating depression scale (SDS) were used to evaluate the cognitive function and depressive symptoms of all the subjects. Patients with mTBI revealed early increases of fractional anisotropy in most areas compared with the healthy controls. Graph theory analyses showed that patients with mTBI had increased nodal shortest path length, along with decreased nodal degree centrality and nodal efficiency, mainly located in the bilateral temporal lobe and right middle occipital gyrus. Moreover, lower nodal shortest path length and higher nodal efficiency of the right middle occipital gyrus were associated with higher SDS scores. Significantly, the strength of the rich club connection in the mTBI group decreased and was associated with the MMSE. Our study demonstrated that the neuroanatomical alterations of mTBI in the acute stage might be an initial step of damage leading to cognitive deficits and depression symptoms, and arguably, these occur due to distinct mechanisms.
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Affiliation(s)
- Wenjing Huang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Wanjun Hu
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Pengfei Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Jun Wang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Yanli Jiang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Laiyang Ma
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Yu Zheng
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Second Clinical School, Lanzhou University, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
- *Correspondence: Jing Zhang
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Medeiros GC, Twose C, Weller A, Dougherty JW, Goes FS, Sair HI, Smith GS, Roy D. Neuroimaging correlates of depression after traumatic brain injury: A systematic review. J Neurotrauma 2022; 39:755-772. [PMID: 35229629 DOI: 10.1089/neu.2021.0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Depression is the most frequent neuropsychiatric complication after traumatic brain injury (TBI) and is associated with poorer outcomes. Neuroimaging has the potential to improve our understanding of the neural correlates of depression after TBI and may improve our capacity to accurately predict and effectively treat this condition. We conducted a systematic review of structural and functional neuroimaging studies that examined the association between depression after TBI, and neuroimaging measures. Electronic searches were conducted in four databases and were complemented by manual searches. In total, 2,035 citations were identified and, ultimately, 38 articles were included totaling 1,793 individuals (median [25%-75%] sample size of 38.5 (21.8-54.3) individuals). The most frequently used modality was structural magnetic resonance imaging (MRI) (n=17, 45%), followed by diffusion tensor imaging (n=11, 29%), resting-state functional MRI (n=10, 26%), task-based functional MRI (n=4, 8%), and positron emission tomography (n=2, 4%). Most studies (n=27, 71%) were cross-sectional. Overall, depression after TBI was associated with lower grey matter measures (volume, thickness, and/or density) and greater white matter damage. However, identification of specific brain areas was somewhat inconsistent. Findings that were replicated in more than one study included reduced grey matter in the rostral anterior cingulate cortex, prefrontal cortex and hippocampus, and damage in five white matter tracts (cingulum, internal capsule, superior longitudinal fasciculi, anterior, and posterior corona radiata). This systematic review found that the available data did not converge on a clear neuroimaging biomarker for depression after TBI. However, there are promising targets that warrant further study.
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Affiliation(s)
- Gustavo C Medeiros
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Claire Twose
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alexandra Weller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John W Dougherty
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Haris I Sair
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gwenn S Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Durga Roy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Refined Analysis of Chronic White Matter Changes after Traumatic Brain Injury and Repeated Sports-Related Concussions: Of Use in Targeted Rehabilitative Approaches? J Clin Med 2022; 11:jcm11020358. [PMID: 35054052 PMCID: PMC8780504 DOI: 10.3390/jcm11020358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 12/10/2022] Open
Abstract
Traumatic brain injury (TBI) or repeated sport-related concussions (rSRC) may lead to long-term memory impairment. Diffusion tensor imaging (DTI) is helpful to reveal global white matter damage but may underestimate focal abnormalities. We investigated the distribution of post-injury regional white matter changes after TBI and rSRC. Six patients with moderate/severe TBI, and 12 athletes with rSRC were included ≥6 months post-injury, and 10 (age-matched) healthy controls (HC) were analyzed. The Repeatable Battery for the Assessment of Neuropsychological Status was performed at the time of DTI. Major white matter pathways were tracked using q-space diffeomorphic reconstruction and analyzed for global and regional changes with a controlled false discovery rate. TBI patients displayed multiple classic white matter injuries compared with HC (p < 0.01). At the regional white matter analysis, the left frontal aslant tract, anterior thalamic radiation, and the genu of the corpus callosum displayed focal changes in both groups compared with HC but with different trends. Both TBI and rSRC displayed worse memory performance compared with HC (p < 0.05). While global analysis of DTI-based parameters did not reveal common abnormalities in TBI and rSRC, abnormalities to the fronto-thalamic network were observed in both groups using regional analysis of the white matter pathways. These results may be valuable to tailor individualized rehabilitative approaches for post-injury cognitive impairment in both TBI and rSRC patients.
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Chen MH, Liu YL, Kuo HW, Tsai SJ, Hsu JW, Huang KL, Tu PC, Bai YM. Neurofilament Light Chain Is a Novel Biomarker for Major Depression and Related Executive Dysfunction. Int J Neuropsychopharmacol 2021; 25:99-105. [PMID: 34637515 PMCID: PMC8832224 DOI: 10.1093/ijnp/pyab068] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/20/2021] [Accepted: 10/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Evidence suggests that major depressive disorder is related to neuroaxonal injury and that neurofilament light chain (NfL) is a biomarker of neuroaxonal injury. In addition, proinflammatory cytokines have been reported to be associated with major depression and neuroaxonal injury. METHODS Forty patients with major depression and 40 age- and sex-matched healthy control participants were enrolled for the measurement of NfL and proinflammatory cytokines and assessment of executive function. General linear models were used to examine the association between NfL levels, proinflammatory cytokine levels, and executive function. RESULTS Patients with major depressive disorder exhibited significantly higher NfL levels (P = .007) than the control participants. NfL levels were positively related to log-transformed levels of tumor necrosis factor-α (P = .004). Higher levels of NfL (P = .002) and tumor necrosis factor-α (P = .013) were associated with greater deficits in executive function. DISCUSSION NfL was a novel biomarker for major depressive disorder and related executive dysfunction. Further studies are necessary to elucidate the role of NfL in the pathophysiology of major depression and related cognitive impairment.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Hsiang-Wei Kuo
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Correspondence: Ya-Mei Bai, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan ()
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Relationship between depression and dorsolateral prefronto-thalamic tract injury in patients with mild traumatic brain injury. Sci Rep 2020; 10:19728. [PMID: 33184443 PMCID: PMC7661494 DOI: 10.1038/s41598-020-76889-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/31/2020] [Indexed: 12/12/2022] Open
Abstract
The prefrontal lobe has been considered to be closely related to depression. This study examined the relationship between depression and three prefronto-thalamic tract (PF-TT) regions (the dorsolateral prefronto-thalamic tract [DLPF-TT], ventrolateral prefronto-thalamic tract [VLPF-TT], and the orbitofronto-thalamic tract [OF-TT]) in patients with mild traumatic brain injury (TBI), using diffusion tensor tractography (DTT). Thirty-seven patients with depression following mild TBI were recruited based on Beck Depression Inventory-II (BDI-II) scores. Thirty-one normal control subjects were also recruited. The three regions of the PF-TTs were reconstructed using probabilistic tractography and DTT parameters for each of the three PF-TT regions were determined. The tract volume of the DLPF-TT and OF-TT in the patient group showed a significant decrease compared to that of the control group (p < 0.05). The BDI-II score of the patient group showed a moderate negative correlation with the tract volume value of the right (r = − 0.33) and left (r = − 0.41) DLPF-TT (p < 0.05). On the other hand, no significant correlations were detected between the BDI-II score of the patient group and the values of the other DTT parameters values for the three PF-TT regions (p > 0.05). Using DTT, depression was found to be closely related to a DLPF-TT injury in patients with mild TBI. We believe that evaluation of the DLPF-TT using DTT would be helpful when assessing patients with depression following mild TBI. These results can provide useful information regarding the proper application of neuromodulation in the management of depression.
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A Pilot Investigation of Repetitive Transcranial Magnetic Stimulation for Post-Traumatic Brain Injury Depression: Safety, Tolerability, and Efficacy. J Neurotrauma 2019; 36:2092-2098. [DOI: 10.1089/neu.2018.6097] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Sang RC, Vawda Y, Greenspoon D, Reed N, Hunt AW. An innovative approach to measuring youth concussion recovery: Occupational performance. Br J Occup Ther 2019. [DOI: 10.1177/0308022619851415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Concussion is a common injury in youth. Studies report that active rehabilitation interventions reduce symptoms in these youth. There is no literature that addresses its impact on occupational performance. The purpose of this study was to identify: (a) occupational performance issues experienced by these youth; (b) changes in occupational performance and satisfaction following participation in a 6-week active rehabilitation intervention; and (c) the relationship between changes in occupational performance and symptoms. Method As part of a larger prospective repeated measures study, measures of occupational performance (Canadian Occupational Performance Measure) and self-reported symptoms (Post-Concussion Symptom Inventory) were collected pre and post intervention. Paired t-test, Spearman correlation, and descriptive analyses were conducted. Results Youth (9–18 years; n = 52) reported a range of occupational performance issues in self-care, productivity, and leisure domains. The most frequently reported occupational performance issues were sport (32.70%) and school (31.75%) activities. Positive changes were found in both performance and satisfaction of occupational performance issues post intervention ( p<.001). Correlation analysis revealed that as symptoms decreased, occupational performance improved ( rs = –.359, p = .020). Conclusion Using a measure of occupational performance may provide meaningful insight into the functional recovery of concussion, and can help identify targeted functional approaches to paediatric concussion management.
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Affiliation(s)
- Robyn Chen Sang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Yasira Vawda
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Dayna Greenspoon
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Nick Reed
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Anne W Hunt
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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Ganzola R, McIntosh AM, Nickson T, Sprooten E, Bastin ME, Giles S, Macdonald A, Sussmann J, Duchesne S, Whalley HC. Diffusion tensor imaging correlates of early markers of depression in youth at high-familial risk for bipolar disorder. J Child Psychol Psychiatry 2018; 59:917-927. [PMID: 29488219 DOI: 10.1111/jcpp.12879] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mood disorders are familial psychiatric diseases, in which patients show reduced white matter (WM) integrity. We sought to determine whether WM integrity was affected in young offspring at high-familial risk of mood disorder before they go on to develop major depressive disorder (MDD). METHODS The Bipolar Family study is a prospective longitudinal study examining young individuals (age 16-25 years) at familial risk of mood disorder on three occasions 2 years apart. This study used baseline imaging data, categorizing groups according to clinical outcome at follow-up. Diffusion tensor MRI data were acquired for 61 controls and 106 high-risk individuals, the latter divided into 78 high-risk subjects who remained well throughout the study ('high-risk well') and 28 individuals who subsequently developed MDD ('high-risk MDD'). Voxel-wise between-group comparison of fractional anisotropy (FA) based on diagnostic status was performed using tract-based spatial statistics (TBSS). RESULTS Compared to controls, both high-risk groups showed widespread decreases in FA (pcorr < .05) at baseline. Although FA in the high-risk MDD group negatively correlated with subthreshold depressive symptoms at the time of scanning (pcorr < .05), there were no statistically significant differences at p-corrected levels between the two high-risk groups. CONCLUSIONS These results suggest that decreased FA is related to the presence of familial risk for mood disorder along with subdiagnostic symptoms at the time of scanning rather than predictive of subsequent diagnosis. Due to the difficulties performing such longitudinal prospective studies, we note, however, that this latter analysis may be underpowered due to sample size within the high-risk MDD group. Further clinical follow-up may clarify these findings.
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Affiliation(s)
- Rossana Ganzola
- Centre de Recherche CERVO, Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada
| | | | - Thomas Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Emma Sprooten
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark E Bastin
- Centre for Clinical Brain Sciences, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - Stephen Giles
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Alix Macdonald
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | | | - Simon Duchesne
- Centre de Recherche CERVO, Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada.,Départment de Radiologie, Faculté de Médecine, Université Laval, Québec, QC, Canada
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13
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Ownsworth T, Gooding K, Beadle E. Self-focused processing after severe traumatic brain injury: Relationship to neurocognitive functioning and mood symptoms. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 58:35-50. [DOI: 10.1111/bjc.12185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Tamara Ownsworth
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Nathan Qld Australia
| | - Kynan Gooding
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Nathan Qld Australia
| | - Elizabeth Beadle
- School of Applied Psychology; Menzies Health Institute Queensland; Griffith University; Nathan Qld Australia
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14
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Tae WS, Ham BJ, Pyun SB, Kang SH, Kim BJ. Current Clinical Applications of Diffusion-Tensor Imaging in Neurological Disorders. J Clin Neurol 2018; 14:129-140. [PMID: 29504292 PMCID: PMC5897194 DOI: 10.3988/jcn.2018.14.2.129] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 12/11/2022] Open
Abstract
Diffusion-tensor imaging (DTI) is a noninvasive medical imaging tool used to investigate the structure of white matter. The signal contrast in DTI is generated by differences in the Brownian motion of the water molecules in brain tissue. Postprocessed DTI scalars can be used to evaluate changes in the brain tissue caused by disease, disease progression, and treatment responses, which has led to an enormous amount of interest in DTI in clinical research. This review article provides insights into DTI scalars and the biological background of DTI as a relatively new neuroimaging modality. Further, it summarizes the clinical role of DTI in various disease processes such as amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Alzheimer's dementia, epilepsy, ischemic stroke, stroke with motor or language impairment, traumatic brain injury, spinal cord injury, and depression. Valuable DTI postprocessing tools for clinical research are also introduced.
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Affiliation(s)
- Woo Suk Tae
- Brain Convergence Research Center, Korea University, Seoul, Korea
| | - Byung Joo Ham
- Brain Convergence Research Center, Korea University, Seoul, Korea
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Sung Bom Pyun
- Brain Convergence Research Center, Korea University, Seoul, Korea
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Korea
| | - Shin Hyuk Kang
- Brain Convergence Research Center, Korea University, Seoul, Korea
- Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea
| | - Byung Jo Kim
- Brain Convergence Research Center, Korea University, Seoul, Korea
- Department of Neurology, Korea University College of Medicine, Seoul, Korea.
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15
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Azouvi P, Arnould A, Dromer E, Vallat-Azouvi C. Neuropsychology of traumatic brain injury: An expert overview. Rev Neurol (Paris) 2017; 173:461-472. [PMID: 28847474 DOI: 10.1016/j.neurol.2017.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/13/2017] [Indexed: 01/12/2023]
Abstract
Traumatic brain injury (TBI) is a serious healthcare problem, and this report is a selective review of recent findings on the epidemiology, pathophysiology and neuropsychological impairments following TBI. Patients who survive moderate-to-severe TBI frequently suffer from a wide range of cognitive deficits and behavioral changes due to diffuse axonal injury. These deficits include slowed information-processing and impaired long-term memory, attention, working memory, executive function, social cognition and self-awareness. Mental fatigue is frequently also associated and can exacerbate the consequences of neuropsychological deficits. Personality and behavioral changes can include combinations of impulsivity and apathy. Even mild TBI raises specific problems: while most patients recover within a few weeks or months, a minority of patients may suffer from long-lasting symptoms (post-concussion syndrome). The pathophysiology of such persistent problems remains a subject of debate, but seems to be due to both injury-related and non-injury-related factors.
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Affiliation(s)
- P Azouvi
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France.
| | - A Arnould
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France
| | - E Dromer
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France
| | - C Vallat-Azouvi
- HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France; Laboratoire de psychopathologie et neuropsychologie, EA 2027, université Paris-8-Saint-Denis, 2, rue de la Liberté, 93526 Saint-Denis, France; Antenne UEROS- UGECAMIDF, hôpital Raymond-Poincaré, 104, boulevard Raymond-Poincaré, 92380 Garches, France
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16
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Wright DK, Johnston LA, Kershaw J, Ordidge R, O'Brien TJ, Shultz SR. Changes in Apparent Fiber Density and Track-Weighted Imaging Metrics in White Matter following Experimental Traumatic Brain Injury. J Neurotrauma 2017; 34:2109-2118. [DOI: 10.1089/neu.2016.4730] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- David K. Wright
- Anatomy and Neuroscience, The University of Melbourne, Parkville, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Leigh A. Johnston
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Department of Electrical & Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia
| | - Jeff Kershaw
- Applied MRI Research, National Institute of Radiological Sciences, QST, Chiba, Japan
| | - Roger Ordidge
- Anatomy and Neuroscience, The University of Melbourne, Parkville, VIC, Australia
| | - Terence J. O'Brien
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Sandy R. Shultz
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
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17
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Tang S, Xu S, Fourney WL, Leiste UH, Proctor JL, Fiskum G, Gullapalli RP. Central Nervous System Changes Induced by Underbody Blast-Induced Hyperacceleration: An in Vivo Diffusion Tensor Imaging and Magnetic Resonance Spectroscopy Study. J Neurotrauma 2017; 34:1972-1980. [DOI: 10.1089/neu.2016.4650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Shiyu Tang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland
- Core for Translational Research in Imaging at Maryland, University of Maryland, Baltimore, Maryland
| | - Su Xu
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland
- Core for Translational Research in Imaging at Maryland, University of Maryland, Baltimore, Maryland
| | - William L. Fourney
- Department of Mechanical Engineering, University of Maryland, College Park, Maryland
- Center of Energetics Concepts Development, University of Maryland, College Park, Maryland
| | - Ulrich H. Leiste
- Department of Mechanical Engineering, University of Maryland, College Park, Maryland
- Center of Energetics Concepts Development, University of Maryland, College Park, Maryland
| | - Julie L. Proctor
- Department of Anesthesiology, University of Maryland, Baltimore, Maryland
- Shock, Trauma, and Anesthesiology Research Center, University of Maryland, Baltimore, Maryland
| | - Gary Fiskum
- Department of Anesthesiology, University of Maryland, Baltimore, Maryland
- Shock, Trauma, and Anesthesiology Research Center, University of Maryland, Baltimore, Maryland
| | - Rao P. Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland
- Core for Translational Research in Imaging at Maryland, University of Maryland, Baltimore, Maryland
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18
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Paniccia MJ, Reed NP. Dove and hawk profiles in youth concussion: Rethinking occupational performance. The Canadian Journal of Occupational Therapy 2017; 84:111-118. [DOI: 10.1177/0008417416688302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background. Youth concussion and its subsequent recovery have been described as heterogeneous; no one injury is the same, and each youth is different in how he or she recovers. Purpose. This paper proposes a theoretical perspective on the management of youth with persistent concussion symptoms. Key Issues. When managing concussion within youth, further consideration of person, occupation, and environment factors may provide insight on (a) the differential spectrum of profiles that exist among youth who have experienced a concussion and (b) how these profiles can support client-centred rehabilitation. Passive-dove and active-hawk stress profiles from evolutionary literature will be used to contextualize return to occupational performance. An innovative, novel model—the Dove-Hawk Model of Allostatic Load for Youth With Persistent Concussion Symptoms—is proposed to illustrate these concepts, and approaches to rehabilitation across the spectrum of profiles are offered. Implications. Viewing persistent youth concussion recovery in this way may elucidate different approaches to client-centred rehabilitation.
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19
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Bailey NW, Rogasch NC, Hoy KE, Maller JJ, Segrave RA, Sullivan CM, Fitzgerald PB. Increased gamma connectivity during working memory retention following traumatic brain injury. Brain Inj 2017; 31:379-389. [PMID: 28095052 DOI: 10.1080/02699052.2016.1239273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PRIMARY OBJECTIVE Alterations to functional connectivity following a traumatic brain injury (TBI) may lead to impaired cognitive performance and major depressive disorder (MDD). In particular, functional gamma band connectivity is thought to reflect information binding important for working memory. The objective of this study was to determine whether altered functional gamma connectivity may be a factor in MDD following TBI (TBI-MDD). RESEARCH DESIGN This study assessed individuals with TBI-MDD, as well as individuals with TBI alone and MDD alone using electroencephalographic recordings while participants performed a working memory task to assess differences in functional connectivity between these groups. METHODS AND PROCEDURES Functional connectivity was compared using the debiased weighted phase lag index (wPLI). wPLI was measured from a group of healthy controls (n = 31), participants with MDD (n = 17), participants with TBI (n = 20) and participants with TBI-MDD (n = 15). MAIN OUTCOMES AND RESULTS Contrary to the predictions, this study found both the groups with TBI and TBI-MDD showed higher gamma connectivity from posterior regions during WM retention. CONCLUSIONS This may reflect dysfunctional functional connectivity in these groups, as a result of maladaptive neuroplastic reorganization.
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Affiliation(s)
- Neil W Bailey
- a Monash Alfred Psychiatry Research Centre , Alfred Hospital and Central Clinical School, Monash University , Melbourne , VIC , Australia
| | - Nigel C Rogasch
- b Monash Clinical and Imaging Neuroscience, School of Psychological Science and Monash Biomedical Imaging , Monash University , Melbourne , Australia
| | - Kate E Hoy
- a Monash Alfred Psychiatry Research Centre , Alfred Hospital and Central Clinical School, Monash University , Melbourne , VIC , Australia
| | - Jerome J Maller
- a Monash Alfred Psychiatry Research Centre , Alfred Hospital and Central Clinical School, Monash University , Melbourne , VIC , Australia
| | - Rebecca A Segrave
- a Monash Alfred Psychiatry Research Centre , Alfred Hospital and Central Clinical School, Monash University , Melbourne , VIC , Australia
| | - Caley M Sullivan
- a Monash Alfred Psychiatry Research Centre , Alfred Hospital and Central Clinical School, Monash University , Melbourne , VIC , Australia
| | - Paul B Fitzgerald
- a Monash Alfred Psychiatry Research Centre , Alfred Hospital and Central Clinical School, Monash University , Melbourne , VIC , Australia
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20
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Spitz G, Alway Y, Gould KR, Ponsford JL. Disrupted White Matter Microstructure and Mood Disorders after Traumatic Brain Injury. J Neurotrauma 2016; 34:807-815. [PMID: 27550509 DOI: 10.1089/neu.2016.4527] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Traumatic brain injury (TBI) is associated with an elevated frequency of mood disorders that may, in part, be explained by changes in white-matter microstructure. This study is the first to examine the relationship between mood disorders and white-matter pathology in a sample of patients with mild to severe TBI using a standardized psychiatric interview. This study reports on a sub-sample of 29 individuals recruited from a large prospective study that examined the evolution of psychiatric disorders following complicated, mild to severe TBI. Individuals with TBI were also compared with 23 healthy control participants. Individuals were invited to complete the Structured Clinical Interview for DSM-IV Disorders (SCID) to diagnose psychiatric disorders. Participants who developed a mood disorder within the first 3 years were categorized into a TBI-Mood group. Diffusion tensor tractography assessed white matter microstructure using atlas-based tract-averaged and along-tract approaches. Fractional anisotropy (FA) was used as the measure of white-matter microstructure. TBI participants with and without a mood disorder did not differ in regard to injury severity and other background factors. Nevertheless, TBI participants diagnosed with a mood disorder displayed significantly lower tract-averaged FA values for the right arcuate fasciculus (p = 0.011), right inferior longitudinal fasciculus (p = 0.009), and anterior segments I (p = 0.0004) and II (p = 0.007) of the corpus callosum, as well as the left (p = 0.014) and right (p = 0.015) fronto-occipital longitudinal fasciculi. The pattern of white matter disruption identified in the current study provides further support for a neurobiological basis of post-TBI mood disorders. Greater understanding of individuals' underlying neuropathology may enable better characterization and prediction of mood disorders. Integration of neuropathology may also inform the potential efficacy of pharmacological and psychological interventions.
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Affiliation(s)
- Gershon Spitz
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University , Clayton, Australia .,Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Yvette Alway
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University , Clayton, Australia .,Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Kate Rachel Gould
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University , Clayton, Australia .,Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Jennie L Ponsford
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University , Clayton, Australia .,Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
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21
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Fu Y, Dong Y, Zhang C, Sun Y, Zhang S, Mu X, Wang H, Xu W, Wu S. Diffusion tensor imaging study in Duchenne muscular dystrophy. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:109. [PMID: 27127762 DOI: 10.21037/atm.2016.03.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is a progressive muscle disorder associated with an intellectual deficit which is non-progressive. The aim of this study was to investigate brain microstructural changes in DMD and to explore the relationship between such changes and cognitive impairment. METHODS All participants (12 DMD patients, 14 age-matched healthy boys), intelligence quotients (IQs) [both full (FIQ) and verbal (VIQ)] were evaluated using the Wechsler intelligence scale for children China revised (WISC-CR) edition, and brain gray matter (GM) and white matter (WM) changes were mapped using diffusion tensor imaging (DTI) with fractional anisotropy (FA). The differences between groups were analyzed using the t-test and the association of cognition with neuroimaging parameters was evaluated using Pearson's correlation coefficient. RESULTS Compared to the normal controls, the DMD group had lower FIQ (82.0±15.39 vs. 120.21±16.06) and significantly lower splenium of corpus callosum (CC) FA values (P<0.05). Splenium of CC FA was positively correlated with VIQ (r=0.588, P=0.044). CONCLUSIONS There were microstructural changes of splenium of CC in DMD patients, which was associated with cognitive impairment.
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Affiliation(s)
- Ya Fu
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Yuru Dong
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Chao Zhang
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Yu Sun
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Shu Zhang
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Xuetao Mu
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Hong Wang
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Weihai Xu
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
| | - Shiwen Wu
- 1 Department of Neurology, 2 Department of MRI, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China ; 3 Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Science, Beijing 100005, China
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22
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Fink AZ, Mogil LB, Lipton ML. Advanced neuroimaging in the clinic: critical appraisal of the evidence base. Br J Radiol 2016; 89:20150753. [PMID: 27074623 DOI: 10.1259/bjr.20150753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The shortage of high-quality systematic reviews in the field of radiology limits evidence-based integration of imaging methods into clinical practice and may perpetuate misconceptions regarding the efficacy and appropriateness of imaging techniques for specific applications. Diffusion tensor imaging for patients with mild traumatic brain injury (DTI-mTBI) and dynamic susceptibility contrast MRI for patients with glioma (DSC-glioma) are applications of quantitative neuroimaging, which similarly detect manifestations of disease where conventional neuroimaging techniques cannot. We performed a critical appraisal of reviews, based on the current evidence-based medicine methodology, addressing the ability of DTI-mTBI and DSC-glioma to (a) detect brain abnormalities and/or (b) predict clinical outcomes. 23 reviews of DTI-mTBI and 26 reviews of DSC-glioma met criteria for inclusion. All reviews addressed detection of brain abnormalities, whereas 12 DTI-mTBI reviews and 22 DSC-glioma reviews addressed prediction of a clinical outcome. All reviews were assessed using a critical appraisal worksheet consisting of 19 yes/no questions. Reviews were graded according to the total number of positive responses and the 2011 Oxford Centre for evidence-based medicine levels of evidence criteria. Reviews addressing DTI-mTBI detection had moderate quality, while those addressing DSC-glioma were of low quality. Reviews addressing prediction of outcomes for both applications were of low quality. Five DTI-mTBI reviews, but only one review of DSC-glioma met criteria for classification as a meta-analysis/systematic/quantitative review.
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Affiliation(s)
- Adam Z Fink
- 1 The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lisa B Mogil
- 1 The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.,2 SUNY Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Michael L Lipton
- 1 The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.,3 Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA.,4 The Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, NY, USA.,5 Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.,6 Departments of Radiology, Albert Einstein College of Medicine, Bronx, NY, USA
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23
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Girgis F, Pace J, Sweet J, Miller JP. Hippocampal Neurophysiologic Changes after Mild Traumatic Brain Injury and Potential Neuromodulation Treatment Approaches. Front Syst Neurosci 2016; 10:8. [PMID: 26903824 PMCID: PMC4746250 DOI: 10.3389/fnsys.2016.00008] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/25/2016] [Indexed: 12/22/2022] Open
Abstract
Traumatic brain injury (TBI) is the leading cause of death and disability in individuals below age 45, and five million Americans live with chronic disability as a result. Mild TBI (mTBI), defined as TBI in the absence of major imaging or histopathological defects, is responsible for a majority of cases. Despite the lack of overt morphological defects, victims of mTBI frequently suffer lasting cognitive deficits, memory difficulties, and behavioral disturbances. There is increasing evidence that cognitive and memory dysfunction is related to subtle physiological changes that occur in the hippocampus, and these impact both the phenotype of deficits observed and subsequent recovery. Therapeutic modulation of physiological activity by means of medications commonly used for other indications or brain stimulation may represent novel treatment approaches. This review summarizes the present body of knowledge regarding neurophysiologic changes that occur in the hippocampus after mTBI, as well as potential targets for therapeutic modulation of neurologic activity.
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Affiliation(s)
- Fady Girgis
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
| | - Jonathan Pace
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
| | - Jennifer Sweet
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
| | - Jonathan P Miller
- Department of Neurosurgery, University Hospitals Case Medical Center, Case Western Reserve University Cleveland, OH, USA
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24
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Isokuortti H, Iverson GL, Kataja A, Brander A, Öhman J, Luoto TM. Who Gets Head Trauma or Recruited in Mild Traumatic Brain Injury Research? J Neurotrauma 2015; 33:232-41. [PMID: 26054639 DOI: 10.1089/neu.2015.3888] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is a public health problem. Outcome from mTBI is heterogeneous in part due to pre-injury individual differences that typically are not well described or understood. Pre-injury health characteristics of all consecutive patients (n=3023) who underwent head computed tomography due to acute head trauma in the emergency department of Tampere University Hospital, Finland, between August 2010 and July 2012 were examined. Patients were screened to obtain a sample of working age adults with no pre-injury medical or mental health problems who had sustained a "pure" mTBI. Of all patients screened, 1990 (65.8%) fulfilled the mTBI criteria, 257 (8.5%) had a more severe TBI, and 776 (25.7%) had a head trauma without obvious signs of brain injury. Injury-related data and participant-related data (e.g., age, sex, diagnosed diseases, and medications) were collected from hospital records. The most common pre-injury diseases were circulatory (39.4%-43.2%), neurological (23.7%-25.2%), and psychiatric (25.8%-27.5%) disorders. Alcohol abuse was present in 18.4%-26.8%. The most common medications were for cardiovascular (33.1%-36.6%), central nervous system (21.4%-30.8%), and blood clotting and anemia indications (21.5%-22.6%). Of the screened patients, only 2.5% met all the enrollment criteria. Age, neurological conditions, and psychiatric problems were the most common reasons for exclusion. Most of the patients sustaining an mTBI have some pre-injury diseases or conditions that could affect clinical outcome. By excluding patients with pre-existing conditions, the patients with known risk factors for poor outcome remain poorly studied.
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Affiliation(s)
| | - Grant L Iverson
- 2 Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital; MassGeneral Hospital for Children Sports Concussion Program; Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston, Massachusetts
| | - Anneli Kataja
- 3 Department of Radiology, Tampere University Hospital , Tampere, Finland
| | - Antti Brander
- 3 Department of Radiology, Tampere University Hospital , Tampere, Finland
| | - Juha Öhman
- 4 Department of Neurosciences and Rehabilitation, Tampere University Hospital , Tampere, Finland
| | - Teemu M Luoto
- 5 Department of Neurosurgery, Tampere University Hospital , Tampere, Finland
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Kulkarni P, Kenkel W, Finklestein SP, Barchet TM, Ren J, Davenport M, Shenton ME, Kikinis Z, Nedelman M, Ferris CF. Use of Anisotropy, 3D Segmented Atlas, and Computational Analysis to Identify Gray Matter Subcortical Lesions Common to Concussive Injury from Different Sites on the Cortex. PLoS One 2015; 10:e0125748. [PMID: 25955025 PMCID: PMC4425537 DOI: 10.1371/journal.pone.0125748] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 03/26/2015] [Indexed: 01/15/2023] Open
Abstract
Traumatic brain injury (TBI) can occur anywhere along the cortical mantel. While the cortical contusions may be random and disparate in their locations, the clinical outcomes are often similar and difficult to explain. Thus a question that arises is, do concussions at different sites on the cortex affect similar subcortical brain regions? To address this question we used a fluid percussion model to concuss the right caudal or rostral cortices in rats. Five days later, diffusion tensor MRI data were acquired for indices of anisotropy (IA) for use in a novel method of analysis to detect changes in gray matter microarchitecture. IA values from over 20,000 voxels were registered into a 3D segmented, annotated rat atlas covering 150 brain areas. Comparisons between left and right hemispheres revealed a small population of subcortical sites with altered IA values. Rostral and caudal concussions were of striking similarity in the impacted subcortical locations, particularly the central nucleus of the amygdala, laterodorsal thalamus, and hippocampal complex. Subsequent immunohistochemical analysis of these sites showed significant neuroinflammation. This study presents three significant findings that advance our understanding and evaluation of TBI: 1) the introduction of a new method to identify highly localized disturbances in discrete gray matter, subcortical brain nuclei without postmortem histology, 2) the use of this method to demonstrate that separate injuries to the rostral and caudal cortex produce the same subcortical, disturbances, and 3) the central nucleus of the amygdala, critical in the regulation of emotion, is vulnerable to concussion.
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Affiliation(s)
- Praveen Kulkarni
- Northeastern University, Boston, Massachusetts, United States of America
| | - William Kenkel
- Northeastern University, Boston, Massachusetts, United States of America
| | | | - Thomas M. Barchet
- Northeastern University, Boston, Massachusetts, United States of America
| | - JingMei Ren
- Biotrofix, Waltham, Massachusetts, United States of America
| | | | - Martha E. Shenton
- Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Zora Kikinis
- Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Mark Nedelman
- Ekam Imaging, Boston, Massachusetts, United States of America
| | - Craig F. Ferris
- Northeastern University, Boston, Massachusetts, United States of America
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Wu XP, Gao YJ, Yang JL, Xu M, Sun DH. Quantitative measurement to evaluate morphological changes of the corpus callosum in patients with subcortical ischemic vascular dementia. Acta Radiol 2015; 56:214-8. [PMID: 24445093 DOI: 10.1177/0284185114520863] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Subcortical ischemic vascular dementia (SIVD) is a subtype of dementia associated with abnormalities in the subcortical white matter regions. Recent imaging techniques can be used to detect such abnormalities in vivo. PURPOSE To examine morphological changes of the corpus callosum in patients with SIVD by using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). MATERIAL AND METHODS MRI was performed to explore changes of cerebral white matter, especially corpus callosum. Brain matter diffusivity was examined with DTI by measuring the fractional anisotropy (FA). Results of 30 patients diagnosed with SIVD and 30 healthy subjects were analyzed and compared. RESULTS The thicknesses of the genu, the anterior third, middle, and posterior third of the body, and the splenium of the corpus callosum were smaller in SIVD patients compared to healthy controls (0.54 ± 0.08 vs. 0.68 ± 0.09 cm, P = 0.0011; 0.27 ± 0.06 vs. 0.38 ± 0.07 cm, P = 0.002; 0.28 ± 0.05 vs. 0.38 ± 0.08 cm, P = 0.009; 0.18 ± 0.04 vs. 0.26 ± 0.06 cm, P = 0.013; 0.54 ± 0.07 vs. 0.72 ± 0.09 cm, P = 0.003, respectively). The FA values of the genu and splenium of the corpus callosum in patients with SIVD were decreased compared to healthy controls (0.664 ± 0.042 vs. 0.778 ± 0.041, P < 0.001; 0.691 ± 0.038 vs. 0.786 ± 0.039, P = 0.001, respectively). CONCLUSION Patients with SIVD exhibit corpus callosum atrophy and morphological changes, and these characteristics may be useful for diagnosis.
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Affiliation(s)
- Xiao-Ping Wu
- Department of Radiology, The Xi’an Municipal Central Hospital, Affiliated Hospital of Xi’an Jiaotong University, Xi’an, PR China
| | - Yan-Jun Gao
- Department of Radiology, The Xi’an Municipal Central Hospital, Affiliated Hospital of Xi’an Jiaotong University, Xi’an, PR China
| | - Jun-Le Yang
- Department of Radiology, The Xi’an Municipal Central Hospital, Affiliated Hospital of Xi’an Jiaotong University, Xi’an, PR China
| | - Min Xu
- Department of Radiology, The Xi’an Municipal Central Hospital, Affiliated Hospital of Xi’an Jiaotong University, Xi’an, PR China
| | - Dong-Hai Sun
- Department of Radiology, The Xi’an Municipal Central Hospital, Affiliated Hospital of Xi’an Jiaotong University, Xi’an, PR China
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Mansour A, Lajiness-O’Neill R. Call for an Integrative and Multi-Disciplinary Approach to Traumatic Brain Injury (TBI). ACTA ACUST UNITED AC 2015. [DOI: 10.4236/psych.2015.64033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Volumetrics relate to the development of depression after traumatic brain injury. Behav Brain Res 2014; 271:147-53. [DOI: 10.1016/j.bbr.2014.05.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 04/24/2014] [Accepted: 05/22/2014] [Indexed: 01/16/2023]
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Higashi Y, Hoshijima M, Yawata T, Nobumoto A, Tsuda M, Shimizu T, Saito M, Ueba T. Suppression of oxidative stress and 5-lipoxygenase activation by edaravone improves depressive-like behavior after concussion. J Neurotrauma 2014; 31:1689-99. [PMID: 24849726 DOI: 10.1089/neu.2014.3331] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Brain concussions are a serious public concern and are associated with neuropsychiatric disorders, such as depression. Patients with concussion who suffer from depression often experience distress. Nevertheless, few pre-clinical studies have examined concussion-induced depression, and there is little information regarding its pharmacological management. Edaravone, a free radical scavenger, can exert neuroprotective effects in several animal models of neurological disorders. However, the effectiveness of edaravone in animal models of concussion-induced depression remains unclear. In this study, we examined whether edaravone could prevent concussion-induced depression. Mice were subjected to a weight-drop injury and intravenously administered edaravone (3.0 mg/kg) or vehicle immediately after impact. Serial magnetic resonance imaging showed no abnormalities of the cerebrum on diffusion T1- and T2-weighted images. We found that edaravone suppressed concussion-induced depressive-like behavior in the forced swim test, which was accompanied by inhibition of increased hippocampal and cortical oxidative stress (OS) and suppression of 5-lipoxygenase (5-LOX) translocation to the nuclear envelope in hippocampal astrocytes. Hippocampal OS in concussed mice was also prevented by the nicotinamide adenine dinucleotide phosphate oxidase inhibitor, apocynin, and administration of BWB70C, a 5-LOX inhibitor, immediately and 24 h after injury prevented depressive-like behaviors in concussed mice. Further, antidepressant effects of edaravone were observed in mice receiving 1.0 or 3.0 mg/kg of edaravone immediately after impact, but not at a lower dose of 0.1 mg/kg. This antidepressant effect persisted up to 1 h after impact, whereas edaravone treatment at 3 h after impact had no effect on concussion-induced depressive-like behavior. These results suggest that edaravone protects against concussion-induced depression, and this protection is mediated by suppression of OS and 5-LOX translocation.
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Affiliation(s)
- Youichirou Higashi
- 1 Department of Neurosurgery, Kochi Medical School, Kochi University , Kochi, Japan
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Wostrack M, Friedrich B, Hammer K, Harmening K, Stankewitz A, Ringel F, Shiban E, Boeckh-Behrens T, Prothmann S, Zimmer C, Meyer B, Förschler A, Ryang YM. Hippocampal damage and affective disorders after treatment of cerebral aneurysms. J Neurol 2014; 261:2128-35. [DOI: 10.1007/s00415-014-7464-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 08/02/2014] [Accepted: 08/04/2014] [Indexed: 01/02/2023]
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Wang H, Zhu J, Reuter M, Vinke LN, Yendiki A, Boas DA, Fischl B, Akkin T. Cross-validation of serial optical coherence scanning and diffusion tensor imaging: a study on neural fiber maps in human medulla oblongata. Neuroimage 2014; 100:395-404. [PMID: 24954840 DOI: 10.1016/j.neuroimage.2014.06.032] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 06/04/2014] [Accepted: 06/12/2014] [Indexed: 11/26/2022] Open
Abstract
We established a strategy to perform cross-validation of serial optical coherence scanner imaging (SOCS) and diffusion tensor imaging (DTI) on a postmortem human medulla. Following DTI, the sample was serially scanned by SOCS, which integrates a vibratome slicer and a multi-contrast optical coherence tomography rig for large-scale three-dimensional imaging at microscopic resolution. The DTI dataset was registered to the SOCS space. An average correlation coefficient of 0.9 was found between the co-registered fiber maps constructed by fractional anisotropy and retardance contrasts. Pixelwise comparison of fiber orientations demonstrated good agreement between the DTI and SOCS measures. Details of the comparison were studied in regions exhibiting a variety of fiber organizations. DTI estimated the preferential orientation of small fiber tracts; however, it didn't capture their complex patterns as SOCS did. In terms of resolution and imaging depth, SOCS and DTI complement each other, and open new avenues for cross-modality investigations of the brain.
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Affiliation(s)
- Hui Wang
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Junfeng Zhu
- Department of Industrial and Systems Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Martin Reuter
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Louis N Vinke
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - David A Boas
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Bruce Fischl
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Taner Akkin
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
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Jia Z, Wang Y, Huang X, Kuang W, Wu Q, Lui S, Sweeney JA, Gong Q. Impaired frontothalamic circuitry in suicidal patients with depression revealed by diffusion tensor imaging at 3.0 T. J Psychiatry Neurosci 2014; 39:170-7. [PMID: 24119793 PMCID: PMC3997602 DOI: 10.1503/jpn.130023] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The neurobiology of suicide is largely unknown. Studies of white matter tracts in patients with a history of suicidal behaviour have shown alteration in the left anterior limb of the internal capsule (ALIC). Our aim was to determine whether particular target fields of fibre projections through the ALIC are affected in depressed patients who recently attempted suicide. METHODS We studied patients with major depressive disorder (MDD) with and without a history of suicide attempts and healthy controls using diffusion tensor imaging (DTI) and deterministic tractography to generate fibre tract maps for each participant. Tract voxels were coded as being unique to the left ALIC. We compared the mean percentage of fibres projecting to relevant brain regions in the 3 groups using analysis of covariance. RESULTS We included 63 patients with MDD (23 with and 40 without a history of suicide attempts) and 46 controls in our study. Both groups of depressed patients had reduced fibre projections through the ALIC to the left medial frontal cortex, orbitofrontal cortex and thalamus. Those with a history of suicide attempts had greater abnormalities than those without suicide attempts in the left orbitofrontal cortex and thalamus. LIMITATIONS Diffusion tensor imaging deterministic tracking is unable to distinguish between afferent and efferent pathways, limiting our ability to distinguish the directionality of altered fibre tracts. CONCLUSION Frontothalamic loops passing through the ALIC are abnormal in patients with depression and significantly more abnormal in depressed patients with a history of suicide attempts than in those without a history of suicide attempts. Abnormal projections to the orbitofrontal cortex and thalamus may disrupt affective and cognitive functions to confer a heightened vulnerability for suicidal behaviour.
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Affiliation(s)
| | | | | | | | | | | | | | - Qiyong Gong
- Correspondence to: Q. Gong, Huaxi Magnetic Resonance Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China;
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Tsai MC, Tsai KJ, Wang HK, Sung PS, Wu MH, Hung KW, Lin SH. Mood disorders after traumatic brain injury in adolescents and young adults: a nationwide population-based cohort study. J Pediatr 2014; 164:136-141.e1. [PMID: 24112864 DOI: 10.1016/j.jpeds.2013.08.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 07/02/2013] [Accepted: 08/21/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To delineate the relationship between traumatic brain injury (TBI) and mood disorders from population-based data in Taiwan. STUDY DESIGN This prospectively followed cohort study involved a subset of the National Health Insurance Research Database containing complete inpatient and outpatient data of 1 million randomly drawn beneficiaries. We included 10- to 24-year-old patients (n = 15,203) receiving the diagnosis of TBI in ambulatory visits or hospitalization from 2000-2004 and their age- and sex-matched comparison insureds using health service in the same year (n = 76,015). Diagnosis of mood disorders was recorded within 5 years after the traumatic event or index use of health service. Baseline demographics, clinical characteristics, and premorbid psychiatric conditions were compared using χ(2) analysis. Increased risk during the 5-year follow-up period was represented by crude and adjusted hazard ratios with 95% CI using a Cox proportional hazard regression. RESULTS A total of 451/15,203 patients with TBI (2.97%) received a diagnosis of mood disorders in the 5-year follow-up period compared with 1153/97,445 individuals (1.52%) without antecedent TBI. After adjusting for select premorbid comorbidities, TBI remained a significant predisposing factor with a 1.96-fold (95% CI 1.74-2.22) increase in risk of mood disorders. CONCLUSIONS Our findings show a higher likelihood of manifesting mood disorders in adolescents and young adults who sustained a prior TBI. Health professionals should carefully monitor both the physical and psychological impacts of head trauma.
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Affiliation(s)
- Meng-Che Tsai
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kuen-Jer Tsai
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hao-Kuang Wang
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Pi-Shan Sung
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ming-Hsiu Wu
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Kuo-Wei Hung
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, Yuan's General Hospital, Kaohsiung, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan.
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35
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Ho L, Zhao W, Dams-O'Connor K, Tang CY, Gordon W, Peskind ER, Yemul S, Haroutunian V, Pasinetti GM. Elevated plasma MCP-1 concentration following traumatic brain injury as a potential "predisposition" factor associated with an increased risk for subsequent development of Alzheimer's disease. J Alzheimers Dis 2013; 31:301-13. [PMID: 22543850 DOI: 10.3233/jad-2012-120598] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We explored whether changes in the expression profile of peripheral blood plasma proteins may provide a clinical, readily accessible "window" into the brain, reflecting molecular alterations following traumatic brain injury (TBI) that might contribute to TBI complications. We recruited fourteen TBI and ten control civilian participants for the study, and also analyzed banked plasma specimens from 20 veterans with TBI and 20 control cases. Using antibody arrays and ELISA assays, we explored differentially-regulated protein species in the plasma of TBI compared to healthy controls from the two independent cohorts. We found three protein biomarker species, monocyte chemotactic protein-1 (MCP-1), insulin-like growth factor-binding protein-3, and epidermal growth factor receptor, that are differentially regulated in plasma specimens of the TBI cases. A three-biomarker panel using all three proteins provides the best potential criterion for separating TBI and control cases. Plasma MCP-1 contents are correlated with the severity of TBI and the index of compromised axonal fiber integrity in the frontal cortex. Based on these findings, we evaluated postmortem brain specimens from 7 mild cognitive impairment (MCI) and 7 neurologically normal cases. We found elevated MCP-1 expression in the frontal cortex of MCI cases that are at high risk for developing Alzheimer's disease. Our findings suggest that additional application of the three-biomarker panel to current diagnostic criteria may lead to improved TBI detection and more sensitive outcome measures for clinical trials. Induction of MCP-1 in response to TBI might be a potential predisposing factor that may increase the risk for development of Alzheimer's disease.
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Affiliation(s)
- Lap Ho
- Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA
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36
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Wada T, Asano Y, Shinoda J. Decreased fractional anisotropy evaluated using tract-based spatial statistics and correlated with cognitive dysfunction in patients with mild traumatic brain injury in the chronic stage. AJNR Am J Neuroradiol 2012; 33:2117-22. [PMID: 22723057 DOI: 10.3174/ajnr.a3141] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The relationship between white matter disruption and cognitive dysfunction of patients with mTBI in the chronic stage remains unclear. The aim of this study was to identify white matter integrity by using DTI in patients with mTBI without morphologic traumatic abnormalities seen with conventional imaging and to evaluate the association of such regions with cognitive function. MATERIALS AND METHODS Diffusion tensor images from 51 consecutive patients with mTBI without morphologic traumatic abnormalities on conventional MRI were processed, and FA maps were generated as a measure of white matter integrity. All subjects underwent cognitive examinations (MMSE and WAIS-R FIQ). Correlations between the skeletonized FA values in the white matter and the cognitive function were analyzed by using regression analysis. RESULTS In patients with mTBI, significantly decreased FA value clusters in the white matter compared with the healthy controls were found in the superior longitudinal fasciculus, superior frontal gyrus, insula, and fornix. Cognitive examination scores positively correlated with FA values in a number of regions in deep brain structures, which were anatomically close or physiologically intimate to the regions with significant FA value reduction, in patients with mTBI. CONCLUSIONS The present study shows that patients with mTBI in the chronic stage have certain regions with abnormally reduced white matter integrity in the brain. Although the clinical and pathologic-anatomic correlation of these findings remains to be elucidated, these brain regions are strongly suggested to be related to chronic persistent cognitive impairments in these patients.
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Affiliation(s)
- T Wada
- Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Kizawa Memorial Hospital, and Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine, Minokamo, Gifu, Japan.
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Maller JJ, Thomson RHS, Pannek K, Rose SE, Bailey N, Lewis PM, Fitzgerald PB. The (Eigen)value of diffusion tensor imaging to investigate depression after traumatic brain injury. Hum Brain Mapp 2012; 35:227-37. [PMID: 23008175 DOI: 10.1002/hbm.22171] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 06/21/2012] [Accepted: 07/10/2012] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Many people with a traumatic brain injury (TBI), even mild to moderate, will develop major depression (MD). Recent studies of patients with MD suggest reduced fractional anisotropy (FA) in dorsolateral prefrontal cortex (DLPFC), temporal lobe tracts, midline, and capsule regions. Some of these pathways have also been found to have reduced FA in patients with TBI. It is unknown whether the pathways implicated in MD after TBI are similar to those with MD without TBI. This study sought to investigate whether there were specific pathways unique to TBI patients who develop MD. METHODS A sample of TBI-MD subjects (N = 14), TBI-no-MD subjects (N = 12), MD-no-TBI (N = 26), and control subjects (no TBI or MD, N = 23), using a strict measurement protocol underwent psychiatric assessments and diffusion tensor brain Magnetic Resonance Imaging (MRI). RESULTS The findings of this study indicate that (1) TBI patients who develop MD have reduced axial diffusivity in DLPFC, corpus callosum (CC), and nucleus accumbens white matter tracts compared to TBI patients who do not develop MD and (2) MD patients without a history of TBI have reduced FA along the CC. We also found that more severe MD relates to altered radial diffusivity. CONCLUSIONS These findings suggest that compromise to specific white matter pathways, including both axonal and myelination aspects, after a mild TBI underlie the susceptibility of these patients developing MD.
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Affiliation(s)
- Jerome J Maller
- Monash Alfred Psychiatry Research Centre, The Alfred & Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia
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Herron TJ, Kang X, Woods DL. Automated measurement of the human corpus callosum using MRI. Front Neuroinform 2012; 6:25. [PMID: 22988433 PMCID: PMC3439830 DOI: 10.3389/fninf.2012.00025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 08/27/2012] [Indexed: 01/16/2023] Open
Abstract
The corpus callosum includes the majority of fibers that connect the two cortical hemispheres. Studies of cross-sectional callosal morphometry and area have revealed developmental, gender, and hemispheric differences in healthy populations and callosal deficits associated with neurodegenerative disease and brain injury. However, accurate quantification of the callosum using magnetic resonance imaging is complicated by intersubject variability in callosal size, shape, and location and often requires manual outlining of the callosum in order to achieve adequate performance. Here we describe an objective, fully automated protocol that utilizes voxel-based images to quantify the area and thickness both of the entire callosum and of different callosal compartments. We verify the method's accuracy, reliability, robustness, and multisite consistency and make comparisons with manual measurements using public brain-image databases. An analysis of age-related changes in the callosum showed increases in length and reductions in thickness and area with age. A comparison of older subjects with and without mild dementia revealed that reductions in anterior callosal area independently predicted poorer cognitive performance after factoring out Mini-Mental Status Examination scores and normalized whole brain volume. Open-source software implementing the algorithm is available at www.nitrc.org/projects/c8c8.
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Affiliation(s)
- Timothy J Herron
- Human Cognitive Neurophysiology Laboratory, Research Service, US Veterans Affairs, Northern California Health Care System Martinez, CA, USA
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Zuo N, Cheng J, Jiang T. Diffusion magnetic resonance imaging for Brainnetome: a critical review. Neurosci Bull 2012; 28:375-88. [PMID: 22833036 PMCID: PMC5560260 DOI: 10.1007/s12264-012-1245-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 04/27/2012] [Indexed: 12/21/2022] Open
Abstract
Increasing evidence shows that the human brain is a highly self-organized system that shows attributes of small-worldness, hierarchy and modularity. The "connectome" was conceived several years ago to identify the underpinning physical connectivities of brain networks. The need for an integration of multi-spatial and -temporal approaches is becoming apparent. Therefore, the "Brainnetome" (brain-net-ome) project was proposed. Diffusion magnetic resonance imaging (dMRI) is a non-invasive way to study the anatomy of brain networks. Here, we review the principles of dMRI, its methodologies, and some of its clinical applications for the Brainnetome. Future research in this field is discussed.
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Affiliation(s)
- Nianming Zuo
- LIAMA Center for Computational Medicine, National Laboratory of Pattern Recognition, Institute of Automation, The Chinese Academy of Sciences, Beijing, 100190 China
| | - Jian Cheng
- LIAMA Center for Computational Medicine, National Laboratory of Pattern Recognition, Institute of Automation, The Chinese Academy of Sciences, Beijing, 100190 China
| | - Tianzi Jiang
- LIAMA Center for Computational Medicine, National Laboratory of Pattern Recognition, Institute of Automation, The Chinese Academy of Sciences, Beijing, 100190 China
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054 China
- The Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4072 Australia
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Abstract
Traumatic brain injury (TBI) and orthopedic injury (OI) patients are prone to anxiety and mood disorders. In the present study, we integrated anatomical and diffusion tensor neuroimaging to investigate structural properties of the amygdala and hippocampus, gray matter regions implicated in anxiety and mood disorders. Children and adolescents were evaluated during the late sub-acute phase of recovery following trauma resulting from either moderate to severe TBI or OI. Mean diffusivity (MD) of the amygdala and hippocampus was elevated following TBI. An interaction of hemisphere, structure, and group revealed that MD of the right amygdala was elevated in females with TBI. Self-reported anxiety scores were not related to either volume or microstructure of the hippocampus, or to volume or fractional anisotropy of the amygdala. Left amygdala MD in the TBI group accounted for 17.5% of variance in anxiety scores. Anxiety symptoms may be mediated by different mechanisms in patients with TBI or OI.
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Shenton ME, Hamoda HM, Schneiderman JS, Bouix S, Pasternak O, Rathi Y, Vu MA, Purohit MP, Helmer K, Koerte I, Lin AP, Westin CF, Kikinis R, Kubicki M, Stern RA, Zafonte R. A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imaging Behav 2012; 6:137-92. [PMID: 22438191 PMCID: PMC3803157 DOI: 10.1007/s11682-012-9156-5] [Citation(s) in RCA: 605] [Impact Index Per Article: 50.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mild traumatic brain injury (mTBI), also referred to as concussion, remains a controversial diagnosis because the brain often appears quite normal on conventional computed tomography (CT) and magnetic resonance imaging (MRI) scans. Such conventional tools, however, do not adequately depict brain injury in mTBI because they are not sensitive to detecting diffuse axonal injuries (DAI), also described as traumatic axonal injuries (TAI), the major brain injuries in mTBI. Furthermore, for the 15 to 30 % of those diagnosed with mTBI on the basis of cognitive and clinical symptoms, i.e., the "miserable minority," the cognitive and physical symptoms do not resolve following the first 3 months post-injury. Instead, they persist, and in some cases lead to long-term disability. The explanation given for these chronic symptoms, i.e., postconcussive syndrome, particularly in cases where there is no discernible radiological evidence for brain injury, has led some to posit a psychogenic origin. Such attributions are made all the easier since both posttraumatic stress disorder (PTSD) and depression are frequently co-morbid with mTBI. The challenge is thus to use neuroimaging tools that are sensitive to DAI/TAI, such as diffusion tensor imaging (DTI), in order to detect brain injuries in mTBI. Of note here, recent advances in neuroimaging techniques, such as DTI, make it possible to characterize better extant brain abnormalities in mTBI. These advances may lead to the development of biomarkers of injury, as well as to staging of reorganization and reversal of white matter changes following injury, and to the ability to track and to characterize changes in brain injury over time. Such tools will likely be used in future research to evaluate treatment efficacy, given their enhanced sensitivity to alterations in the brain. In this article we review the incidence of mTBI and the importance of characterizing this patient population using objective radiological measures. Evidence is presented for detecting brain abnormalities in mTBI based on studies that use advanced neuroimaging techniques. Taken together, these findings suggest that more sensitive neuroimaging tools improve the detection of brain abnormalities (i.e., diagnosis) in mTBI. These tools will likely also provide important information relevant to outcome (prognosis), as well as play an important role in longitudinal studies that are needed to understand the dynamic nature of brain injury in mTBI. Additionally, summary tables of MRI and DTI findings are included. We believe that the enhanced sensitivity of newer and more advanced neuroimaging techniques for identifying areas of brain damage in mTBI will be important for documenting the biological basis of postconcussive symptoms, which are likely associated with subtle brain alterations, alterations that have heretofore gone undetected due to the lack of sensitivity of earlier neuroimaging techniques. Nonetheless, it is noteworthy to point out that detecting brain abnormalities in mTBI does not mean that other disorders of a more psychogenic origin are not co-morbid with mTBI and equally important to treat. They arguably are. The controversy of psychogenic versus physiogenic, however, is not productive because the psychogenic view does not carefully consider the limitations of conventional neuroimaging techniques in detecting subtle brain injuries in mTBI, and the physiogenic view does not carefully consider the fact that PTSD and depression, and other co-morbid conditions, may be present in those suffering from mTBI. Finally, we end with a discussion of future directions in research that will lead to the improved care of patients diagnosed with mTBI.
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Affiliation(s)
- M E Shenton
- Clinical Neuroscience Laboratory, Department of Psychiatry, VA Boston Healthcare System, Brockton, MA, USA.
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Van Horn JD, Irimia A, Torgerson CM, Chambers MC, Kikinis R, Toga AW. Mapping connectivity damage in the case of Phineas Gage. PLoS One 2012; 7:e37454. [PMID: 22616011 PMCID: PMC3353935 DOI: 10.1371/journal.pone.0037454] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 04/23/2012] [Indexed: 01/01/2023] Open
Abstract
White matter (WM) mapping of the human brain using neuroimaging techniques has gained considerable interest in the neuroscience community. Using diffusion weighted (DWI) and magnetic resonance imaging (MRI), WM fiber pathways between brain regions may be systematically assessed to make inferences concerning their role in normal brain function, influence on behavior, as well as concerning the consequences of network-level brain damage. In this paper, we investigate the detailed connectomics in a noted example of severe traumatic brain injury (TBI) which has proved important to and controversial in the history of neuroscience. We model the WM damage in the notable case of Phineas P. Gage, in whom a "tamping iron" was accidentally shot through his skull and brain, resulting in profound behavioral changes. The specific effects of this injury on Mr. Gage's WM connectivity have not previously been considered in detail. Using computed tomography (CT) image data of the Gage skull in conjunction with modern anatomical MRI and diffusion imaging data obtained in contemporary right handed male subjects (aged 25-36), we computationally simulate the passage of the iron through the skull on the basis of reported and observed skull fiducial landmarks and assess the extent of cortical gray matter (GM) and WM damage. Specifically, we find that while considerable damage was, indeed, localized to the left frontal cortex, the impact on measures of network connectedness between directly affected and other brain areas was profound, widespread, and a probable contributor to both the reported acute as well as long-term behavioral changes. Yet, while significantly affecting several likely network hubs, damage to Mr. Gage's WM network may not have been more severe than expected from that of a similarly sized "average" brain lesion. These results provide new insight into the remarkable brain injury experienced by this noteworthy patient.
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Affiliation(s)
- John Darrell Van Horn
- Laboratory of Neuro Imaging-LONI, Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America.
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Lin WC, Chou KH, Chen CC, Huang CC, Chen HL, Lu CH, Li SH, Wang YL, Cheng YF, Lin CP. White matter abnormalities correlating with memory and depression in heroin users under methadone maintenance treatment. PLoS One 2012; 7:e33809. [PMID: 22496768 PMCID: PMC3322116 DOI: 10.1371/journal.pone.0033809] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 02/17/2012] [Indexed: 01/07/2023] Open
Abstract
Methadone maintenance treatment (MMT) has elevated rates of co-morbid memory deficit and depression that are associated with higher relapse rates for substance abuse. White matter (WM) disruption in MMT patients have been reported but their impact on these co-morbidities is unknown. This study aimed to investigate changes in WM integrity of MMT subjects using diffusion tensor image (DTI), and their relationship with history of heroin and methadone use in treated opiate-dependent individuals. The association between WM integrity changes from direct group comparisons and the severity of memory deficit and depression was also investigated. Differences in WM integrity between 35 MMT patients and 23 healthy controls were evaluated using DTI with tract-based spatial statistical analysis. Differences in DTI indices correlated with diminished memory function, Beck Depression Inventory, duration of heroin use and MMT, and dose of heroin and methadone administration. Changes in WM integrity were found in several WM regions, including the temporal and frontal lobes, pons, cerebellum, and cingulum bundles. The duration of MMT was associated with declining DTI indices in the superior longitudinal fasciculus and para-hippocampus. MMT patients had more memory and emotional deficits than healthy subjects. Worse scores in both depression and memory functions were associated with altered WM integrity in the superior longitudinal fasciculus, para-hippocampus, and middle cerebellar peduncle in MMT. Patients on MMT also had significant WM differences in the reward circuit and in depression- and memory-associated regions. Correlations among decreased DTI indices, disease severity, and accumulation effects of methadone suggest that WM alterations may be involved in the psychopathology and pathophysiology of co-morbidities in MMT.
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Affiliation(s)
- Wei-Che Lin
- Department of Diagnostic Radiology, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chih Chen
- Department of Psychiatry, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chu-Chung Huang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Internal Medicine, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ya-Ling Wang
- Department of Psychiatry, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu-Fan Cheng
- Department of Diagnostic Radiology, Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ching-Po Lin
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Abstract
This article discusses recent findings on the neurobiology of pediatric depression as well as the interplay between genetic and environmental factors in determining the risk for the disorder. Utilizing data from both animal and human studies, the authors focus on the evolving understanding of the developmental neurobiology of emotional regulation, cognitive function and social behavior as it applies to the risk and clinical course of depression. Treatment implications and directions for future research are also discussed.
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Affiliation(s)
- John M. Weir
- Center for Molecular and Behavioral Neuroscience, Meharry Medical College, Nashville Tennessee
| | - Arthurine Zakama
- Vanderbilt University, Nashville, Tennessee, Nashville Tennessee
| | - Uma Rao
- Center for Molecular and Behavioral Neuroscience, Meharry Medical College, Nashville Tennessee
- Vanderbilt University, Nashville, Tennessee, Nashville Tennessee
- Department of Psychiatry and Behavioral Sciences, Meharry Medical College, Nashville Tennessee
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Shah S, Yallampalli R, Merkley TL, McCauley SR, Bigler ED, MacLeod M, Chu Z, Li X, Troyanskaya M, Hunter JV, Levin HS, Wilde EA. Diffusion tensor imaging and volumetric analysis of the ventral striatum in adults with traumatic brain injury. Brain Inj 2012; 26:201-10. [DOI: 10.3109/02699052.2012.654591] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Seehaus AK, Roebroeck A, Chiry O, Kim DS, Ronen I, Bratzke H, Goebel R, Galuske RAW. Histological validation of DW-MRI tractography in human postmortem tissue. Cereb Cortex 2012; 23:442-50. [PMID: 22345356 DOI: 10.1093/cercor/bhs036] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Despite several previous attempts, histological validation of diffusion-weighted magnetic resonance imaging (DW-MRI)-based tractography as true axonal fiber pathways remains difficult. In the present study, we establish a method to compare histological and tractography data precisely enough for statements on the level of single tractography pathways. To this end, we used carbocyanine dyes to trace connections in human postmortem tissue and aligned them to high-resolution DW-MRI of the same tissue processed within the diffusion tensor imaging (DTI) formalism. We provide robust definitions of sensitivity (true positives) and specificity (true negatives) for DTI tractography and characterize tractography paths in terms of receiver operating characteristics. With sensitivity and specificity rates of approximately 80%, we could show a clear correspondence between histological and inferred tracts. Furthermore, we investigated the effect of fractional anisotropy (FA) thresholds for the tractography and identified FA values between 0.02 and 0.08 as optimal in our study. Last, we validated the course of entire tractography curves to move beyond correctness determination based on pairs of single points on a tract. Thus, histological techniques, in conjunction with alignment and processing tools, may serve as an important validation method of DW-MRI on the level of inferred tractography projections between brain areas.
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Affiliation(s)
- Arne K Seehaus
- Department of Biology, Technische Universität Darmstadt, 64287 Darmstadt, Germany.
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Krishna R, Grinn M, Giordano N, Thirunavukkarasu M, Tadi P, Das S. Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report. J Med Case Rep 2012; 6:66. [PMID: 22339800 PMCID: PMC3299601 DOI: 10.1186/1752-1947-6-66] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 02/16/2012] [Indexed: 11/10/2022] Open
Abstract
Introduction Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques. Case presentation This is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy. Conclusion Minor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.
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Affiliation(s)
- Ranga Krishna
- Medical Clinic of New York, 1513 Voorhies Avenue, Brooklyn, New York 11235, USA.
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Metzler-Baddeley C, O'Sullivan MJ, Bells S, Pasternak O, Jones DK. How and how not to correct for CSF-contamination in diffusion MRI. Neuroimage 2012; 59:1394-403. [PMID: 21924365 DOI: 10.1016/j.neuroimage.2011.08.043] [Citation(s) in RCA: 225] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 07/25/2011] [Accepted: 08/16/2011] [Indexed: 01/09/2023] Open
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Turner RC, Lucke-Wold BP, Robson MJ, Omalu BI, Petraglia AL, Bailes JE. Repetitive traumatic brain injury and development of chronic traumatic encephalopathy: a potential role for biomarkers in diagnosis, prognosis, and treatment? Front Neurol 2012; 3:186. [PMID: 23335911 PMCID: PMC3547169 DOI: 10.3389/fneur.2012.00186] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 12/21/2012] [Indexed: 02/05/2023] Open
Abstract
The diagnosis of chronic traumatic encephalopathy (CTE) upon autopsy in a growing number of athletes and soldiers alike has resulted in increased awareness, by both the scientific/medical and lay communities, of the potential for lasting effects of repetitive traumatic brain injury. While the scientific community has come to better understand the clinical presentation and underlying pathophysiology of CTE, the diagnosis of CTE remains autopsy-based, which prevents adequate monitoring and tracking of the disease. The lack of established biomarkers or imaging modalities for diagnostic and prognostic purposes also prevents the development and implementation of therapeutic protocols. In this work the clinical history and pathologic findings associated with CTE are reviewed, as well as imaging modalities that have demonstrated some promise for future use in the diagnosis and/or tracking of CTE or repetitive brain injury. Biomarkers under investigation are also discussed with particular attention to the timing of release and potential utility in situations of repetitive traumatic brain injury. Further investigation into imaging modalities and biomarker elucidation for the diagnosis of CTE is clearly both needed and warranted.
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Affiliation(s)
- Ryan C. Turner
- Department of Neurosurgery, School of Medicine, West Virginia UniversityMorgantown, WV, USA
- Center for Neuroscience, School of Medicine, West Virginia UniversityMorgantown, WV, USA
- *Correspondence: Ryan C. Turner, Department of Neurosurgery, School of Medicine, West Virginia University, One Medical Center Drive, Suite 4300, Health Sciences Center, PO Box 9183, Morgantown, WV 26506-9183, USA. e-mail:
| | - Brandon P. Lucke-Wold
- Department of Neurosurgery, School of Medicine, West Virginia UniversityMorgantown, WV, USA
- Center for Neuroscience, School of Medicine, West Virginia UniversityMorgantown, WV, USA
| | - Matthew J. Robson
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia UniversityMorgantown, WV, USA
| | - Bennet I. Omalu
- Department of Pathology, University of CaliforniaDavis, CA, USA
| | - Anthony L. Petraglia
- Department of Neurosurgery, University of Rochester Medical CenterRochester, NY, USA
| | - Julian E. Bailes
- Department of Neurosurgery, NorthShore University Health SystemEvanston, IL, USA
- Section of Neurosurgery, Department of Surgery, University of Chicago Medical CenterChicago, IL, USA
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Max JE, Keatley E, Wilde EA, Bigler ED, Schachar RJ, Saunders AE, Ewing-Cobbs L, Chapman SB, Dennis M, Yang TT, Levin HS. Depression in children and adolescents in the first 6 months after traumatic brain injury. Int J Dev Neurosci 2011; 30:239-45. [PMID: 22197971 DOI: 10.1016/j.ijdevneu.2011.12.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Revised: 12/08/2011] [Accepted: 12/09/2011] [Indexed: 11/17/2022] Open
Abstract
The objective was to assess the nature, rate, predictive factors, and neuroimaging correlates of novel (new-onset) depressive disorders, both definite and subclinical, after traumatic brain injury (TBI). Children with TBI from consecutive admissions were enrolled and studied with psychiatric interviews soon after injury (baseline), and again 6 months post-injury. Novel definite/subclinical depressive disorders at 6-month follow up occurred in 11% (n=15) of the children and subsets of children with non-anxious depression (n=9) and anxious depression (n=6) were identified. Novel definite/subclinical depressive disorder was significantly associated with older age at the time of injury, family history of anxiety disorder, left inferior frontal gyrus (IFG) lesions, and right frontal white matter lesions. Non-anxious depressions were associated with older age at injury, left IFG and left temporal pole lesions. Anxious depressions were associated with family history of anxiety disorder, Personality Change due to TBI, right frontal white matter lesions, and left parietal lesions. These findings, which are similar to those reported after adult TBI, identify both similarities and differences in non-anxious and anxious depression following childhood TBI with respect to lesion laterality, genetic factors (in the form of family psychiatric history of anxiety disorder), age at injury, and more generalized affective dysregulation.
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Affiliation(s)
- Jeffrey E Max
- Department of Psychiatry, University of California, San Diego, CA 92123, United States.
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