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Everson CA, Szabo A, Plyer C, Hammeke TA, Stemper BD, Budde MD. Subclinical brain manifestations of repeated mild traumatic brain injury are changed by chronic exposure to sleep loss, caffeine, and sleep aids. Exp Neurol 2024; 381:114928. [PMID: 39168169 DOI: 10.1016/j.expneurol.2024.114928] [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: 04/19/2024] [Revised: 07/30/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION After mild traumatic brain injury (mTBI), the brain is labile for weeks and months and vulnerable to repeated concussions. During this time, patients are exposed to everyday circumstances that, in themselves, affect brain metabolism and blood flow and neural processing. How commonplace activities interact with the injured brain is unknown. The present study in an animal model investigated the extent to which three commonly experienced exposures-daily caffeine usage, chronic sleep loss, and chronic sleep aid medication-affect the injured brain in the chronic phase. METHODS Subclinical trauma by repeated mTBIs was produced by our head rotational acceleration injury model, which causes brain injury consistent with the mechanism of concussion in humans. Forty-eight hours after a third mTBI, chronic administrations of caffeine, sleep restriction, or zolpidem (sedative hypnotic) began and were continued for 70 days. On Days 30 and 60 post injury, resting state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) were performed. RESULTS Chronic caffeine, sleep restriction, and zolpidem each changed the subclinical brain characteristics of mTBI at both 30 and 60 days post injury, detected by different MRI modalities. Each treatment caused microstructural alterations in DTI metrics in the insular cortex and retrosplenial cortex compared with mTBI, but also uniquely affected other gray and white matter regions. Zolpidem administration affected the largest number of individual structures in mTBI at both 30 and 60 days, and not necessarily toward normalization (sham treatment). Chronic sleep restriction changed local functional connectivity at 30 days in diametrical opposition to chronic caffeine ingestion, and both treatment outcomes were different from sham, mTBI-only and zolpidem comparisons. The results indicate that commonly encountered exposures modify subclinical brain activity and structure long after healing is expected to be complete. CONCLUSIONS Changes in activity and structure detected by fMRI are widely understood to reflect changes in the functions of the affected region which conceivably underlie mTBI neuropathology and symptomatology in the chronic phase after injury.
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Affiliation(s)
- Carol A Everson
- Department of Medicine (Endocrinology and Molecular Medicine) and Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Aniko Szabo
- Division of Biostatistics, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA,.
| | - Cade Plyer
- Neurology Residency Program, Department of Neurology, University of Iowa Hospitals and Clinics, Iowa, USA.
| | - Thomas A Hammeke
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian D Stemper
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA; Neuroscience Research, Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Matthew D Budde
- Neuroscience Research, Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
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Hobson BA, Rowland DJ, Dou Y, Saito N, Harmany ZT, Bruun DA, Harvey DJ, Chaudhari AJ, Garbow JR, Lein PJ. A longitudinal MRI and TSPO PET-based investigation of brain region-specific neuroprotection by diazepam versus midazolam following organophosphate-induced seizures. Neuropharmacology 2024; 251:109918. [PMID: 38527652 PMCID: PMC11250911 DOI: 10.1016/j.neuropharm.2024.109918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
Acute poisoning with organophosphorus cholinesterase inhibitors (OPs), such as OP nerve agents and pesticides, can cause life threatening cholinergic crisis and status epilepticus (SE). Survivors often experience significant morbidity, including brain injury, acquired epilepsy, and cognitive deficits. Current medical countermeasures for acute OP poisoning include a benzodiazepine to mitigate seizures. Diazepam was long the benzodiazepine included in autoinjectors used to treat OP-induced seizures, but it is now being replaced in many guidelines by midazolam, which terminates seizures more quickly, particularly when administered intramuscularly. While a direct correlation between seizure duration and the extent of brain injury has been widely reported, there are limited data comparing the neuroprotective efficacy of diazepam versus midazolam following acute OP intoxication. To address this data gap, we used non-invasive imaging techniques to longitudinally quantify neuropathology in a rat model of acute intoxication with the OP diisopropylfluorophosphate (DFP) with and without post-exposure intervention with diazepam or midazolam. Magnetic resonance imaging (MRI) was used to monitor neuropathology and brain atrophy, while positron emission tomography (PET) with a radiotracer targeting translocator protein (TSPO) was utilized to assess neuroinflammation. Animals were scanned at 3, 7, 28, 65, 91, and 168 days post-DFP and imaging metrics were quantitated for the hippocampus, amygdala, piriform cortex, thalamus, cerebral cortex and lateral ventricles. In the DFP-intoxicated rat, neuroinflammation persisted for the duration of the study coincident with progressive atrophy and ongoing tissue remodeling. Benzodiazepines attenuated neuropathology in a region-dependent manner, but neither benzodiazepine was effective in attenuating long-term neuroinflammation as detected by TSPO PET. Diffusion MRI and TSPO PET metrics were highly correlated with seizure severity, and early MRI and PET metrics were positively correlated with long-term brain atrophy. Collectively, these results suggest that anti-seizure therapy alone is insufficient to prevent long-lasting neuroinflammation and tissue remodeling.
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Affiliation(s)
- Brad A Hobson
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA; Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA.
| | - Douglas J Rowland
- Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA.
| | - Yimeng Dou
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
| | - Naomi Saito
- Department of Public Health Sciences, University of California, Davis, School of Medicine, California 95616, USA.
| | - Zachary T Harmany
- Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA.
| | - Donald A Bruun
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California, Davis, School of Medicine, California 95616, USA.
| | - Abhijit J Chaudhari
- Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA; Department of Radiology, University of California, Davis, School of Medicine, California 95817, USA.
| | - Joel R Garbow
- Biomedical Magnetic Resonance Center, Mallinckrodt Institute of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, 63110, USA.
| | - Pamela J Lein
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
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Talbott JF, Shah V, Ye AQ. Diffusion Imaging of the Spinal Cord: Clinical Applications. Radiol Clin North Am 2024; 62:273-285. [PMID: 38272620 DOI: 10.1016/j.rcl.2023.10.002] [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: 01/27/2024]
Abstract
Spinal cord pathologic condition often presents as a neurologic emergency where timely and accurate diagnosis is critical to expedite appropriate treatment and minimize severe morbidity and even mortality. MR imaging is the gold standard imaging technique for diagnosing patients with suspected spinal cord pathologic condition. This review will focus on the basic principles of diffusion imaging and how spinal anatomy presents technical challenges to its application. Both the promises and shortcomings of spinal diffusion imaging will then be explored in the context of several clinical spinal cord pathologies for which diffusion has been evaluated.
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Affiliation(s)
- Jason F Talbott
- Department of Radiology and Biomedical Imaging, Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, Room 1X57, San Francisco, CA 94110, USA; Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital.
| | - Vinil Shah
- Department of Radiology and Biomedical Imaging, Neuroradiology Division, University of California San Francisco, 505 Parnassus Avenue, #M-391, San Francisco, CA 94143, USA
| | - Allen Q Ye
- Department of Radiology and Biomedical Imaging, Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Avenue, Room 1X57, San Francisco, CA 94110, USA; Department of Radiology and Biomedical Imaging, Neuroradiology Division, University of California San Francisco, 505 Parnassus Avenue, #M-391, San Francisco, CA 94143, USA
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Everson CA, Szabo A, Plyer C, Hammeke TA, Stemper BD, Budde MD. Sleep loss, caffeine, sleep aids and sedation modify brain abnormalities of mild traumatic brain injury. Exp Neurol 2024; 372:114620. [PMID: 38029810 DOI: 10.1016/j.expneurol.2023.114620] [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: 08/23/2023] [Revised: 11/06/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Abstract
Little evidence exists about how mild traumatic brain injury (mTBI) is affected by commonly encountered exposures of sleep loss, sleep aids, and caffeine that might be potential therapeutic opportunities. In addition, while propofol sedation is administered in severe TBI, its potential utility in mild TBI is unclear. Each of these exposures is known to have pronounced effects on cerebral metabolism and blood flow and neurochemistry. We hypothesized that they each interact with cerebral metabolic dynamics post-injury and change the subclinical characteristics of mTBI. MTBI in rats was produced by head rotational acceleration injury that mimics the biomechanics of human mTBI. Three mTBIs spaced 48 h apart were used to increase the likelihood that vulnerabilities induced by repeated mTBI would be manifested without clinically relevant structural damage. After the third mTBI, rats were immediately sleep deprived or administered caffeine or suvorexant (an orexin antagonist and sleep aid) for the next 24 h or administered propofol for 5 h. Resting state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) were performed 24 h after the third mTBI and again after 30 days to determine changes to the brain mTBI phenotype. Multi-modal analyses on brain regions of interest included measures of functional connectivity and regional homogeneity from rs-fMRI, and mean diffusivity (MD) and fractional anisotropy (FA) from DTI. Each intervention changed the mTBI profile of subclinical effects that presumably underlie healing, compensation, damage, and plasticity. Sleep loss during the acute post-injury period resulted in dramatic changes to functional connectivity. Caffeine, propofol sedation and suvorexant were especially noteworthy for differential effects on microstructure in gray and white matter regions after mTBI. The present results indicate that commonplace exposures and short-term sedation alter the subclinical manifestations of repeated mTBI and therefore likely play roles in symptomatology and vulnerability to damage by repeated mTBI.
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Affiliation(s)
- Carol A Everson
- Department of Medicine (Endocrinology and Molecular Medicine) and Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Aniko Szabo
- Division of Biostatistics, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Cade Plyer
- Neurology Residency Program, Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | - Thomas A Hammeke
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian D Stemper
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA; Neuroscience Research, Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA.
| | - Mathew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
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Savitz J, Goeckner BD, Ford BN, Kent Teague T, Zheng H, Harezlak J, Mannix R, Tugan Muftuler L, Brett BL, McCrea MA, Meier TB. The effects of cytomegalovirus on brain structure following sport-related concussion. Brain 2023; 146:4262-4273. [PMID: 37070698 PMCID: PMC10545519 DOI: 10.1093/brain/awad126] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 04/19/2023] Open
Abstract
The neurotrophic herpes virus cytomegalovirus is a known cause of neuropathology in utero and in immunocompromised populations. Cytomegalovirus is reactivated by stress and inflammation, possibly explaining the emerging evidence linking it to subtle brain changes in the context of more minor disturbances of immune function. Even mild forms of traumatic brain injury, including sport-related concussion, are major physiological stressors that produce neuroinflammation. In theory, concussion could predispose to the reactivation of cytomegalovirus and amplify the effects of physical injury on brain structure. However, to our knowledge this hypothesis remains untested. This study evaluated the effect of cytomegalovirus serostatus on white and grey matter structure in a prospective study of athletes with concussion and matched contact-sport controls. Athletes who sustained concussion (n = 88) completed MRI at 1, 8, 15 and 45 days post-injury; matched uninjured athletes (n = 73) completed similar visits. Cytomegalovirus serostatus was determined by measuring serum IgG antibodies (n = 30 concussed athletes and n = 21 controls were seropositive). Inverse probability of treatment weighting was used to adjust for confounding factors between athletes with and without cytomegalovirus. White matter microstructure was assessed using diffusion kurtosis imaging metrics in regions previously shown to be sensitive to concussion. T1-weighted images were used to quantify mean cortical thickness and total surface area. Concussion-related symptoms, psychological distress, and serum concentration of C-reactive protein at 1 day post-injury were included as exploratory outcomes. Planned contrasts compared the effects of cytomegalovirus seropositivity in athletes with concussion and controls, separately. There was a significant effect of cytomegalovirus on axial and radial kurtosis in athletes with concussion but not controls. Cytomegalovirus positive athletes with concussion showed greater axial (P = 0.007, d = 0.44) and radial (P = 0.010, d = 0.41) kurtosis than cytomegalovirus negative athletes with concussion. Similarly, there was a significant association of cytomegalovirus with cortical thickness in athletes with concussion but not controls. Cytomegalovirus positive athletes with concussion had reduced mean cortical thickness of the right hemisphere (P = 0.009, d = 0.42) compared with cytomegalovirus negative athletes with concussion and showed a similar trend for the left hemisphere (P = 0.036, d = 0.33). There was no significant effect of cytomegalovirus on kurtosis fractional anisotropy, surface area, symptoms and C-reactive protein. The results raise the possibility that cytomegalovirus infection contributes to structural brain abnormalities in the aftermath of concussion perhaps via an amplification of concussion-associated neuroinflammation. More work is needed to identify the biological pathways underlying this process and to clarify the clinical relevance of this putative viral effect.
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Affiliation(s)
- Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK 74119, USA
| | - Bryna D Goeckner
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Bart N Ford
- Department of Pharmacology and Physiology, Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA
| | - T Kent Teague
- Department of Psychiatry, The University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA
- Department of Surgery, The University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA
- Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, Tulsa, OK 74135, USA
| | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Amrami KK, Khanna A, Frick MA, Spinner RJ. Imaging Peripheral Nerve Injuries of the Lower Extremities: What Surgeons Need to Know. Semin Ultrasound CT MR 2023. [DOI: 10.1053/j.sult.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Obenaus A, Rodriguez-Grande B, Lee JB, Dubois CJ, Fournier ML, Cador M, Caille S, Badaut J. A single mild juvenile TBI in male mice leads to regional brain tissue abnormalities at 12 months of age that correlate with cognitive impairment at the middle age. Acta Neuropathol Commun 2023; 11:32. [PMID: 36859364 PMCID: PMC9976423 DOI: 10.1186/s40478-023-01515-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 01/12/2023] [Indexed: 03/03/2023] Open
Abstract
Traumatic brain injury (TBI) has the highest incidence amongst the pediatric population and its mild severity represents the most frequent cases. Moderate and severe injuries as well as repetitive mild TBI result in lasting morbidity. However, whether a single mild TBI sustained during childhood can produce long-lasting modifications within the brain is still debated. We aimed to assess the consequences of a single juvenile mild TBI (jmTBI) at 12 months post-injury in a mouse model. Non-invasive diffusion tensor imaging (DTI) revealed significant microstructural alterations in the hippocampus and the in the substantia innominata/nucleus basalis (SI/NB), structures known to be involved in spatial learning and memory. DTI changes paralled neuronal loss, increased astrocytic AQP4 and microglial activation in the hippocampus. In contrast, decreased astrocytic AQP4 expression and microglia activation were observed in SI/NB. Spatial learning and memory were impaired and correlated with alterations in DTI-derived derived fractional ansiotropy (FA) and axial diffusivity (AD). This study found that a single juvenile mild TBI leads to significant region-specific DTI microstructural alterations, distant from the site of impact, that correlated with cognitive discriminative novel object testing and spatial memory impairments at 12 months after a single concussive injury. Our findings suggest that exposure to jmTBI leads to a chronic abnormality, which confirms the need for continued monitoring of symptoms and the development of long-term treatment strategies to intervene in children with concussions.
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Affiliation(s)
- Andre Obenaus
- Department of Pediatrics, University of California, Irvine, CA, USA
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | | | - Jeong Bin Lee
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Christophe J Dubois
- CNRS UMR 5536 RMSB, University of Bordeaux, 146 Rue Léo Saignat, 33076, Bordeaux Cedex, France
| | | | - Martine Cador
- CNRS, EPHE, INCIA UMR5287, University of Bordeaux, F33000, Bordeaux, France
| | - Stéphanie Caille
- CNRS, EPHE, INCIA UMR5287, University of Bordeaux, F33000, Bordeaux, France
| | - Jerome Badaut
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
- CNRS, EPHE, INCIA UMR5287, University of Bordeaux, F33000, Bordeaux, France.
- CNRS UMR 5536 RMSB, University of Bordeaux, 146 Rue Léo Saignat, 33076, Bordeaux Cedex, France.
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Lee SY, Schmit BD, Kurpad SN, Budde MD. Acute Magnetic Resonance Imaging Predictors of Chronic Motor Function and Tissue Sparing in Rat Cervical Spinal Cord Injury. J Neurotrauma 2022; 39:1727-1740. [PMID: 35708112 PMCID: PMC9734017 DOI: 10.1089/neu.2022.0034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Predicting functional outcomes from spinal cord injury (SCI) at the acute setting is important for patient management. This work investigated the relationship of early magnetic resonance imaging (MRI) biomarkers in a rat model of cervical contusion SCI with long-term functional outcome and tissue sparing. Forty rats with contusion injury at C5 at either the spinal cord midline (bilateral) or over the lateral cord (unilateral) were examined using in vivo multi-modal quantitative MRI at 1 day post-injury. The extent of T2-weighted hyperintensity reflecting edema was greater in the bilateral model compared with the unilateral injury. Diffusion tensor imaging (DTI) exhibited microscopic damage in similar regions of the cord as reductions in fractional anisotropy (FA) and mean diffusivity (MD), but DTI parameter maps were also confounded by the presence of vasogenic edema that locally increased FA and MD. In comparison, filtered diffusion-weighted imaging (fDWI) more clearly delineated the location of acute axonal damage without effects of vasogenic edema. Pairwise correlation analysis revealed that 28-day motor functional outcomes were most strongly associated with the extent of edema (R = -0.69). Principal component analysis identified close associations of motor functional score with tissue sparing, the extent of edema, lesion area, and injury type (unilateral or bilateral). Among the diffusion MRI parameters, lesion areas measured with fDWI had the strongest association with functional outcome (R = -0.41). Voxelwise correlation analysis identified a locus of white matter damage associated with function in the dorsal white matter, although this was likely driven by variance across the two injury patterns (unilateral and bilateral injury). Nonetheless, correlation with motor function within the damaged region found in the voxelwise analysis outperformed morphological lesion area measurement as a predictor of chronic function. Collectively, this study characterized anatomical and diffusion MRI signatures of acute SCI at cervical spine and their association with chronic functional outcomes and histological results.
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Affiliation(s)
- Seung-Yi Lee
- Neuroscience Doctoral Program, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Biophysics Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Brian D. Schmit
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shekar N. Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Matthew D. Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Morales-Guadarrama A, Salgado-Ceballos H, Grijalva I, Morales-Corona J, Hernández-Godínez B, Ibáñez-Contreras A, Ríos C, Diaz-Ruiz A, Cruz GJ, Olayo MG, Sánchez-Torres S, Mondragón-Lozano R, Alvarez-Mejia L, Fabela-Sánchez O, Olayo R. Evolution of Spinal Cord Transection of Rhesus Monkey Implanted with Polymer Synthesized by Plasma Evaluated by Diffusion Tensor Imaging. Polymers (Basel) 2022; 14:polym14050962. [PMID: 35267785 PMCID: PMC8912689 DOI: 10.3390/polym14050962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
In spinal cord injury (SCI) there is damage to the nervous tissue, due to the initial damage and pathophysiological processes that are triggered subsequently. There is no effective therapeutic strategy for motor functional recovery derived from the injury. Several studies have demonstrated neurons growth in cell cultures on polymers synthesized by plasma derived from pyrrole, and the increased recovery of motor function in rats by implanting the polymer in acute states of the SCI in contusion and transection models. In the process of transferring these advances towards humans it is recommended to test in mayor species, such as nonhuman primates, prioritizing the use of non-invasive techniques to evaluate the injury progression with the applied treatments. This work shows the ability of diffusion tensor imaging (DTI) to evaluate the evolution of the SCI in nonhuman primates through the fraction of anisotropy (FA) analysis and the diffusion tensor tractography (DTT) calculus. The injury progression was analysed up to 3 months after the injury day by FA and DTT. The FA recovery and the DTT re-stabilization were observed in the experimental implanted subject with the polymer, in contrast with the non-implanted subject. The parameters derived from DTI are concordant with the histology and the motor functional behaviour.
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Affiliation(s)
- Axayacatl Morales-Guadarrama
- Centro Nacional de Investigación en Imagenología e Instrumentación Médica, Universidad Autónoma Metropolitana Iztapalapa, CDMX, Mexico City 09340, Mexico;
- Departamento de Ingeniería Eléctrica, Universidad Autónoma Metropolitana Iztapalapa, CDMX, Mexico City 09340, Mexico;
- Departamento de Física, Instituto Nacional de Investigaciones Nucleares, Axapusco 52750, Mexico; (G.J.C.); (M.G.O.)
| | - Hermelinda Salgado-Ceballos
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades Centro Médico Nacional Siglo XXI, CDMX, Mexico City 06720, Mexico; (H.S.-C.); (I.G.); (S.S.-T.); (L.A.-M.)
- Centro de Investigación del Proyecto CAMINA A.C., CDMX, Mexico City 14050, Mexico;
| | - Israel Grijalva
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades Centro Médico Nacional Siglo XXI, CDMX, Mexico City 06720, Mexico; (H.S.-C.); (I.G.); (S.S.-T.); (L.A.-M.)
- Centro de Investigación del Proyecto CAMINA A.C., CDMX, Mexico City 14050, Mexico;
| | - Juan Morales-Corona
- Departamento de Física, Universidad Autónoma Metropolitana Iztapalapa, CDMX, Mexico City 09340, Mexico;
| | - Braulio Hernández-Godínez
- Investigación Biomédica Aplicada S.A.S. de C.V., CDMX, Mexico City 14240, Mexico; (B.H.-G.); (A.I.-C.)
| | | | - Camilo Ríos
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez S.S.A., CDMX, Mexico City 14269, Mexico; (C.R.); (A.D.-R.)
| | - Araceli Diaz-Ruiz
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez S.S.A., CDMX, Mexico City 14269, Mexico; (C.R.); (A.D.-R.)
| | - Guillermo Jesus Cruz
- Departamento de Física, Instituto Nacional de Investigaciones Nucleares, Axapusco 52750, Mexico; (G.J.C.); (M.G.O.)
| | - María Guadalupe Olayo
- Departamento de Física, Instituto Nacional de Investigaciones Nucleares, Axapusco 52750, Mexico; (G.J.C.); (M.G.O.)
| | - Stephanie Sánchez-Torres
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades Centro Médico Nacional Siglo XXI, CDMX, Mexico City 06720, Mexico; (H.S.-C.); (I.G.); (S.S.-T.); (L.A.-M.)
- Centro de Investigación del Proyecto CAMINA A.C., CDMX, Mexico City 14050, Mexico;
| | - Rodrigo Mondragón-Lozano
- Centro de Investigación del Proyecto CAMINA A.C., CDMX, Mexico City 14050, Mexico;
- Catedrático CONACyT-Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, CDMX, Mexico City 06720, Mexico
| | - Laura Alvarez-Mejia
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Enfermedades Neurológicas, Hospital de Especialidades Centro Médico Nacional Siglo XXI, CDMX, Mexico City 06720, Mexico; (H.S.-C.); (I.G.); (S.S.-T.); (L.A.-M.)
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez S.S.A., CDMX, Mexico City 14269, Mexico; (C.R.); (A.D.-R.)
| | - Omar Fabela-Sánchez
- Departamento de Ingeniería Eléctrica, Universidad Autónoma Metropolitana Iztapalapa, CDMX, Mexico City 09340, Mexico;
- Departamento de Química Macromoléculas y Nanomateriales, Centro de Investigación en Química Aplicada, Saltillo 25294, Mexico
| | - Roberto Olayo
- Departamento de Física, Universidad Autónoma Metropolitana Iztapalapa, CDMX, Mexico City 09340, Mexico;
- Correspondence:
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10
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Awad H, Raza A, Saklayen S, Bhandary S, Kelani H, Powers C, Bourekas E, Essandoh M. Combined Stroke and Spinal Cord Infarction in Hybrid Type I Aortic Arch Debranching and TEVAR and the Dual Role of the Left Subclavian Artery. J Cardiothorac Vasc Anesth 2022:S1053-0770(22)00122-7. [PMID: 35339354 DOI: 10.1053/j.jvca.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/08/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Hamdy Awad
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University in Columbus, Columbus, OH.
| | - Arwa Raza
- Ohio State University College of Medicine in Columbus, Columbus, OH
| | - Samiya Saklayen
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University in Columbus, Columbus, OH
| | - Sujatha Bhandary
- Department of Anesthesiology at Emory University School of Medicine in Atlanta, Atlanta, GA
| | - Hesham Kelani
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University in Columbus, Columbus, OH
| | - Ciaran Powers
- Department of Neurosurgery at the Wexner Medical Center at the Ohio State University in Columbus, Columbus, OH
| | - Eric Bourekas
- Department of Radiology at Wexner Medical Center at the Ohio State University in Columbus, Columbus, OH
| | - Michael Essandoh
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University in Columbus, Columbus, OH
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11
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Murphy SA, Furger R, Kurpad SN, Arpinar VE, Nencka A, Koch K, Budde MD. Filtered Diffusion-Weighted MRI of the Human Cervical Spinal Cord: Feasibility and Application to Traumatic Spinal Cord Injury. AJNR Am J Neuroradiol 2021; 42:2101-2106. [PMID: 34620590 DOI: 10.3174/ajnr.a7295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In traumatic spinal cord injury, DTI is sensitive to injury but is unable to differentiate multiple pathologies. Axonal damage is a central feature of the underlying cord injury, but prominent edema confounds its detection. The purpose of this study was to examine a filtered DWI technique in patients with acute spinal cord injury. MATERIALS AND METHODS The MR imaging protocol was first evaluated in a cohort of healthy subjects at 3T (n = 3). Subsequently, patients with acute cervical spinal cord injury (n = 8) underwent filtered DWI concurrent with their acute clinical MR imaging examination <24 hours postinjury at 1.5T. DTI was obtained with 25 directions at a b-value of 800 s/mm2. Filtered DWI used spinal cord-optimized diffusion-weighting along 26 directions with a "filter" b-value of 2000 s/mm2 and a "probe" maximum b-value of 1000 s/mm2. Parallel diffusivity metrics obtained from DTI and filtered DWI were compared. RESULTS The high-strength diffusion-weighting perpendicular to the cord suppressed signals from tissues outside of the spinal cord, including muscle and CSF. The parallel ADC acquired from filtered DWI at the level of injury relative to the most cranial region showed a greater decrease (38.71%) compared with the decrease in axial diffusivity acquired by DTI (17.68%). CONCLUSIONS The results demonstrated that filtered DWI is feasible in the acute setting of spinal cord injury and reveals spinal cord diffusion characteristics not evident with conventional DTI.
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Affiliation(s)
- S A Murphy
- From the Department of Neurosurgery (S.A.M., R.F., S.N.K., M.D.B.)
| | - R Furger
- From the Department of Neurosurgery (S.A.M., R.F., S.N.K., M.D.B.)
- Center for Neurotrauma Research (R.F., S.N.K., M.D.B.)
| | - S N Kurpad
- From the Department of Neurosurgery (S.A.M., R.F., S.N.K., M.D.B.)
- Center for Neurotrauma Research (R.F., S.N.K., M.D.B.)
| | - V E Arpinar
- Center for Imaging Research (V.E.A., A.N., K.K.), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - A Nencka
- Center for Imaging Research (V.E.A., A.N., K.K.), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - K Koch
- Center for Imaging Research (V.E.A., A.N., K.K.), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - M D Budde
- From the Department of Neurosurgery (S.A.M., R.F., S.N.K., M.D.B.)
- Center for Neurotrauma Research (R.F., S.N.K., M.D.B.)
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12
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Braga Silva J, Chammas M, Chammas PE, Andrade R, Hochhegger B, Leal BLM. Evaluation of peripheral nerve injury by magnetic resonance neurography: A systematic review. HAND SURGERY & REHABILITATION 2021; 41:7-13. [PMID: 34543765 DOI: 10.1016/j.hansur.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/28/2021] [Accepted: 09/07/2021] [Indexed: 12/01/2022]
Abstract
In view of the limitations of current methods for assessing peripheral nerve injury, there is a need for technical innovations to improve diagnosis, surgical approach and postoperative monitoring. The objective of this study was to conduct a systematic review to analyze the applicability of magnetic resonance neurography in peripheral nerve injuries. The present systematic review focused on the use of magnetic resonance neurography. The literature was searched in the PUBMED, Cochrane Library and Virtual Health Library databases using the PICO method. One hundred sixty-two articles were retrieved with the terms "magnetic resonance imaging" and "peripheral nerve injury", with a filter for the last 10 years (2010-2020). Nineteen were eligible for the review. Most were reviews, with few systematic reviews of randomized controlled trials. Although not included in the recommended protocol, MRI is increasingly used due to its numerous advantages: it is non-invasive, providing objective visualization of neural and perineural tissues, fascicular representation as a result of high resolution, and objective visualization of serial interval images of successful treatment. This is one of the first systematic reviews of the literature regarding the use of magnetic resonance imaging neurography to assess peripheral nerve injury, highlighting the need to implement new imaging techniques in this field of medical practice.
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Affiliation(s)
- Jefferson Braga Silva
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Av. Ipiranga 6681, Partenon, Porto Alegre RS, 90619-900, Brazil; Service of Hand Surgery and Reconstructive Microsurgery, São Lucas Hospital, Centro Clinico PUCRS, Av. Ipiranga 6690, Suite 216, Porto Alegre, RS, 90610-000, Brazil.
| | - Michel Chammas
- Service of hand surgery and peripheral nerve surgery, SOS Main, Hospital Lapeyronie, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Pierre-Emmanuel Chammas
- Service of hand surgery and peripheral nerve surgery, SOS Main, Hospital Lapeyronie, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Rubens Andrade
- Radiology Service, São Lucas Hospital, Brain Institute, São Lucas Hospital, Centro Clinico PUCRS, Av. Ipiranga 6690, Porto Alegre, RS, 90610-000, Brazil
| | - Bruno Hochhegger
- Radiology Service, São Lucas Hospital, Brain Institute, São Lucas Hospital, Centro Clinico PUCRS, Av. Ipiranga 6690, Porto Alegre, RS, 90610-000, Brazil
| | - Bruna Leiria Meréje Leal
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Av. Ipiranga 6681, Partenon, Porto Alegre RS, 90619-900, Brazil
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13
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Awad H, Raza A, Saklayen S, Bhandary S, Kelani H, Powers C, Bourekas E, Stine I, Milner R, Valentine E, Essandoh M. Combined Stroke and Spinal Cord Ischemia in Hybrid Type I Aortic Arch Debranching and TEVAR and the Dual Role of the Left Subclavian Artery. J Cardiothorac Vasc Anesth 2021; 36:3687-3700. [PMID: 34538558 DOI: 10.1053/j.jvca.2021.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Hamdy Awad
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University, Columbus, OH.
| | - Arwa Raza
- Ohio State University College of Medicine, Columbus, OH
| | - Samiya Saklayen
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University, Columbus, OH
| | - Sujatha Bhandary
- Department of Anesthesiology at Emory University School of Medicine, Atlanta, GA
| | - Hesham Kelani
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University, Columbus, OH
| | - Ciaran Powers
- Department of Neurosurgery at the Wexner Medical Center at the Ohio State University, Columbus, OH
| | - Eric Bourekas
- Department of Radiology at Wexner Medical Center at the Ohio State University, Columbus, OH
| | - Ian Stine
- Department of Surgery at the University of Chicago, Chicago, IL
| | - Ross Milner
- Department of Surgery at the University of Chicago, Chicago, IL
| | - Elizabeth Valentine
- Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Michael Essandoh
- Department of Anesthesiology at the Wexner Medical Center at the Ohio State University, Columbus, OH
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14
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Szczepankiewicz F, Westin CF, Nilsson M. Gradient waveform design for tensor-valued encoding in diffusion MRI. J Neurosci Methods 2021; 348:109007. [PMID: 33242529 PMCID: PMC8443151 DOI: 10.1016/j.jneumeth.2020.109007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022]
Abstract
Diffusion encoding along multiple spatial directions per signal acquisition can be described in terms of a b-tensor. The benefit of tensor-valued diffusion encoding is that it unlocks the 'shape of the b-tensor' as a new encoding dimension. By modulating the b-tensor shape, we can control the sensitivity to microscopic diffusion anisotropy which can be used as a contrast mechanism; a feature that is inaccessible by conventional diffusion encoding. Since imaging methods based on tensor-valued diffusion encoding are finding an increasing number of applications we are prompted to highlight the challenge of designing the optimal gradient waveforms for any given application. In this review, we first establish the basic design objectives in creating field gradient waveforms for tensor-valued diffusion MRI. We also survey additional design considerations related to limitations imposed by hardware and physiology, potential confounding effects that cannot be captured by the b-tensor, and artifacts related to the diffusion encoding waveform. Throughout, we discuss the expected compromises and tradeoffs with an aim to establish a more complete understanding of gradient waveform design and its impact on accurate measurements and interpretations of data.
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Affiliation(s)
- Filip Szczepankiewicz
- Radiology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Clinical Sciences, Lund University, Lund, Sweden.
| | - Carl-Fredrik Westin
- Radiology, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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15
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Muftuler LT, Meier TB, Keith M, Budde MD, Huber DL, McCrea MA. Serial Diffusion Kurtosis Magnetic Resonance Imaging Study during Acute, Subacute, and Recovery Periods after Sport-Related Concussion. J Neurotrauma 2020; 37:2081-2092. [PMID: 32253977 DOI: 10.1089/neu.2020.6993] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Sport-related concussion (SRC) is common in contact sports, but there remains a lack of reliable, unbiased biomarkers of brain injury and recovery. Although the symptoms of SRC generally resolve over a period of days to weeks, the lack of a biomarker impairs detection and return-to-play decisions. To this date, the pathophysiological recovery profile and relationships between brain changes and symptoms remained unclear. In the current study, diffusion kurtosis imaging (DKI) was used to monitor the effects of SRC on the brain and the trajectory of recovery in concussed American football players (n = 96) at <48 h, and 8, 15, and 45 days post-injury, who were compared with a matched group of uninjured players (n = 82). The concussed group reported significantly higher symptoms within 48 h after injury than controls, which resolved by the 8-day follow-up. The concussed group also demonstrated poorer performance on balance testing at <48 h and 8 days than controls. There were no significant differences between the groups in the Standardized Assessment of Concussion (SAC), a cognitive screening measure. DKI data were acquired with 3 mm isotropic resolution, and analyzed using tract-based spatial statistics (TBSS). Additionally, voxel- and region of interest-based analyses were also conducted. At <48 h, the concussed group showed significantly higher axial kurtosis than the control group. These differences increased in extent and magnitude at 8 days, then receded at 15 days, and returned to the normal levels by 45 days. Kurtosis fractional anisotropy (FA) exhibited a delayed response, with a consistent increase by days 15 and 45. The results indicate that changes detected in the acute period appear to be prolonged compared with clinical recovery, but additional brain changes not observable acutely appear to progress. Although further studies are needed to understand the pathological features of DKI changes after SRC, these findings highlight a potential disparity between clinical symptoms and pathophysiological recovery after SRC.
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Affiliation(s)
- L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Center for Neurotrauma Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Center for Neurotrauma Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Monica Keith
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Center for Neurotrauma Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Daniel L Huber
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Center for Neurotrauma Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Center for Neurotrauma Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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16
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Mittal N, Tayal S. Advance computer analysis of magnetic resonance imaging (MRI) for early brain tumor detection. Int J Neurosci 2020; 131:555-570. [PMID: 32241208 DOI: 10.1080/00207454.2020.1750390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE The brain tumor grows inside the skull and interposes with regular brain functioning. The tumor growth may possibly result in cancer at a later stage. The early detection of brain tumor is crucial for successful treatment of fatal disease. The tumor presence is normally detected by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) images. The MRI/CT images are highly complex and involve huge data. This requires highly tedious and time-consuming process for detection of small tumors for the neurologists. Thus, there is a need to develop an effective and less time-consuming imaging technique for early detection of brain tumors. MATERIALS AND METHODS This paper mainly focuses on early detecting and localizing the brain tumor region using segmentation of patient's MRI images. The Matlab software experiments are performed on a set of fifteen tumorous MRI images. In the proposed work, four image segmentation modalities namely watershed transform, k-means clustering, thresholding and Fuzzy C Means Clustering techniques with median filtering have been implemented. RESULTS The results are verified by quantitative comparison of results in terms of image quality evaluation parameters-Entropy, standard deviation and Naturalness Image Quality Evaluator. A remarkable rise in the entropy and standard deviation values has been noticed. CONCLUSIONS The watershed transform segmentation with median filtering yields the best quality brain tumor images. The noteworthy improvement in visibility of the MRI images may highly increase the possibilities of early detection and successful treatment of brain tumor disease and thereby assists the clinicians to decide the precise therapies.
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Affiliation(s)
- Neetu Mittal
- Amity Institute of Information Technology, Amity University Uttar Pradesh, Noida, India
| | - Satyam Tayal
- Thapar Institute of Engineering and Technology, Patiala, India
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17
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Huang Y, Zhang X, Guo H, Chen H, Guo D, Huang F, Xu Q, Qu X. Phase-constrained reconstruction of high-resolution multi-shot diffusion weighted image. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2020; 312:106690. [PMID: 32066067 DOI: 10.1016/j.jmr.2020.106690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/18/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Diffusion weighted imaging (DWI) is a unique examining method in tumor diagnosis, acute stroke evaluation. Single-shot echo planar imaging is currently conventional method for DWI. However, single-shot DWI suffers from image distortion, blurring and low spatial resolution. Although multi-shot DWI improves image resolution, it brings phase variations among different shots at the same time. In this paper, we introduce a smooth phase constraint of each shot image into multi-shot navigator-free DWI reconstruction by imposing the low-rankness of Hankel matrix constructed from the k-space data. Furthermore, we exploit the partial sum minimization of singular values to constrain the low-rankness of Hankel matrix. Results on brain imaging data show that the proposed method outperforms the state-of-the-art methods in terms of artifacts removal and our method potentially has the ability to reconstruct high number of shot of DWI.
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Affiliation(s)
- Yiman Huang
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, School of Electronic Science and Engineering, Xiamen University, Xiamen 361005, China
| | - Xinlin Zhang
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, School of Electronic Science and Engineering, Xiamen University, Xiamen 361005, China
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing 100084, China
| | - Huijun Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing 100084, China
| | - Di Guo
- School of Computer and Information Engineering, Fujian Provincial University Key Laboratory of Internet of Things Application Technology, Xiamen University of Technology, Xiamen 361024, China
| | - Feng Huang
- Neusoft Medical System, Shanghai 200241, China
| | - Qin Xu
- Neusoft Medical System, Shanghai 200241, China
| | - Xiaobo Qu
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, School of Electronic Science and Engineering, Xiamen University, Xiamen 361005, China.
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18
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Wilkins N, Skinner NP, Motovylyak A, Schmit BD, Kurpad S, Budde MD. Evolution of Magnetic Resonance Imaging as Predictors and Correlates of Functional Outcome after Spinal Cord Contusion Injury in the Rat. J Neurotrauma 2020; 37:889-898. [PMID: 31830856 DOI: 10.1089/neu.2019.6731] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Clinical methods for determining the severity of traumatic spinal cord injury (SCI) and long-term functional outcome in the acute setting are limited in their prognostic accuracy because of the heterogeneity of injury and dynamic injury progression. The aim of this study was to evaluate the time course and sensitivity of advanced magnetic resonance imaging (MRI) methods to neurological function after SCI in a rat contusion model. Rats received a graded contusion injury at T10 using a weight-drop apparatus. MRI consisted of morphological measures from T2-weighted imaging, quantitative T2 imaging, and diffusion-weighted imaging (DWI) at 1, 30, and 90 days post-injury (dpi). The derived metrics were compared with neurological function assessed using weekly Basso, Beattie, and Bresnahan (BBB) locomotor scoring and return of reflexive micturition function. At the acute time point (1 dpi), diffusion metrics sensitive to axonal injury at the injury epicenter had the strongest correlation with time-matched BBB scores and best predicted 90-dpi BBB scores. At 30 dpi, axonal water fraction derived from DWI and T2 values were both correlated with time-matched locomotor scores. At the chronic time point (90 dpi), cross-sectional area was most closely correlated to BBB. Overall, the results demonstrate differential sensitivity of MRI metrics at different time points after injury, but the metrics follow the expected pathology of acute axonal injury followed by continued degeneration and finally a terminal level of atrophy. Specificity of DWI in the acute setting may make it impactful as a prognostic tool while T2 imaging provided the most information about injury severity in chronic injury.
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Affiliation(s)
- Natasha Wilkins
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nathan P Skinner
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.,Medical Scientist Training Program, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alice Motovylyak
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Brian D Schmit
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Shekar Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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19
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MR Imaging for Assessing Injury Severity and Prognosis in Acute Traumatic Spinal Cord Injury. Radiol Clin North Am 2019; 57:319-339. [DOI: 10.1016/j.rcl.2018.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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20
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Spondylotic traumatic central cord syndrome: a hidden discoligamentous injury? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 28:434-441. [DOI: 10.1007/s00586-018-5796-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/12/2018] [Indexed: 11/26/2022]
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