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Irimia A. Neuroinformatics and Analysis of Traumatic Brain Injury and Related Conditions. Neuroinformatics 2024:10.1007/s12021-024-09691-5. [PMID: 39331248 DOI: 10.1007/s12021-024-09691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024]
Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA.
- Corwin D. Denney Research Center, Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, 90089, USA.
- Department of Quantitative and Computational Biology, Dana & David Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, CA, 90089, USA.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 de Crespigny Park, London, SE5 8AF, UK.
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Alnawmasi MM, Khuu SK. Deficits in the pupillary response associated with abnormal visuospatial attention allocation in mild traumatic brain injury. J Clin Exp Neuropsychol 2023; 45:855-873. [PMID: 38368620 DOI: 10.1080/13803395.2024.2314727] [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] [Received: 02/21/2023] [Accepted: 11/25/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The ability to allocate visual attention is known to be impaired in patients with mild traumatic brain injury (mTBI). In the present study, we investigated a possible neural correlate of this cognitive deficit by examining the pupil response of patients with mTBI whilst performing a modified Posner visual search task. METHOD Two experiments were conducted in which the target location was either not cued (Experiment 1) or cued (Experiment 2). Additionally, in Experiment 2, the type of cue (endogenous vs exogenous cue) and cue validity were treated as independent variables. In both experiments, search efficiency was varied by changing shape similarity between target and distractor patterns. The reaction time required to judge whether the target was present or absent and pupil dilation metrics, particularly the pupil dilation latency (PDL) and amplitude (PDA), were measured. Thirteen patients with chronic mTBI and 21 age-, sex-, and IQ -matched controls participated in the study. RESULTS In Experiment 1, patients with mTBI displayed a similar PDA for both efficient and inefficient search conditions, while control participants had a significantly larger PDA in inefficient search conditions compared to efficient search conditions. As cognitive load is positively correlated with PDA, our findings suggest that mTBI patients were unable to apply more mental effort whilst performing visual search, particularly if the task is difficult when visual search is inefficient. In Experiment 2, when the target location was cued, patients with mTBI displayed no significant pupil dilation response to the target regardless of the efficiency of the search, nor whether the cue was valid or invalid. These results contrasted with control participants, who were additionally sensitive to the validity of the cue in which PDA was smaller for cue-valid conditions than invalid conditions, particularly for efficient search conditions. CONCLUSION Pupillometry provided further evidence of attention allocation deficits following mTBI.
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Affiliation(s)
- Mohammed M Alnawmasi
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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Mahoney SO, Chowdhury NF, Ngo V, Imms P, Irimia A. Mild Traumatic Brain Injury Results in Significant and Lasting Cortical Demyelination. Front Neurol 2022; 13:854396. [PMID: 35812106 PMCID: PMC9262516 DOI: 10.3389/fneur.2022.854396] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Despite contributing to neurocognitive deficits, intracortical demyelination after traumatic brain injury (TBI) is understudied. This study uses magnetic resonance imaging (MRI) to map intracortical myelin and its change in healthy controls and after mild TBI (mTBI). Acute mTBI involves reductions in relative myelin content primarily in lateral occipital regions. Demyelination mapped ~6 months post-injury is significantly more severe than that observed in typical aging (p < 0.05), with temporal, cingulate, and insular regions losing more myelin (30%, 20%, and 16%, respectively) than most other areas, although occipital regions experience 22% less demyelination. Thus, occipital regions may be more susceptible to primary injury, whereas temporal, cingulate and insular regions may be more susceptible to later manifestations of injury sequelae. The spatial profiles of aging- and mTBI-related chronic demyelination overlap substantially; exceptions include primary motor and somatosensory cortices, where myelin is relatively spared post-mTBI. These features resemble those of white matter demyelination and cortical thinning during Alzheimer's disease, whose risk increases after mTBI.
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Affiliation(s)
- Sean O. Mahoney
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Nahian F. Chowdhury
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Van Ngo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Phoebe Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Andrew and Edna Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Andrei Irimia
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Amgalan A, Maher AS, Imms P, Ha MY, Fanelle TA, Irimia A. Functional Connectome Dynamics After Mild Traumatic Brain Injury According to Age and Sex. Front Aging Neurosci 2022; 14:852990. [PMID: 35663576 PMCID: PMC9158471 DOI: 10.3389/fnagi.2022.852990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
Neural and cognitive deficits after mild traumatic brain injury (mTBI) are paralleled by changes in resting state functional correlation (FC) networks that mirror post-traumatic pathophysiology effects on functional outcomes. Using functional magnetic resonance images acquired both acutely and chronically after injury (∼1 week and ∼6 months post-injury, respectively), we map post-traumatic FC changes across 136 participants aged 19-79 (52 females), both within and between the brain's seven canonical FC networks: default mode, dorsal attention, frontoparietal, limbic, somatomotor, ventral attention, and visual. Significant sex-dependent FC changes are identified between (A) visual and limbic, and between (B) default mode and somatomotor networks. These changes are significantly associated with specific functional recovery patterns across all cognitive domains (p < 0.05, corrected). Changes in FC between default mode, somatomotor, and ventral attention networks, on the one hand, and both temporal and occipital regions, on the other hand, differ significantly by age group (p < 0.05, corrected), and are paralleled by significant sex differences in cognitive recovery independently of age at injury (p < 0.05, corrected). Whereas females' networks typically feature both significant (p < 0.036, corrected) and insignificant FC changes, males more often exhibit significant FC decreases between networks (e.g., between dorsal attention and limbic, visual and limbic, default-mode and somatomotor networks, p < 0.0001, corrected), all such changes being accompanied by significantly weaker recovery of cognitive function in males, particularly older ones (p < 0.05, corrected). No significant FC changes were found across 35 healthy controls aged 66-92 (20 females). Thus, male sex and older age at injury are risk factors for significant FC alterations whose patterns underlie post-traumatic cognitive deficits. This is the first study to map, systematically, how mTBI impacts FC between major human functional networks.
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Affiliation(s)
- Anar Amgalan
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Alexander S. Maher
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Phoebe Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Michelle Y. Ha
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Timothy A. Fanelle
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
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Khanmohammadi S, Laurido-Soto O, Eisenman LN, Kummer TT, Ching S. Localizing focal brain injury via EEG spectral variance. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Irimia A, Maher AS, Chaudhari NN, Chowdhury NF, Jacobs EB. Acute cognitive deficits after traumatic brain injury predict Alzheimer's disease-like degradation of the human default mode network. GeroScience 2020; 42:1411-1429. [PMID: 32743786 DOI: 10.1007/s11357-020-00245-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023] Open
Abstract
Traumatic brain injury (TBI) and Alzheimer's disease (AD) are prominent neurological conditions whose neural and cognitive commonalities are poorly understood. The extent of TBI-related neurophysiological abnormalities has been hypothesized to reflect AD-like neurodegeneration because TBI can increase vulnerability to AD. However, it remains challenging to prognosticate AD risk partly because the functional relationship between acute posttraumatic sequelae and chronic AD-like degradation remains elusive. Here, functional magnetic resonance imaging (fMRI), network theory, and machine learning (ML) are leveraged to study the extent to which geriatric mild TBI (mTBI) can lead to AD-like alteration of resting-state activity in the default mode network (DMN). This network is found to contain modules whose extent of AD-like, posttraumatic degradation can be accurately prognosticated based on the acute cognitive deficits of geriatric mTBI patients with cerebral microbleeds. Aside from establishing a predictive physiological association between geriatric mTBI, cognitive impairment, and AD-like functional degradation, these findings advance the goal of acutely forecasting mTBI patients' chronic deviations from normality along AD-like functional trajectories. The association of geriatric mTBI with AD-like changes in functional brain connectivity as early as ~6 months post-injury carries substantial implications for public health because TBI has relatively high prevalence in the elderly.
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Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA. .,Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
| | - Alexander S Maher
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Nikhil N Chaudhari
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Nahian F Chowdhury
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Elliot B Jacobs
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Calvillo M, Irimia A. Neuroimaging and Psychometric Assessment of Mild Cognitive Impairment After Traumatic Brain Injury. Front Psychol 2020; 11:1423. [PMID: 32733322 PMCID: PMC7358255 DOI: 10.3389/fpsyg.2020.01423] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) can be serious partly due to the challenges of assessing and treating its neurocognitive and affective sequelae. The effects of a single TBI may persist for years and can limit patients’ activities due to somatic complaints (headaches, vertigo, sleep disturbances, nausea, light or sound sensitivity), affective sequelae (post-traumatic depressive symptoms, anxiety, irritability, emotional instability) and mild cognitive impairment (MCI, including social cognition disturbances, attention deficits, information processing speed decreases, memory degradation and executive dysfunction). Despite a growing amount of research, study comparison and knowledge synthesis in this field are problematic due to TBI heterogeneity and factors like injury mechanism, age at or time since injury. The relative lack of standardization in neuropsychological assessment strategies for quantifying sequelae adds to these challenges, and the proper administration of neuropsychological testing relative to the relationship between TBI, MCI and neuroimaging has not been reviewed satisfactorily. Social cognition impairments after TBI (e.g., disturbed emotion recognition, theory of mind impairment, altered self-awareness) and their neuroimaging correlates have not been explored thoroughly. This review consolidates recent findings on the cognitive and affective consequences of TBI in relation to neuropsychological testing strategies, to neurobiological and neuroimaging correlates, and to patient age at and assessment time after injury. All cognitive domains recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are reviewed, including social cognition, complex attention, learning and memory, executive function, language and perceptual-motor function. Affect and effort are additionally discussed owing to their relationships to cognition and to their potentially confounding effects. Our findings highlight non-negligible cognitive and affective impairments following TBI, their gravity often increasing with injury severity. Future research should study (A) language, executive and perceptual-motor function (whose evolution post-TBI remains under-explored), (B) the effects of age at and time since injury, and (C) cognitive impairment severity as a function of injury severity. Such efforts should aim to develop and standardize batteries for cognitive subdomains—rather than only domains—with high ecological validity. Additionally, they should utilize multivariate techniques like factor analysis and related methods to clarify which cognitive subdomains or components are indeed measured by standardized tests.
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Affiliation(s)
- Maria Calvillo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.,Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
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Influence of Patient-Specific Head Modeling on EEG Source Imaging. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2020; 2020:5076865. [PMID: 32328152 PMCID: PMC7157795 DOI: 10.1155/2020/5076865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/11/2020] [Accepted: 02/21/2020] [Indexed: 11/26/2022]
Abstract
Electromagnetic source imaging (ESI) techniques have become one of the most common alternatives for understanding cognitive processes in the human brain and for guiding possible therapies for neurological diseases. However, ESI accuracy strongly depends on the forward model capabilities to accurately describe the subject's head anatomy from the available structural data. Attempting to improve the ESI performance, we enhance the brain structure model within the individual-defined forward problem formulation, combining the head geometry complexity of the modeled tissue compartments and the prior knowledge of the brain tissue morphology. We validate the proposed methodology using 25 subjects, from which a set of magnetic-resonance imaging scans is acquired, extracting the anatomical priors and an electroencephalography signal set needed for validating the ESI scenarios. Obtained results confirm that incorporating patient-specific head models enhances the performed accuracy and improves the localization of focal and deep sources.
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9
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Irimia A, Wei S, Lu N, Moore CM, Kennedy DN. Mobile Monitoring of Traumatic Brain Injury in Older Adults: Challenges and Opportunities. Neuroinformatics 2019; 15:227-230. [PMID: 28748392 DOI: 10.1007/s12021-017-9335-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA.
| | - Susan Wei
- Division of Biostatistics, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Nanshu Lu
- Department of Aerospace Engineering and Engineering Mechanics, Cockrell School of Engineering, University of Texas, 210 East 24th Street, Austin, TX, 78705, USA
| | - Constance M Moore
- Center for Comparative Neuroimaging & Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Biotech One, Worcester, MA, 01605, USA
| | - David N Kennedy
- Eunice Kennedy Shriver Center & Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01605, USA
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Cuartas Morales E, Acosta-Medina CD, Castellanos-Dominguez G, Mantini D. A Finite-Difference Solution for the EEG Forward Problem in Inhomogeneous Anisotropic Media. Brain Topogr 2018; 32:229-239. [PMID: 30341590 DOI: 10.1007/s10548-018-0683-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/08/2018] [Indexed: 11/24/2022]
Abstract
Accurate source localization of electroencephalographic (EEG) signals requires detailed information about the geometry and physical properties of head tissues. Indeed, these strongly influence the propagation of neural activity from the brain to the sensors. Finite difference methods (FDMs) are head modelling approaches relying on volumetric data information, which can be directly obtained using magnetic resonance (MR) imaging. The specific goal of this study is to develop a computationally efficient FDM solution that can flexibly integrate voxel-wise conductivity and anisotropy information. Given the high computational complexity of FDMs, we pay particular attention to attain a very low numerical error, as evaluated using exact analytical solutions for spherical volume conductor models. We then demonstrate the computational efficiency of our FDM numerical solver, by comparing it with alternative solutions. Finally, we apply the developed head modelling tool to high-resolution MR images from a real experimental subject, to demonstrate the potential added value of incorporating detailed voxel-wise conductivity and anisotropy information. Our results clearly show that the developed FDM can contribute to a more precise head modelling, and therefore to a more reliable use of EEG as a brain imaging tool.
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Affiliation(s)
- Ernesto Cuartas Morales
- Signal Processing and Recognition Group, Faculty of Engineering, Universidad Nacional de Colombia, Km 9 Vía al Aeropuerto la Nubia, Manizales, 170001, Colombia
| | - Carlos D Acosta-Medina
- Signal Processing and Recognition Group, Faculty of Engineering, Universidad Nacional de Colombia, Km 9 Vía al Aeropuerto la Nubia, Manizales, 170001, Colombia
| | - German Castellanos-Dominguez
- Signal Processing and Recognition Group, Faculty of Engineering, Universidad Nacional de Colombia, Km 9 Vía al Aeropuerto la Nubia, Manizales, 170001, Colombia
| | - Dante Mantini
- Research Center for Motor Control and Neuroplasticity, KU Leuven, Tervuursevest 101, 3001, Leuven, Belgium. .,Functional Neuroimaging Laboratory, IRCCS San Camillo Hospital Foundation, 30126, Venice, Italy.
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11
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Irimia A, Van Horn JD, Vespa PM. Cerebral microhemorrhages due to traumatic brain injury and their effects on the aging human brain. Neurobiol Aging 2018; 66:158-164. [PMID: 29579686 PMCID: PMC5924627 DOI: 10.1016/j.neurobiolaging.2018.02.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 02/24/2018] [Accepted: 02/27/2018] [Indexed: 01/08/2023]
Abstract
Although cerebral microbleeds (CMBs) are frequently associated with traumatic brain injury (TBI), their effects on clinical outcome after TBI remain controversial and poorly understood, particularly in older adults. Here we (1) highlight major challenges and opportunities associated with studying the effects of TBI-mediated CMBs; (2) review the evidence on their potential effects on cognitive and neural outcome as a function of age at injury; and (3) suggest priorities for future research on understanding the clinical implications of CMBs. Although TBI-mediated CMBs are likely distinct from those due to cerebral amyloid angiopathy or other neurodegenerative diseases, the effects of these 2 CMB types on brain function may share common features. Furthermore, in older TBI victims, the incidence of TBI-mediated CMBs may approximate that of cerebral amyloid angiopathy-related CMBs, and thus warrants detailed study. Because the alterations effected by CMBs on brain structure and function are both unique and age-dependent, it seems likely that novel, age-tailored therapeutic approaches are necessary for the adequate clinical interpretation and treatment of these ubiquitous and underappreciated TBI sequelae.
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Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, USC Leonard Davis School of Gerontology, University of Southern California, Los Angeles CA, USA.
| | - John D Van Horn
- USC Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Paul M Vespa
- Departments of Neurosurgery and Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Chen JH, Xu YN, Ji M, Li PP, Yang LK, Wang YH. Multimodal monitoring combined with hypothermia for the management of severe traumatic brain injury: A case report. Exp Ther Med 2018; 15:4253-4258. [PMID: 29731820 PMCID: PMC5921228 DOI: 10.3892/etm.2018.5994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 02/02/2018] [Indexed: 12/17/2022] Open
Abstract
Traumatic brain injury (TBI) is a prominent public health issue that has a significant negative impact on patients and their family members. It is the leading cause of mortality and disability among young (below 50 years old) individuals. Intracranial hypertension (ICH) remains the single most difficult therapeutic challenge for the management of severe TBI. Therapeutic hypothermia may reduce intracranial hypertension and improve patient outcomes; however, the use of hypothermia is controversial. It has been reported that therapeutic hypothermia elicits no therapeutic benefit for patients with TBI. The present study presents two patients with severe(s) TBI who were admitted to 101st Hospital of the People's Liberation Army Between June 2017 to October 2017. Multimodal brain monitoring measurements of intracranial pressure, cerebral perfusion pressure (CPP) and bispectral index (BIS) were used during assisted hypothermia for management of patients with sTBI. The duration, degree of hypothermia treatment and speed of re-warming were assessed.
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Affiliation(s)
- Jun-Hui Chen
- Department of Neurosurgery, 101st Hospital of The People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Yi-Nong Xu
- Department of Neurosurgery, Taizhou No. 4 Hospital, Taizhou, Jiangsu 225300, P.R. China
| | - Meng Ji
- Department of Neurosurgery, Taizhou No. 4 Hospital, Taizhou, Jiangsu 225300, P.R. China
| | - Pei-Pei Li
- Department of Neurosurgery, 101st Hospital of The People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Li-Kun Yang
- Department of Neurosurgery, 101st Hospital of The People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Yu-Hai Wang
- Department of Neurosurgery, 101st Hospital of The People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
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Influence of Realistic Head Modeling on EEG Forward Problem. Brain Inform 2018. [DOI: 10.1007/978-3-030-05587-5_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jang H, Huang S, Hammer DX, Wang L, Rafi H, Ye M, Welle CG, Fisher JAN. Alterations in neurovascular coupling following acute traumatic brain injury. NEUROPHOTONICS 2017; 4:045007. [PMID: 29296629 PMCID: PMC5741992 DOI: 10.1117/1.nph.4.4.045007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
Following acute traumatic brain injury (TBI), timely transport to a hospital can significantly improve the prognosis for recovery. There is, however, a dearth of quantitative biomarkers for brain injury that can be rapidly acquired and interpreted in active, field environments in which TBIs are frequently incurred. We explored potential functional indicators for TBI that can be noninvasively obtained through portable detection modalities, namely optical and electrophysiological approaches. By combining diffuse correlation spectroscopy with colocalized electrophysiological measurements in a mouse model of TBI, we observed concomitant alterations in sensory-evoked cerebral blood flow (CBF) and electrical potentials following controlled cortical impact. Injury acutely reduced the peak amplitude of both electrophysiological and CBF responses, which mostly recovered to baseline values within 30 min, and intertrial variability for these parameters was also acutely altered. Notably, the postinjury dynamics of the CBF overshoot and undershoot amplitudes differed significantly; whereas the amplitude of the initial peak of stimulus-evoked CBF recovered relatively rapidly, the ensuing undershoot did not appear to recover within 30 min of injury. Additionally, acute injury induced apparent low-frequency oscillatory behavior in CBF ([Formula: see text]). Histological assessment indicated that these physiological alterations were not associated with any major, persisting anatomical changes. Several time-domain features of the blood flow and electrophysiological responses showed strong correlations in recovery kinetics. Overall, our results reveal an array of stereotyped, injury-induced alterations in electrophysiological and hemodynamic responses that can be rapidly obtained using a combination of portable detection techniques.
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Affiliation(s)
- Hyounguk Jang
- New York Medical College, Department of Physiology, Valhalla, New York, United States
- U.S. Food and Drug Administration, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Stanley Huang
- U.S. Food and Drug Administration, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Daniel X. Hammer
- U.S. Food and Drug Administration, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Lin Wang
- New York Medical College, Department of Physiology, Valhalla, New York, United States
| | - Harmain Rafi
- New York Medical College, Department of Physiology, Valhalla, New York, United States
| | - Meijun Ye
- U.S. Food and Drug Administration, Division of Biomedical Physics, Silver Spring, Maryland, United States
| | - Cristin G. Welle
- U.S. Food and Drug Administration, Division of Biomedical Physics, Silver Spring, Maryland, United States
- University of Colorado Denver, Departments of Neurosurgery and Bioengineering, Aurora, Colorado, United States
| | - Jonathan A. N. Fisher
- New York Medical College, Department of Physiology, Valhalla, New York, United States
- U.S. Food and Drug Administration, Division of Biomedical Physics, Silver Spring, Maryland, United States
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Bedside functional brain imaging in critically-ill children using high-density EEG source modeling and multi-modal sensory stimulation. NEUROIMAGE-CLINICAL 2016; 12:198-211. [PMID: 27453817 PMCID: PMC4942736 DOI: 10.1016/j.nicl.2016.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 06/24/2016] [Accepted: 06/30/2016] [Indexed: 12/03/2022]
Abstract
Acute brain injury is a common cause of death and critical illness in children and young adults. Fundamental management focuses on early characterization of the extent of injury and optimizing recovery by preventing secondary damage during the days following the primary injury. Currently, bedside technology for measuring neurological function is mainly limited to using electroencephalography (EEG) for detection of seizures and encephalopathic features, and evoked potentials. We present a proof of concept study in patients with acute brain injury in the intensive care setting, featuring a bedside functional imaging set-up designed to map cortical brain activation patterns by combining high density EEG recordings, multi-modal sensory stimulation (auditory, visual, and somatosensory), and EEG source modeling. Use of source-modeling allows for examination of spatiotemporal activation patterns at the cortical region level as opposed to the traditional scalp potential maps. The application of this system in both healthy and brain-injured participants is demonstrated with modality-specific source-reconstructed cortical activation patterns. By combining stimulation obtained with different modalities, most of the cortical surface can be monitored for changes in functional activation without having to physically transport the subject to an imaging suite. The results in patients in an intensive care setting with anatomically well-defined brain lesions suggest a topographic association between their injuries and activation patterns. Moreover, we report the reproducible application of a protocol examining a higher-level cortical processing with an auditory oddball paradigm involving presentation of the patient's own name. This study reports the first successful application of a bedside functional brain mapping tool in the intensive care setting. This application has the potential to provide clinicians with an additional dimension of information to manage critically-ill children and adults, and potentially patients not suited for magnetic resonance imaging technologies. We demonstrate the use of high-density EEG combined with multi-modality sensory stimulation and source modeling to generate functional brain activation maps. This is the first demonstration of source-level monitoring of functional brain responses in multiple modalities in children with acute brain injuries in ICU. The set-up is designed to examine higher-level cortical processing by using an auditory oddball paradigm involving the subject’s own name.
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The biological cost of the depression of consciousness. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rcae.2014.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rapp PE, Keyser DO, Albano A, Hernandez R, Gibson DB, Zambon RA, Hairston WD, Hughes JD, Krystal A, Nichols AS. Traumatic brain injury detection using electrophysiological methods. Front Hum Neurosci 2015; 9:11. [PMID: 25698950 PMCID: PMC4316720 DOI: 10.3389/fnhum.2015.00011] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 01/07/2015] [Indexed: 11/20/2022] Open
Abstract
Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI). This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: (1) Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. (2) ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are non-disclosing. (3) The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including non-linear dynamical analysis, complexity measures, analysis of causal interactions, graph theory, and information dynamics. (4) Reports of high specificity in qEEG evaluations of TBI must be interpreted with care. High specificities have been reported in carefully constructed clinical studies in which healthy controls were compared against a carefully selected TBI population. The published literature indicates, however, that similar abnormalities in qEEG measures are observed in other neuropsychiatric disorders. While it may be possible to distinguish a clinical patient from a healthy control participant with this technology, these measures are unlikely to discriminate between, for example, major depressive disorder, bipolar disorder, or TBI. The specificities observed in these clinical studies may well be lost in real world clinical practice. (5) The absence of specificity does not preclude clinical utility. The possibility of use as a longitudinal measure of treatment response remains. However, efficacy as a longitudinal clinical measure does require acceptable test-retest reliability. To date, very few test-retest reliability studies have been published with qEEG data obtained from TBI patients or from healthy controls. This is a particular concern because high variability is a known characteristic of the injured central nervous system.
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Affiliation(s)
- Paul E. Rapp
- Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, USA
| | - David O. Keyser
- Uniformed Services University of the Health Sciences School of Medicine, Bethesda, MD, USA
| | | | - Rene Hernandez
- US Navy Bureau of Medicine and Surgery, Frederick, MD, USA
| | | | | | - W. David Hairston
- U. S. Army Research Laboratory, Aberdeen Proving Ground, Aberdeen, MD, USA
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The biological cost of the depression of consciousness☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1097/01819236-201543020-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Irimia A, Van Horn JD. Epileptogenic focus localization in treatment-resistant post-traumatic epilepsy. J Clin Neurosci 2014; 22:627-31. [PMID: 25542591 DOI: 10.1016/j.jocn.2014.09.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/16/2014] [Accepted: 09/21/2014] [Indexed: 11/15/2022]
Abstract
Pharmacologically intractable post-traumatic epilepsy (PTE) is a major clinical challenge for patients with penetrating traumatic brain injury, where the risk for this condition remains very high even decades after injury. Although over 20 anti-epileptic drugs (AED) are in common use today, approximately one-third of epilepsy patients have drug-refractory seizures and even more have AED-related adverse effects which compromise life quality. Simultaneously, there have been repeated recommendations by radiologists and neuroimaging experts to incorporate localization based on electroencephalography (EEG) into the process of clinical decision making regarding PTE patients. Nevertheless, thus far, little progress has been accomplished towards the use of EEG as a reliable tool for locating epileptogenic foci prior to surgical resection. In this review, we discuss the epidemiology of pharmacologically resistant PTE, address the need for effective anti-epileptogenic treatments, and highlight recent progress in the development of noninvasive methods for the accurate localization of PTE foci for the purpose of neurosurgical intervention. These trends indicate the current emergence of promising methodologies for the noninvasive study of post-traumatic epileptogenesis and for the improved neurosurgical planning of epileptic foci resection.
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Affiliation(s)
- Andrei Irimia
- The Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, 2001 North Soto Street, SSB1-102, Los Angeles, CA 90032, USA
| | - John Darrell Van Horn
- The Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, 2001 North Soto Street, SSB1-102, Los Angeles, CA 90032, USA.
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Li Y, Liu XP, Ling XH, Li JQ, Yang WW, Zhang DK, Li LH, Yang Y. Mapping brain injury with symmetrical-channels' EEG signal analysis--a pilot study. Sci Rep 2014; 4:5023. [PMID: 24846704 PMCID: PMC4028679 DOI: 10.1038/srep05023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 05/02/2014] [Indexed: 11/09/2022] Open
Abstract
A technique for detecting brain injury at the bedside has great clinical value, but conventional imaging techniques (such as computed tomography [CT] and magnetic resonance imaging) are impractical. In this study, a novel method–the symmetrical channel electroencephalogram (EEG) signal analysis–was developed for this purpose. The study population consisted of 45 traumatic brain injury patients and 10 healthy controls. EEG signals in resting and stimulus states were acquired, and approximate entropy (ApEn) and slow-wave coefficient were extracted to calculate the ratio values of ApEn and SWC for injured and uninjured areas. Statistical analyses showed that the ratio values for both ApEn and SWC between injured and uninjured brain areas differed significantly (P < 0.05) for both resting and name call stimulus states. A set of criteria (range of ratio values) to determine whether a brain area is injured or uninjured was proposed and its reliability was verified by statistical analyses and CT images.
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Affiliation(s)
- Yi Li
- 1] College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China [2]
| | - Xiao-ping Liu
- 1] College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China [2]
| | - Xian-hong Ling
- College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China
| | - Jing-qi Li
- Wu jing Hospital, Rehabilitation Center, Hangzhou Zhejiang 31400, China
| | - Wen-wei Yang
- College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China
| | - Dan-ke Zhang
- College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China
| | - Li-hua Li
- College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China
| | - Yong Yang
- College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou Zhejiang 310018, China
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Goh SYM, Irimia A, Torgerson CM, Horn JDV. Neuroinformatics challenges to the structural, connectomic, functional and electrophysiological multimodal imaging of human traumatic brain injury. Front Neuroinform 2014; 8:19. [PMID: 24616696 PMCID: PMC3935464 DOI: 10.3389/fninf.2014.00019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 02/11/2014] [Indexed: 01/14/2023] Open
Abstract
Throughout the past few decades, the ability to treat and rehabilitate traumatic brain injury (TBI) patients has become critically reliant upon the use of neuroimaging to acquire adequate knowledge of injury-related effects upon brain function and recovery. As a result, the need for TBI neuroimaging analysis methods has increased in recent years due to the recognition that spatiotemporal computational analyses of TBI evolution are useful for capturing the effects of TBI dynamics. At the same time, however, the advent of such methods has brought about the need to analyze, manage, and integrate TBI neuroimaging data using informatically inspired approaches which can take full advantage of their large dimensionality and informational complexity. Given this perspective, we here discuss the neuroinformatics challenges for TBI neuroimaging analysis in the context of structural, connectivity, and functional paradigms. Within each of these, the availability of a wide range of neuroimaging modalities can be leveraged to fully understand the heterogeneity of TBI pathology; consequently, large-scale computer hardware resources and next-generation processing software are often required for efficient data storage, management, and analysis of TBI neuroimaging data. However, each of these paradigms poses challenges in the context of informatics such that the ability to address them is critical for augmenting current capabilities to perform neuroimaging analysis of TBI and to improve therapeutic efficacy.
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Affiliation(s)
- S Y Matthew Goh
- Department of Neurology, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - Andrei Irimia
- Department of Neurology, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - Carinna M Torgerson
- Department of Neurology, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - John D Van Horn
- Department of Neurology, Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
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