1
|
Rojczyk P, Heller C, Seitz-Holland J, Kaufmann E, Sydnor VJ, Berger L, Pankatz L, Rathi Y, Bouix S, Pasternak O, Salat D, Hinds SR, Esopenko C, Fortier CB, Milberg WP, Shenton ME, Koerte IK. Intimate partner violence perpetration among veterans: associations with neuropsychiatric symptoms and limbic microstructure. Front Neurol 2024; 15:1360424. [PMID: 38882690 PMCID: PMC11178105 DOI: 10.3389/fneur.2024.1360424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 05/03/2024] [Indexed: 06/18/2024] Open
Abstract
Background Intimate partner violence (IPV) perpetration is highly prevalent among veterans. Suggested risk factors of IPV perpetration include combat exposure, post-traumatic stress disorder (PTSD), depression, alcohol use, and mild traumatic brain injury (mTBI). While the underlying brain pathophysiological characteristics associated with IPV perpetration remain largely unknown, previous studies have linked aggression and violence to alterations of the limbic system. Here, we investigate whether IPV perpetration is associated with limbic microstructural abnormalities in military veterans. Further, we test the effect of potential risk factors (i.e., PTSD, depression, substance use disorder, mTBI, and war zone-related stress) on the prevalence of IPV perpetration. Methods Structural and diffusion-weighted magnetic resonance imaging (dMRI) data were acquired from 49 male veterans of the Iraq and Afghanistan wars (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF) of the Translational Research Center for TBI and Stress Disorders (TRACTS) study. IPV perpetration was assessed using the psychological aggression and physical assault sub-scales of the Revised Conflict Tactics Scales (CTS2). Odds ratios were calculated to assess the likelihood of IPV perpetration in veterans with either of the following diagnoses: PTSD, depression, substance use disorder, or mTBI. Fractional anisotropy tissue (FA) measures were calculated for limbic gray matter structures (amygdala-hippocampus complex, cingulate, parahippocampal gyrus, entorhinal cortex). Partial correlations were calculated between IPV perpetration, neuropsychiatric symptoms, and FA. Results Veterans with a diagnosis of PTSD, depression, substance use disorder, or mTBI had higher odds of perpetrating IPV. Greater war zone-related stress, and symptom severity of PTSD, depression, and mTBI were significantly associated with IPV perpetration. CTS2 (psychological aggression), a measure of IPV perpetration, was associated with higher FA in the right amygdala-hippocampus complex (r = 0.400, p = 0.005). Conclusion Veterans with psychiatric disorders and/or mTBI exhibit higher odds of engaging in IPV perpetration. Further, the more severe the symptoms of PTSD, depression, or TBI, and the greater the war zone-related stress, the greater the frequency of IPV perpetration. Moreover, we report a significant association between psychological aggression against an intimate partner and microstructural alterations in the right amygdala-hippocampus complex. These findings suggest the possibility of a structural brain correlate underlying IPV perpetration that requires further research.
Collapse
Affiliation(s)
- Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Valerie J Sydnor
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
| | - Luisa Berger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Lara Pankatz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Software Engineering and IT, École de technologie supérieure, Montreal, QC, Canada
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - David Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
- Massachusetts General Hospital Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States
| | - Sidney R Hinds
- Department of Radiology and Neurology, Uniformed Services University, Bethesda, MD, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
| |
Collapse
|
2
|
Zagorchev L, Hyde DE, Li C, Wenzel F, Fläschner N, Ewald A, O'Donoghue S, Hancock K, Lim RX, Choi DC, Kelly E, Gupta S, Wilden J. Shape-constrained deformable brain segmentation: Methods and quantitative validation. Neuroimage 2024; 289:120542. [PMID: 38369167 DOI: 10.1016/j.neuroimage.2024.120542] [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: 11/09/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024] Open
Abstract
MRI-guided neuro interventions require rapid, accurate, and reproducible segmentation of anatomical brain structures for identification of targets during surgical procedures and post-surgical evaluation of intervention efficiency. Segmentation algorithms must be validated and cleared for clinical use. This work introduces a methodology for shape-constrained deformable brain segmentation, describes the quantitative validation used for its clinical clearance, and presents a comparison with manual expert segmentation and FreeSurfer, an open source software for neuroimaging data analysis. ClearPoint Maestro is software for fully-automatic brain segmentation from T1-weighted MRI that combines a shape-constrained deformable brain model with voxel-wise tissue segmentation within the cerebral hemispheres and the cerebellum. The performance of the segmentation was validated in terms of accuracy and reproducibility. Segmentation accuracy was evaluated with respect to training data and independently traced ground truth. Segmentation reproducibility was quantified and compared with manual expert segmentation and FreeSurfer. Quantitative reproducibility analysis indicates superior performance compared to both manual expert segmentation and FreeSurfer. The shape-constrained methodology results in accurate and highly reproducible segmentation. Inherent point based-correspondence provides consistent target identification ideal for MRI-guided neuro interventions.
Collapse
Affiliation(s)
- Lyubomir Zagorchev
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA.
| | - Damon E Hyde
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Chen Li
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Fabian Wenzel
- Philips Research Hamburg, Medical Image Processing and Analytics, Röntgenstraße 24-26, Hamburg, 22335, Germany
| | - Nick Fläschner
- Philips Research Hamburg, Medical Image Processing and Analytics, Röntgenstraße 24-26, Hamburg, 22335, Germany
| | - Arne Ewald
- Philips Research Hamburg, Medical Image Processing and Analytics, Röntgenstraße 24-26, Hamburg, 22335, Germany
| | - Stefani O'Donoghue
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Kelli Hancock
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Ruo Xuan Lim
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Dennis C Choi
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Eddie Kelly
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Shruti Gupta
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| | - Jessica Wilden
- ClearPoint Neuro, Clinical Science and Applications, 120 S. Sierra Ave., Suite 100, Solana Beach, 92075, CA, USA
| |
Collapse
|
3
|
Naumenko Y, Yuryshinetz I, Zabenko Y, Pivneva T. Mild traumatic brain injury as a pathological process. Heliyon 2023; 9:e18342. [PMID: 37519712 PMCID: PMC10372741 DOI: 10.1016/j.heliyon.2023.e18342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
Traumatic brain injury (TBI) is defined as dysfunction or other evidence of brain pathology caused by external physical force. More than 69 million new cases of TBI are registered worldwide each year, 80% of them - mild TBI. Based on the physical mechanism of induced trauma, we can separate its pathophysiology into primary and secondary injuries. Many literature sources have confirmed that mechanically induced brain injury initiates ionic, metabolic, inflammatory, and neurovascular changes in the CNS, which can lead to acute, subacute, and chronic neurological consequences. Despite the global nature of the disease, its high heterogeneity, lack of a unified classification system, rapid fluctuation of epidemiological trends, and variability of long-term consequences significantly complicate research and the development of new therapeutic strategies. In this review paper, we systematize current knowledge of biomechanical and molecular mechanisms of mild TBI and provide general information on the classification and epidemiology of this complex disorder.
Collapse
Affiliation(s)
- Yana Naumenko
- Bogomoletz Institute of Physiology, Department of Sensory Signalization, Kyiv, Ukraine
| | - Irada Yuryshinetz
- Bogomoletz Institute of Physiology, Department of Sensory Signalization, Kyiv, Ukraine
| | - Yelyzaveta Zabenko
- Bogomoletz Institute of Physiology, Department of Sensory Signalization, Kyiv, Ukraine
| | - Tetyana Pivneva
- Bogomoletz Institute of Physiology, Department of Sensory Signalization, Kyiv, Ukraine
- Kyiv Academic University, Kyiv, Ukraine
| |
Collapse
|
4
|
Volumetric MRI Findings in Mild Traumatic Brain Injury (mTBI) and Neuropsychological Outcome. Neuropsychol Rev 2023; 33:5-41. [PMID: 33656702 DOI: 10.1007/s11065-020-09474-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
Region of interest (ROI) volumetric assessment has become a standard technique in quantitative neuroimaging. ROI volume is thought to represent a coarse proxy for making inferences about the structural integrity of a brain region when compared to normative values representative of a healthy sample, adjusted for age and various demographic factors. This review focuses on structural volumetric analyses that have been performed in the study of neuropathological effects from mild traumatic brain injury (mTBI) in relation to neuropsychological outcome. From a ROI perspective, the probable candidate structures that are most likely affected in mTBI represent the target regions covered in this review. These include the corpus callosum, cingulate, thalamus, pituitary-hypothalamic area, basal ganglia, amygdala, and hippocampus and associated structures including the fornix and mammillary bodies, as well as whole brain and cerebral cortex along with the cerebellum. Ventricular volumetrics are also reviewed as an indirect assessment of parenchymal change in response to injury. This review demonstrates the potential role and limitations of examining structural changes in the ROIs mentioned above in relation to neuropsychological outcome. There is also discussion and review of the role that post-traumatic stress disorder (PTSD) may play in structural outcome in mTBI. As emphasized in the conclusions, structural volumetric findings in mTBI are likely just a single facet of what should be a multimodality approach to image analysis in mTBI, with an emphasis on how the injury damages or disrupts neural network integrity. The review provides an historical context to quantitative neuroimaging in neuropsychology along with commentary about future directions for volumetric neuroimaging research in mTBI.
Collapse
|
5
|
Chiu LS, Anderton RS. The role of the microbiota-gut-brain axis in long-term neurodegenerative processes following traumatic brain injury. Eur J Neurosci 2023; 57:400-418. [PMID: 36494087 PMCID: PMC10107147 DOI: 10.1111/ejn.15892] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
Traumatic brain injury (TBI) can be a devastating and debilitating disease to endure. Due to improvements in clinical practice, declining mortality rates have led to research into the long-term consequences of TBI. For example, the incidence and severity of TBI have been associated with an increased susceptibility of developing neurodegenerative disorders, such as Parkinson's or Alzheimer's disease. However, the mechanisms linking this alarming association are yet to be fully understood. Recently, there has been a groundswell of evidence implicating the microbiota-gut-brain axis in the pathogenesis of these diseases. Interestingly, survivors of TBI often report gastrointestinal complaints and animal studies have demonstrated gastrointestinal dysfunction and dysbiosis following injury. Autonomic dysregulation and chronic inflammation appear to be the main driver of these pathologies. Consequently, this review will explore the potential role of the microbiota-gut-brain axis in the development of neurodegenerative diseases following TBI.
Collapse
Affiliation(s)
- Li Shan Chiu
- School of Medicine, The University Notre Dame Australia, Fremantle, Western Australia, Australia
- Ear Science Institute Australia, Nedlands, Western Australia, Australia
| | - Ryan S Anderton
- Institute for Health Research, The University Notre Dame Australia, Fremantle, Western Australia, Australia
| |
Collapse
|
6
|
Toman E, Hodgson S, Riley M, Welbury R, Di Pietro V, Belli A. Concussion in the UK: a contemporary narrative review. Trauma Surg Acute Care Open 2022; 7:e000929. [PMID: 36274785 PMCID: PMC9582316 DOI: 10.1136/tsaco-2022-000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/03/2022] [Indexed: 11/18/2022] Open
Abstract
Concussion has been receiving an increasing amount of media exposure following several high-profile professional sports controversies and multimillion-dollar lawsuits. The potential life-changing sequalae of concussion and the rare, but devasting, second impact syndrome have also gained much attention. Despite this, our knowledge of the pathological processes involved is limited and often extrapolated from research into more severe brain injuries. As there is no objective diagnostic test for concussion. Relying on history and examination only, the diagnosis of concussion has become the rate-limiting step in widening research into the disease. Clinical study protocols therefore frequently exclude the most vulnerable groups of patients such as those with existing cognitive impairment, concurrent intoxication, mental health issues or learning difficulties. This up-to-date narrative review aims to summarize our current concussion knowledge and provides an insight into promising avenues for future research.
Collapse
Affiliation(s)
- Emma Toman
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sam Hodgson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Max Riley
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Richard Welbury
- School of Dentistry, University of Central Lancashire, Preston, UK
| | - Valentina Di Pietro
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Antonio Belli
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK,NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
7
|
Braga MFM, Juranek J, Eiden LE, Li Z, Figueiredo TH, de Araujo Furtado M, Marini AM. GABAergic circuits of the basolateral amygdala and generation of anxiety after traumatic brain injury. Amino Acids 2022; 54:1229-1249. [PMID: 35798984 DOI: 10.1007/s00726-022-03184-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Traumatic brain injury (TBI) has reached epidemic proportions around the world and is a major public health concern in the United States. Approximately 2.8 million individuals sustain a traumatic brain injury and are treated in an Emergency Department yearly in the U.S., and about 50,000 of them die. Persistent symptoms develop in 10-15% of the cases including neuropsychiatric disorders. Anxiety is the second most common neuropsychiatric disorder that develops in those with persistent neuropsychiatric symptoms after TBI. Abnormalities or atrophy in the temporal lobe has been shown in the overwhelming number of TBI cases. The basolateral amygdala (BLA), a temporal lobe structure that consolidates, stores and generates fear and anxiety-based behavioral outputs, is a critical brain region in the anxiety circuitry. In this review, we sought to capture studies that characterized the relationship between human post-traumatic anxiety and structural/functional alterations in the amygdala. We compared the human findings with results obtained with a reproducible mild TBI animal model that demonstrated a direct relationship between the alterations in the BLA and an anxiety-like phenotype. From this analysis, both preliminary insights, and gaps in knowledge, have emerged which may open new directions for the development of rational and more efficacious treatments.
Collapse
Affiliation(s)
- Maria F M Braga
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Jenifer Juranek
- Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, 77030, USA
| | - Lee E Eiden
- Section On Molecular Neuroscience, National Institute of Mental Health, Intramural Research Program, Bethesda, MD, 20814, USA
| | - Zheng Li
- Section On Synapse Development and Plasticity, National Institute of Mental Health, Intramural Research Program, Bethesda, MD, 20814, USA
| | - Taiza H Figueiredo
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marcio de Araujo Furtado
- Department of Anatomy, Physiology and Genetics and Program in Neuroscience, Uniformed Services University of the Health Science School of Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Ann M Marini
- Department of Neurology and Program in Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| |
Collapse
|
8
|
Wang ML, Wei XE, Yu MM, Li WB. Cognitive impairment in mild traumatic brain injury: a diffusion kurtosis imaging and volumetric study. Acta Radiol 2022; 63:504-512. [PMID: 33641452 DOI: 10.1177/0284185121998317] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND A significant number of patients with mild traumatic brain injury (mTBI) would experience cognitive deficit. PURPOSE To investigate the brain structural changes in sub-acute mTBI by diffusion kurtosis imaging (DKI) and volumetric analysis, and to assess the relationship between brain structural changes and cognitive functions. MATERIAL AND METHODS A total of 23 patients with sub-acute mTBI and 24 control participants were recruited. All the participants underwent examinations of neuropsychological tests, DKI, and magnetic resonance imaging (MRI)-based morphological scans. Images were investigated using whole brain-based analysis and further regions of interest-based analysis for subcortical nuclei. The neuropsychological tests were compared between the mTBI and the control group. Correlation analysis was performed to examine the relationship between gray matter (GM) volume, DKI parameters, and cognitive functions. RESULTS Compared with control participants, mTBI patients performed worse in the domains of verbal memory, attention and executive function (P < 0.05). No regional GM volume differences were observed between the mTBI and control groups (P > 0.05). Using DKI, patients with mTBI showed lower mean kurtosis (MK) in widespread white matter (WM) regions and several subcortical nuclei (P < 0.05), and higher mean diffusivity (MD) in the right pallidum (P < 0.05). Lower MK value of multiple WM regions and several subcortical nuclei correlated with cognitive impairment (P < 0.05). CONCLUSION DKI was sensitive in detecting brain microstructural changes in patients with sub-acute mTBI showing lower MK value in widespread WM regions and several subcortical nuclei, which were statistically associated with cognitive deficits.
Collapse
Affiliation(s)
- Ming-Liang Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiao-Er Wei
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Meng-Meng Yu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wen-Bin Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Imaging center, Kashgar Prefecture Second People’s Hospital, Kashgar, PR China
| |
Collapse
|
9
|
Roine T, Mohammadian M, Hirvonen J, Kurki T, Posti JP, Takala RS, Newcombe V, Tallus J, Katila AJ, Maanpää HR, Frantzen J, Menon D, Tenovuo O. Structural brain connectivity correlates with outcome in mild traumatic brain injury. J Neurotrauma 2022; 39:336-347. [PMID: 35018829 DOI: 10.1089/neu.2021.0093] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We investigated the topology of structural brain connectivity networks and its association to outcome following mild traumatic brain injury, a major cause of permanent disability. Eighty-five patients with mild traumatic brain injury underwent MRI twice, about three weeks and eight months after injury, and 30 age-matched orthopedic trauma control subjects were scanned. Outcome was assessed with Extended Glasgow Outcome Scale on average eight months after injury. We performed constrained spherical deconvolution based probabilistic streamlines tractography on diffusion MRI data and parcellated cortical and subcortical gray matter into 84 regions based on T1-weighted data to reconstruct structural brain connectivity networks weighted by the number of streamlines. Graph theoretical methods were employed to measure network properties in both patients and controls, and correlations between these properties and outcome were calculated. We found no global differences in the network properties between patients with mild traumatic brain injury and orthopedic control subjects at either stage. However, we found significantly increased betweenness centrality of the right pars opercularis in the chronic stage compared to control subjects. Furthermore, both global and local network properties correlated significantly with outcome. Higher normalized global efficiency, degree, and strength as well as lower small-worldness were associated with better outcome. Correlations between the outcome and the local network properties were the most prominent in the left putamen and the left postcentral gyrus. Our results indicate that both global and local network properties provide valuable information about the outcome already in the acute/subacute stage, and therefore, are promising biomarkers for prognostic purposes in mild traumatic brain injury.
Collapse
Affiliation(s)
- Timo Roine
- University of Turku, 8058, Turku Brain and Mind Center, Turku, Finland.,Aalto University School of Science, 313201, Department of Neuroscience and Biomedical Engineering, Espoo, Finland;
| | - Mehrbod Mohammadian
- University of Turku Faculty of Medicine, 60654, Department of Clinical Neurosciences, Turku, Finland.,Turku University Hospital, 60652, Turku Brain Injury Center, Neurocenter, Turku, Finland;
| | - Jussi Hirvonen
- TYKS Turku University Hospital, 60652, Department of Radiology, Turku, Varsinais-Suomi, Finland;
| | - Timo Kurki
- University of Turku Faculty of Medicine, 60654, Department of Clinical Neurosciences, Turku, Finland.,Turku University Hospital, 60652, Turku Brain Injury Center, Neurocenter, Turku, Finland.,TYKS Turku University Hospital, 60652, Department of Radiology, Turku, Varsinais-Suomi, Finland;
| | - Jussi P Posti
- University of Turku Faculty of Medicine, 60654, Department of Clinical Neurosciences, Turku, Finland.,Turku University Hospital, 60652, Turku Brain Injury Center, Neurocenter, Turku, Varsinais-Suomi, Finland.,TYKS Turku University Hospital, 60652, Department of Neurosurgery. Neurocenter, Turku, Varsinais-Suomi, Finland;
| | - Riikka Sk Takala
- Turku University Hospital, Perioperative Services, Intensive Care Medicine and Pain Management, Turku, Finland.,University of Turku, 8058, Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku, Varsinais-Suomi, Finland;
| | - Virginia Newcombe
- University of Cambridge, Division of Anaesthesia, Addenbrooke's Hospital, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Jussi Tallus
- Turku University Hospital, 60652, Turku Brain Injury Center, Neurocenter, Turku, Varsinais-Suomi, Finland;
| | - Ari J Katila
- Turku University Hospital, Perioperative Services, Intensive Care Medicine and Pain Management, Turku, Varsinais-Suomi, Finland;
| | - Henna-Riikka Maanpää
- Turku University Hospital, 60652, Turku Brain Injury Center, Neurocenter, Turku, Varsinais-Suomi, Finland.,Turku University Hospital, Department of Neurosurgery, Neurocenter, Turku, Varsinais-Suomi, Finland;
| | - Janek Frantzen
- Turku University Hospital, Turku Brain Injury Center, Neurocenter, Turku, Finland.,Turku University Hospital, Department of Neurosurgery, Neurocenter, Turku, Varsinais-Suomi, Finland.,University of Turku Faculty of Medicine, 60654, Department of Clinical Neurosciences, Turku, Finland;
| | - David Menon
- University of Cambridge, Division of Anaesthesia, Addenbrooke's Hospital, Cambridge, United Kingdom of Great Britain and Northern Ireland;
| | - Olli Tenovuo
- University of Turku Faculty of Medicine, 60654, Department of Clinical Neurosciences, Turku, Finland.,Turku University Hospital, 60652, Turku Brain Injury Center, Neurocenter, Turku, Finland;
| |
Collapse
|
10
|
Huizinga W, Poot DHJ, Vinke EJ, Wenzel F, Bron EE, Toussaint N, Ledig C, Vrooman H, Ikram MA, Niessen WJ, Vernooij MW, Klein S. Differences Between MR Brain Region Segmentation Methods: Impact on Single-Subject Analysis. Front Big Data 2021; 4:577164. [PMID: 34723175 PMCID: PMC8552517 DOI: 10.3389/fdata.2021.577164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 05/21/2021] [Indexed: 12/03/2022] Open
Abstract
For the segmentation of magnetic resonance brain images into anatomical regions, numerous fully automated methods have been proposed and compared to reference segmentations obtained manually. However, systematic differences might exist between the resulting segmentations, depending on the segmentation method and underlying brain atlas. This potentially results in sensitivity differences to disease and can further complicate the comparison of individual patients to normative data. In this study, we aim to answer two research questions: 1) to what extent are methods interchangeable, as long as the same method is being used for computing normative volume distributions and patient-specific volumes? and 2) can different methods be used for computing normative volume distributions and assessing patient-specific volumes? To answer these questions, we compared volumes of six brain regions calculated by five state-of-the-art segmentation methods: Erasmus MC (EMC), FreeSurfer (FS), geodesic information flows (GIF), multi-atlas label propagation with expectation–maximization (MALP-EM), and model-based brain segmentation (MBS). We applied the methods on 988 non-demented (ND) subjects and computed the correlation (PCC-v) and absolute agreement (ICC-v) on the volumes. For most regions, the PCC-v was good (>0.75), indicating that volume differences between methods in ND subjects are mainly due to systematic differences. The ICC-v was generally lower, especially for the smaller regions, indicating that it is essential that the same method is used to generate normative and patient data. To evaluate the impact on single-subject analysis, we also applied the methods to 42 patients with Alzheimer’s disease (AD). In the case where the normative distributions and the patient-specific volumes were calculated by the same method, the patient’s distance to the normative distribution was assessed with the z-score. We determined the diagnostic value of this z-score, which showed to be consistent across methods. The absolute agreement on the AD patients’ z-scores was high for regions of thalamus and putamen. This is encouraging as it indicates that the studied methods are interchangeable for these regions. For regions such as the hippocampus, amygdala, caudate nucleus and accumbens, and globus pallidus, not all method combinations showed a high ICC-z. Whether two methods are indeed interchangeable should be confirmed for the specific application and dataset of interest.
Collapse
Affiliation(s)
- W Huizinga
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, Netherlands
| | - D H J Poot
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, Netherlands
| | - E J Vinke
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
| | - F Wenzel
- Philips Research Hamburg, Hamburg, Germany
| | - E E Bron
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, Netherlands
| | - N Toussaint
- School of Biomedical Engineering, King's College London, London, United Kingdom
| | - C Ledig
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, United Kingdom
| | - H Vrooman
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
| | - W J Niessen
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, Netherlands.,Quantitative Imaging Group, Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, Netherlands
| | - M W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
| | - S Klein
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine and Medical Informatics, Erasmus MC, Rotterdam, Netherlands
| |
Collapse
|
11
|
Ross DE, Seabaugh JD, Seabaugh JM, Plumley J, Ha J, Burton JA, Vandervaart A, Mischel R, Blount A, Seabaugh D, Shepherd K, Barcelona J, Ochs AL. Patients with chronic mild or moderate traumatic brain injury have abnormal longitudinal brain volume enlargement more than atrophy. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211018049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Many studies have found brain atrophy in patients with traumatic brain injury (TBI), but most of those studies examined patients with moderate or severe TBI. A few recent studies in patients with chronic mild or moderate TBI found abnormally large brain volume. Some of these studies used NeuroQuant®, FDA-cleared software for measuring MRI brain volume. It is not known if the abnormal enlargement occurs before or after injury. The purpose of the current study was to test the hypothesis that it occurs after injury. Methods 55 patients with chronic mild or moderate TBI were compared to NeuroQuant® normal controls ( n > 4000) with respect to MRI brain volume change from before injury (time 0 [t0], estimated volume) to after injury (t1, measured volume). A subset of 36 patients were compared to the normal controls with respect to longitudinal change of brain volume after injury from t1 to t2. Results The patients had abnormally fast increase of brain volume for multiple brain regions, including whole brain, cerebral cortical gray matter, and subcortical regions. Discussion This is the first report of extensive abnormal longitudinal brain volume enlargement in patients with TBI. In particular, the findings suggested that the previously reported findings of cross-sectional brain volume abnormal enlargement were due to longitudinal enlargement after, not before, injury. Abnormal longitudinal enlargement of the posterior cingulate cortex correlated with neuropathic headaches, partially replicating a previously reported finding that was associated with neuroinflammation.
Collapse
Affiliation(s)
- David E Ross
- Virginia Institute of Neuropsychiatry, Midlothian, USA
| | | | | | | | - Junghoon Ha
- Virginia Commonwealth University, School of Medicine, Richmond, USA
| | - Jason A Burton
- Virginia Commonwealth University, School of Medicine, Richmond, USA
| | | | - Ryan Mischel
- Virginia Commonwealth University, School of Medicine, Richmond, USA
| | - Alyson Blount
- Randolph Macon College, Undergraduate Program, Ashland, USA
| | | | - Katherine Shepherd
- Virginia Institute of Neuropsychiatry, Midlothian, USA
- James Madison University, Undergraduate Program, Harrisonburg, USA
| | | | - Alfred L Ochs
- Virginia Institute of Neuropsychiatry, Midlothian, USA
- Virginia Commonwealth University, School of Medicine, Richmond, USA
| | | |
Collapse
|
12
|
Zhuo J, Jiang L, Rhodes CS, Roys S, Shanmuganathan K, Chen H, Prince JL, Badjatia N, Gullapalli RP. Early Stage Longitudinal Subcortical Volumetric Changes following Mild Traumatic Brain Injury. Brain Inj 2021; 35:725-733. [PMID: 33822686 PMCID: PMC8207827 DOI: 10.1080/02699052.2021.1906445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/15/2021] [Accepted: 03/17/2021] [Indexed: 01/07/2023]
Abstract
Objective: To investigate early brain volumetric changes from acute to 6 months following mild traumatic brain injury (mTBI) in deep gray matter regions and their association with patient 6-month outcome.Methods: Fifty-six patients with mTBI underwent MRI and behavioral evaluation at acute (<10 days) and approximately 1 and 6 months post injury. Regional volume changes were investigated in key gray matter regions: thalamus, hippocampus, putamen, caudate, pallidum, and amygdala, and compared with volumes from 34 healthy control subjects. In patients with mTBI, we further assessed associations between longitudinal regional volume changes with patient outcome measures at 6 months including post-concussive symptoms, cognitive performance, and overall satisfaction with life.Results: Reduction in thalamic and hippocampal volumes was observed at 1 month among patients with mTBI. Such volume reduction persisted in the thalamus until 6 months. Changes in thalamic volumes also correlated with multiple symptom and functional outcome measures in patients at 6 months.Conclusion: Our results indicate that the thalamus may be differentially affected among patients with mTBI, resulting in both structural and functional deficits with subsequent post-concussive sequelae and may serve as a biomarker for the assessment of efficacy of novel therapeutic interventions.
Collapse
Affiliation(s)
- Jiachen Zhuo
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Li Jiang
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Chandler Sours Rhodes
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | - Steven Roys
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Karthikamanthan Shanmuganathan
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Hegang Chen
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - Jerry L. Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD
| | - Neeraj Badjatia
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD
| | - Rao P. Gullapalli
- Center for Advanced Imaging Research, Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD
| |
Collapse
|
13
|
Fortier-Lebel O, Jobin B, Lécuyer-Giguère F, Gaubert M, Giguère JF, Gagnon JF, Boller B, Frasnelli J. Verbal Episodic Memory Alterations and Hippocampal Atrophy in Acute Mild Traumatic Brain Injury. J Neurotrauma 2021; 38:1506-1514. [PMID: 33724054 DOI: 10.1089/neu.2020.7475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Episodic memory deficit is a symptom frequently observed after a mild traumatic brain injury (mTBI). However, few studies have investigated the impact of a single and acute mTBI on episodic memory and structural cerebral changes. To do so, we conducted two experiments. In the first, we evaluated verbal episodic memory by using a word recall test, in 52 patients with mTBI (mean age 33.1 [12.2] years) 2-4 weeks after a first mTBI, compared with 54 healthy controls (31.3 [9.2] years) and followed both groups up for 6 months. In the second, we measured hippocampal volume in a subset of 40 participants (20 patients with mTBI, 20 controls) from Experiment 1 using magnetic resonance imaging (MRI; T1-weighted images) and correlated memory performance scores to hippocampal volume. Experiment 1 showed significantly reduced verbal episodic memory within the first month after an mTBI and a tendency for a reduction 6 months later, more pronounced for men. In Experiment 2, patients with mTBI exhibited a generally reduced hippocampal volume; however, we did not observe any linear correlation between hippocampal volume and memory scores. These results suggest that one single mTBI is associated with both episodic memory alteration and reduced volume of the hippocampus in the acute phase. Future studies are needed to elucidate the link between both measures.
Collapse
Affiliation(s)
- Olivier Fortier-Lebel
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.,Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - Benoît Jobin
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Fanny Lécuyer-Giguère
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Malo Gaubert
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.,Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | | | - Jean-François Gagnon
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Johannes Frasnelli
- Research Centre of the Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.,Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| |
Collapse
|
14
|
Abstract
Supplemental digital content is available in the text. Objective The aims of this study were to investigate changes in regional brain volume after concussion (mild traumatic brain injury) and to examine the relationship between change in brain volume and cognitive deficits. Design Twenty-eight patients with mild traumatic brain injury and 27 age-matched controls were included in this study. Magnetic resonance imaging (3 T) data were obtained from the participants. Structural brain volume changes were examined using tensor-based morphometry, which identifies regional structural differences in the whole brain, including cerebrospinal fluid, gray matter, and white matter. Volume contraction and expansion were compared between groups using a two-sample t test. The association between time post-injury or neurocognitive function and volumetric changes was examined using regression analysis. Results Individuals with mild traumatic brain injury exhibited volume reduction in the brainstem, including the pontine reticular formation. Regional cerebral volume changes were not associated with time post-injury but were significantly associated with neurocognitive function, especially with executive card sorting test, forward digit span test, and performance on verbal learning test. The greater regional cerebral volume was associated with better cognitive performance after mild traumatic brain injury. Conclusion Decreased brainstem volume may indicate its vulnerability to traumatic injury, and cerebral volume in specific regions was positively associated with patients’ cognitive function after injury.
Collapse
|
15
|
Zivanovic N, Virani S, Rajaram AA, Lebel C, Yeates KO, Brooks BL. Cortical Volume and Thickness in Youth Several Years After Concussion. J Child Neurol 2021; 36:186-194. [PMID: 33059521 DOI: 10.1177/0883073820962930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The long-term effects of pediatric concussion on brain morphometry remain poorly delineated. This study used magnetic resonance imaging (MRI) to investigate cortical volume and thickness in youth several years after concussion. METHODS Participants aged 8-19 years old with a history of concussion (n = 37) or orthopedic injury (n = 20) underwent MRI, rated their postconcussion symptoms, and completed cognitive testing on average 2.6 years (SD = 1.6) after injury. FreeSurfer was used to obtain cortical volume and thickness measurements as well as determine any significant correlations between brain morphometry, postconcussion symptoms (parent and self-report), and cognitive functioning. RESULTS No significant group differences were found for either cortical volume or thickness. Youth with a history of concussion had higher postconcussion symptom scores (both parent and self-report Postconcussion Symptom Inventory) than the orthopedic injury group, but symptom ratings did not significantly correlate with cortical volume or thickness. Across both groups, faster reaction time on a computerized neurocognitive test battery (CNS Vital Signs) was associated with a thinner cortex in the left pars triangularis of the inferior frontal gyrus and the left caudal anterior cingulate. Better verbal memory was associated with a thinner cortex in the left rostral middle frontal gyrus. CONCLUSION Findings do not support differences in cortical volume or thickness approximately 2.5 years postconcussion in youth, suggesting either long-term cortical recovery or no cortical differences as a result of injury. Further research using a longitudinal study design and larger samples is needed.
Collapse
Affiliation(s)
- Nikola Zivanovic
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Shane Virani
- 70402Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Neurosciences Program, 157744Alberta Children's Hospital, Calgary, Alberta, Canada.,157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Alysha A Rajaram
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Lebel
- 157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Department of Radiology, 2129University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Keith Owen Yeates
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Brian L Brooks
- 432222Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Neurosciences Program, 157744Alberta Children's Hospital, Calgary, Alberta, Canada.,157744Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, Calgary, Alberta, Canada.,Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
16
|
Bobholz SA, Brett BL, España LY, Huber DL, Mayer AR, Harezlak J, Broglio SP, McAllister T, McCrea MA, Meier TB. Prospective study of the association between sport-related concussion and brain morphometry (3T-MRI) in collegiate athletes: study from the NCAA-DoD CARE Consortium. Br J Sports Med 2020; 55:169-174. [PMID: 32917671 DOI: 10.1136/bjsports-2020-102002] [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] [Accepted: 07/31/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To determine the acute and early long-term associations of sport-related concussion (SRC) and subcortical and cortical structures in collegiate contact sport athletes. METHODS Athletes with a recent SRC (n=99) and matched contact (n=91) and non-contact sport controls (n=95) completed up to four neuroimaging sessions from 24 to 48 hours to 6 months postinjury. Subcortical volumes (amygdala, hippocampus, thalamus and dorsal striatum) and vertex-wise measurements of cortical thickness/volume were computed using FreeSurfer. Linear mixed-effects models examined the acute and longitudinal associations between concussion and structural metrics, controlling for intracranial volume (or mean thickness) and demographic variables (including prior concussions and sport exposure). RESULTS There were significant group-dependent changes in amygdala volumes across visits (p=0.041); this effect was driven by a trend for increased amygdala volume at 6 months relative to subacute visits in contact controls, with no differences in athletes with SRC. No differences were observed in any cortical metric (ie, thickness or volume) for primary or secondary analyses. CONCLUSION A single SRC had minimal associations with grey matter structure across a 6-month time frame.
Collapse
Affiliation(s)
- Samuel A Bobholz
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Benjamin L Brett
- Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lezlie Y España
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Daniel L Huber
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew R Mayer
- Neurology and Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.,The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA.,Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jaroslaw Harezlak
- Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Thomas McAllister
- Psychiatry, Indiana University School of Medicine, Bloomington, Indiana, USA
| | - Michael A McCrea
- Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Timothy B Meier
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA .,Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | |
Collapse
|
17
|
Zagorchev L, Brueck M, Flaschner N, Wenzel F, Hyde D, Ewald A, Peters J. Patient-Specific Sensor Registration for Electrical Source Imaging Using a Deformable Head Model. IEEE Trans Biomed Eng 2020; 68:267-275. [PMID: 32746029 DOI: 10.1109/tbme.2020.3003112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Electrical source imaging of brain activity is most accurate when using individualized bioelectric head models. Constructing these models requires identifying electrode positions on the scalp surface. Current methods such as photogrammetry involve significant user interaction that limits integration in clinical workflows. This work introduces and validates a new, fully-automatic method for sensor registration. METHODS Average electrode coordinates are registered to the mean scalp mesh of a shape-constrained deformable head model used for tissue segmentation. Patient-specific electrode positions can be identified on the deformed scalp surface using point-based correspondence after model adaptation. RESULTS The performance of the proposed method for sensor registration is evaluated with simulated and real data. Electrode variability is quantified for a photogrammetry-based solution and compared against the proposed sensor registration. CONCLUSION A fully-automated model-based approach can identify electrode locations with similar accuracy as a current state-of-the-art photogrammetry system. SIGNIFICANCE The new method for sensor registration presented in this work is rapid and fully automatic. It eliminates any user dependent inaccuracy introduced in sensor registration and ensures reproducible results. More importantly, it can more easily be integrated in clinical workflows, enabling broader adoption of electrical source imaging technologies.
Collapse
|
18
|
Clark AL, Sorg SF, Holiday K, Bigler ED, Bangen KJ, Evangelista ND, Bondi MW, Schiehser DM, Delano-Wood L. Fatigue Is Associated With Global and Regional Thalamic Morphometry in Veterans With a History of Mild Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:382-392. [PMID: 29385016 PMCID: PMC6066453 DOI: 10.1097/htr.0000000000000377] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Fatigue is a complex, multidimensional phenomenon that commonly occurs following traumatic brain injury (TBI). The thalamus-a structure vulnerable to both primary and secondary injuries in TBI-is thought to play a pivotal role in the manifestation of fatigue. We explored how neuroimaging markers of local and global thalamic morphometry relate to the subjective experience of fatigue post-TBI. METHODS Sixty-three Veterans with a history of mild TBI underwent structural magnetic resonance imaging and completed questionnaires related to fatigue and psychiatric symptoms. FMRIB's Software (FSL) was utilized to obtain whole brain and thalamic volume estimates, as well as to perform regional thalamic morphometry analyses. RESULTS Independent of age, sex, intracranial volume, posttraumatic stress disorder, and depressive symptoms, greater levels of self-reported fatigue were significantly associated with decreased right (P = .026) and left (P = .046) thalamic volumes. Regional morphometry analyses revealed that fatigue was significantly associated with reductions in the anterior and dorsomedial aspects of the right thalamic body (P < .05). Similar trends were observed for the left thalamic body (P < .10). CONCLUSIONS Both global and regional thalamic morphometric changes are associated with the subjective experience of fatigue in Veterans with a history of mild TBI. These findings support a theory in which disruption of thalamocorticostriatal circuitry may result in the manifestation of fatigue in individuals with a history of neurotrauma.
Collapse
Affiliation(s)
- Alexandra L. Clark
- San Diego State University/University of California, San Diego
(SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System (VASDHS)
| | - Scott F. Sorg
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Kelsey Holiday
- San Diego State University/University of California, San Diego
(SDSU/UCSD) Joint Doctoral Program in Clinical Psychology
- VA San Diego Healthcare System (VASDHS)
| | - Erin D. Bigler
- Department of Psychology and the Neuroscience Center, Brigham and
Young University
| | - Katherine J. Bangen
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | | | - Mark W. Bondi
- VA San Diego Healthcare System (VASDHS)
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Dawn M. Schiehser
- VA San Diego Healthcare System (VASDHS)
- Center of Excellence for Stress and Mental Health, VASDHS
- University of California San Diego, School of Medicine, Department
of Psychiatry
| | - Lisa Delano-Wood
- VA San Diego Healthcare System (VASDHS)
- Center of Excellence for Stress and Mental Health, VASDHS
- University of California San Diego, School of Medicine, Department
of Psychiatry
| |
Collapse
|
19
|
Ross DE, Seabaugh JD, Seabaugh JM, Alvarez C, Ellis LP, Powell C, Hall C, Reese C, Cooper L, Ochs AL. Patients with chronic mild or moderate traumatic brain injury have abnormal brain enlargement. Brain Inj 2019; 34:11-19. [DOI: 10.1080/02699052.2019.1669074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- David E. Ross
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
| | | | | | - Claudia Alvarez
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- Randolph Macon College, Ashland, VA, USA
| | - Laura Peyton Ellis
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- Randolph Macon College, Ashland, VA, USA
| | - Christopher Powell
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Christopher Hall
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- University of Virginia, Charlottesville, VA, USA
| | - Christopher Reese
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- University of North Carolina at Wilmington, Wilmington, NC, USA
| | - Leah Cooper
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Alfred L. Ochs
- Virginia Institute of Neuropsychiatry, Midlothian, VA, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
20
|
Pagnozzi AM, Fripp J, Rose SE. Quantifying deep grey matter atrophy using automated segmentation approaches: A systematic review of structural MRI studies. Neuroimage 2019; 201:116018. [PMID: 31319182 DOI: 10.1016/j.neuroimage.2019.116018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/01/2019] [Accepted: 07/12/2019] [Indexed: 12/13/2022] Open
Abstract
The deep grey matter (DGM) nuclei of the brain play a crucial role in learning, behaviour, cognition, movement and memory. Although automated segmentation strategies can provide insight into the impact of multiple neurological conditions affecting these structures, such as Multiple Sclerosis (MS), Huntington's disease (HD), Alzheimer's disease (AD), Parkinson's disease (PD) and Cerebral Palsy (CP), there are a number of technical challenges limiting an accurate automated segmentation of the DGM. Namely, the insufficient contrast of T1 sequences to completely identify the boundaries of these structures, as well as the presence of iso-intense white matter lesions or extensive tissue loss caused by brain injury. Therefore in this systematic review, 269 eligible studies were analysed and compared to determine the optimal approaches for addressing these technical challenges. The automated approaches used among the reviewed studies fall into three broad categories, atlas-based approaches focusing on the accurate alignment of atlas priors, algorithmic approaches which utilise intensity information to a greater extent, and learning-based approaches that require an annotated training set. Studies that utilise freely available software packages such as FIRST, FreeSurfer and LesionTOADS were also eligible, and their performance compared. Overall, deep learning approaches achieved the best overall performance, however these strategies are currently hampered by the lack of large-scale annotated data. Improving model generalisability to new datasets could be achieved in future studies with data augmentation and transfer learning. Multi-atlas approaches provided the second-best performance overall, and may be utilised to construct a "silver standard" annotated training set for deep learning. To address the technical challenges, providing robustness to injury can be improved by using multiple channels, highly elastic diffeomorphic transformations such as LDDMM, and by following atlas-based approaches with an intensity driven refinement of the segmentation, which has been done with the Expectation Maximisation (EM) and level sets methods. Accounting for potential lesions should be achieved with a separate lesion segmentation approach, as in LesionTOADS. Finally, to address the issue of limited contrast, R2*, T2* and QSM sequences could be used to better highlight the DGM due to its higher iron content. Future studies could look to additionally acquire these sequences by retaining the phase information from standard structural scans, or alternatively acquiring these sequences for only a training set, allowing models to learn the "improved" segmentation from T1-sequences alone.
Collapse
Affiliation(s)
- Alex M Pagnozzi
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
| | - Stephen E Rose
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
| |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW The concussion public health burden has increased alongside our knowledge of the pathophysiology of mild traumatic brain injury (mTBI). The purpose of this review is to summarize our current understanding of mTBI pathophysiology and biomechanics and how these underlying principles correlate with clinical manifestations of mTBI. RECENT FINDINGS Changes in post-mTBI glutamate and GABA concentrations seem to be region-specific and time-dependent. Genetic variability may predict recovery and symptom severity while gender differences appear to be associated with the neuroinflammatory response and neuroplasticity. Ongoing biomechanical research has shown a growing body of evidence in support of an "individual-specific threshold" for mTBI that varies based on individual intrinsic factors. The literature demonstrates a well-characterized timeframe for mTBI pathophysiologic changes in animal models while work in this area continues to grow in humans. Current human research shows that these underlying post-mTBI effects are multifactorial and may correlate with symptomatology and recovery. While wearable sensor technology has advanced biomechanical impact research, a definitive concussion threshold remains elusive.
Collapse
Affiliation(s)
- Rafael Romeu-Mejia
- Department of Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
- UCLA Brain Injury Research Center, Los Angeles, CA, USA
| | - Christopher C Giza
- Department of Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
- UCLA Brain Injury Research Center, Los Angeles, CA, USA
- Department of Pediatrics/Pediatric Neurology, Mattel Children's Hospital UCLA, Los Angeles, CA, USA
| | - Joshua T Goldman
- Department of Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA.
- Department of Family Medicine, Division of Sports Medicine, UCLA, Los Angeles, CA, USA.
- Department of Orthopedic Surgery, UCLA, Los Angeles, CA, USA.
- Department of Intercollegiate Athletics, UCLA, Los Angeles, CA, USA.
- Center for Sports Medicine, Orthopedic Institute for Children, Los Angeles, CA, USA.
| |
Collapse
|
22
|
Goldman-Yassen AE, Chen KX, Edasery D, Hsu K, Ye K, Lipton ML. Near-Term Decrease in Brain Volume following Mild Traumatic Injury Is Detectible in the Context of Preinjury Volumetric Stability: Neurobiologic Insights from Analysis of Historical Imaging Examinations. AJNR Am J Neuroradiol 2018; 39:1821-1826. [PMID: 30190258 DOI: 10.3174/ajnr.a5769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/29/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Neurodegeneration after mild traumatic brain injury may manifest as decreasing regional brain volume that evolves from months to years following mild traumatic brain injury and is associated with worse clinical outcomes. We hypothesized that quantitative brain volume derived from CT of the head, performed for clinical indications during routine care, would change with time and provide insights into the putative neuroinflammatory response to mild traumatic brain injury. MATERIALS AND METHODS We searched the electronic medical record of our institution for NCCTs of the head performed in patients with mild traumatic brain injury and included those who also underwent NCCTs of the head 1 month to 1 year before and after mild traumatic brain injury for an indication unrelated to trauma. Controls underwent 3 sequential NCCTs of the head with indications unrelated to trauma. The whole-brain and intracranial volume groups were computed using ITK-SNAP. Brain volumes normalized to intracranial volumes were compared across time points using the Wilcoxon signed-rank test. RESULTS We identified 48 patients from 2005 to 2015 who underwent NCCTs of the head in the emergency department for mild traumatic brain injury and had NCCTs of the head performed both before and after mild traumatic brain injury. Median normalized brain volumes significantly decreased on the follow-up study post-mild traumatic brain injury (0.86 versus 0.84, P < .001) and were similar compared with pre-mild traumatic brain injury studies (0.87 versus 0.86, P = .927). There was no significant difference between normalized brain volumes in the 48 controls. CONCLUSIONS A decrease in brain volume following mild traumatic brain injury is detectable on CT and is not seen in similar patients with non-mild traumatic brain injury during a similar timeframe. Given the stability of brain volume before mild traumatic brain injury, CT volume loss may represent the subtle effects of neurodegeneration.
Collapse
Affiliation(s)
- A E Goldman-Yassen
- From the Department of Radiology (A.E.G.-Y., K.X.C., D.E., K.H.), Montefiore Medical Center, Bronx, New York
| | - K X Chen
- From the Department of Radiology (A.E.G.-Y., K.X.C., D.E., K.H.), Montefiore Medical Center, Bronx, New York
| | - D Edasery
- From the Department of Radiology (A.E.G.-Y., K.X.C., D.E., K.H.), Montefiore Medical Center, Bronx, New York
| | - K Hsu
- From the Department of Radiology (A.E.G.-Y., K.X.C., D.E., K.H.), Montefiore Medical Center, Bronx, New York
| | - K Ye
- Department of Epidemiology and Population Health (K.Y.), Albert Einstein College of Medicine, Bronx, New York
| | - M L Lipton
- Gruss Magnetic Resonance Research Center Departments of Radiology, Psychiatry and Behavioral Sciences and Dominick P. Purpura Department of Neuroscience (M.L.L.), Albert Einstein College of Medicine, Bronx, New York.
| |
Collapse
|
23
|
Misquitta K, Dadar M, Tarazi A, Hussain MW, Alatwi MK, Ebraheem A, Multani N, Khodadadi M, Goswami R, Wennberg R, Tator C, Green R, Colella B, Davis KD, Mikulis D, Grinberg M, Sato C, Rogaeva E, Louis Collins D, Tartaglia MC. The relationship between brain atrophy and cognitive-behavioural symptoms in retired Canadian football players with multiple concussions. Neuroimage Clin 2018; 19:551-558. [PMID: 29984163 PMCID: PMC6029563 DOI: 10.1016/j.nicl.2018.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/08/2018] [Accepted: 05/12/2018] [Indexed: 10/31/2022]
Abstract
Multiple concussions, particularly in contact sports, have been associated with cognitive deficits, psychiatric impairment and neurodegenerative diseases like chronic traumatic encephalopathy. We used volumetric and deformation-based morphometric analyses to test the hypothesis that repeated concussions may be associated with smaller regional brain volumes, poorer cognitive performance and behavioural symptoms among former professional football players compared to healthy controls. This study included fifty-three retired Canadian Football League players, 25 age- and education-matched healthy controls, and controls from the Cambridge Centre for Aging and Neuroscience database for validation. Volumetric analyses revealed greater hippocampal atrophy than expected for age in former athletes with multiple concussions than controls and smaller left hippocampal volume was associated with poorer verbal memory performance in the former athletes. Deformation-based morphometry confirmed smaller bilateral hippocampal volume that was associated with poorer verbal memory performance in athletes. Repeated concussions may lead to greater regional atrophy than expected for age.
Collapse
Affiliation(s)
- Karen Misquitta
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Mahsa Dadar
- McConnell Brain Imaging Centre, Montreal Neurological Institute, 3801 Rue Universite, Montreal, QC H3A 2B4, Canada
| | - Apameh Tarazi
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Mohammed W Hussain
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Mohammed K Alatwi
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Ahmed Ebraheem
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Namita Multani
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada; Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Mozhgan Khodadadi
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Ruma Goswami
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Brain, Imaging and Behaviour-Systems Neuroscience, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Richard Wennberg
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Charles Tator
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Department of Surgery, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Division of Neurosurgery, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Robin Green
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON M5G 2A2, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Brenda Colella
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON M5G 2A2, Canada
| | - Karen Deborah Davis
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Brain, Imaging and Behaviour-Systems Neuroscience, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - David Mikulis
- Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Department of Medical Imaging, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Mark Grinberg
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada
| | - Christine Sato
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, 3801 Rue Universite, Montreal, QC H3A 2B4, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Ave, Toronto, ON M5T 0S8, Canada; Canadian Concussion Center, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Division of Neurology, Krembil Neuroscience Centre, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.
| |
Collapse
|
24
|
Rapid fully automatic segmentation of subcortical brain structures by shape-constrained surface adaptation. Med Image Anal 2018; 46:146-161. [DOI: 10.1016/j.media.2018.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 02/23/2018] [Accepted: 03/08/2018] [Indexed: 11/18/2022]
|
25
|
Pertab JL, Merkley TL, Cramond AJ, Cramond K, Paxton H, Wu T. Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review. NeuroRehabilitation 2018; 42:397-427. [PMID: 29660949 PMCID: PMC6027940 DOI: 10.3233/nre-172298] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Recent evidence suggests that autonomic nervous dysfunction may be one of many potential factors contributing to persisting post-concussion symptoms. OBJECTIVE This is the first systematic review to explore the impact of concussion on multiple aspects of autonomic nervous system functioning. METHODS The methods employed are in compliance with the American Academy of Neurology (AAN) and PRISMA standards. Embase, MEDLINE, PsychINFO, and Science Citation Index literature searches were performed using relevant indexing terms for articles published prior to the end of December 2016. Data extraction was performed by two independent groups, including study quality indicators to determine potential risk for bias according to the 4-tiered classification scheme of the AAN. RESULTS Thirty-six articles qualified for inclusion in the analysis. Only three studies (one Class II and two Class IV) did not identify anomalies in measures of ANS functioning in concussed populations. CONCLUSIONS The evidence supports the conclusion that it is likely that concussion causes autonomic nervous system anomalies. An awareness of this relationship increases our understanding of the physical impact of concussion, partially explains the overlap of concussion symptoms with other medical conditions, presents opportunities for further research, and has the potential to powerfully inform treatment decisions.
Collapse
Affiliation(s)
- Jon L. Pertab
- Neurosciences Institute, Intermountain Healthcare, Murray, UT, USA
| | - Tricia L. Merkley
- Department of Clinical Neuropsychology, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Kelly Cramond
- Summit Neuropsychology, Reno, NV, USA
- VA Sierra Nevada Healthcare System, Reno, NV, USA
| | - Holly Paxton
- Hauenstein Neurosciences of Mercy Health and Department of Translational Science and Molecular Medicine, Michigan State University, MI, USA
| | - Trevor Wu
- Hauenstein Neurosciences of Mercy Health and Department of Translational Science and Molecular Medicine, Michigan State University, MI, USA
| |
Collapse
|
26
|
Davenport ND, Gullickson JT, Grey SF, Hirsch S, Sponheim SR. Longitudinal evaluation of ventricular volume changes associated with mild traumatic brain injury in military service members. Brain Inj 2018; 32:1245-1255. [PMID: 29985658 DOI: 10.1080/02699052.2018.1494854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PRIMARY OBJECTIVE To investigate differences in longitudinal trajectories of ventricle-brain ratio (VBR), a general measure of brain atrophy, between Veterans with and without history of mild traumatic brain injury (mTBI). RESEARCH DESIGN Structural magnetic resonance imaging (MRI) was used to calculate VBR in 70 Veterans with a history of mTBI and 34 Veterans without such history at two time points approximately 3 and 8 years after a combat deployment. MAIN OUTCOMES AND RESULTS Both groups demonstrated a quadratic relationship between VBR and age that is consistent with normal developmental trajectories. Veterans with history of mTBI had larger total brain volume, but no interaction between mTBI and age was observed for brain volume, ventricular volume, or VBR. CONCLUSIONS In our longitudinal sample of deployed Veterans, mTBI was not associated with gross brain atrophy as reflected by abnormally high VBR or abnormal increases in VBR over time.
Collapse
Affiliation(s)
- Nicholas D Davenport
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
| | - James T Gullickson
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
| | - Scott F Grey
- c RTI International , Research Triangle Park , NC , USA
| | - Shawn Hirsch
- c RTI International , Research Triangle Park , NC , USA
| | - Scott R Sponheim
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
| | -
- a Minneapolis Veterans Affairs Health Care System , Minneapolis , MN , USA.,b Department of Psychiatry , University of Minnesota , Minneapolis , MN , USA
| |
Collapse
|
27
|
Ravikumar N, Gooya A, Çimen S, Frangi AF, Taylor ZA. Group-wise similarity registration of point sets using Student's t-mixture model for statistical shape models. Med Image Anal 2017; 44:156-176. [PMID: 29248842 DOI: 10.1016/j.media.2017.11.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 07/11/2017] [Accepted: 11/25/2017] [Indexed: 01/18/2023]
Abstract
A probabilistic group-wise similarity registration technique based on Student's t-mixture model (TMM) and a multi-resolution extension of the same (mr-TMM) are proposed in this study, to robustly align shapes and establish valid correspondences, for the purpose of training statistical shape models (SSMs). Shape analysis across large cohorts requires automatic generation of the requisite training sets. Automated segmentation and landmarking of medical images often result in shapes with varying proportions of outliers and consequently require a robust method of alignment and correspondence estimation. Both TMM and mrTMM are validated by comparison with state-of-the-art registration algorithms based on Gaussian mixture models (GMMs), using both synthetic and clinical data. Four clinical data sets are used for validation: (a) 2D femoral heads (K= 1000 samples generated from DXA images of healthy subjects); (b) control-hippocampi (K= 50 samples generated from T1-weighted magnetic resonance (MR) images of healthy subjects); (c) MCI-hippocampi (K= 28 samples generated from MR images of patients diagnosed with mild cognitive impairment); and (d) heart shapes comprising left and right ventricular endocardium and epicardium (K= 30 samples generated from short-axis MR images of: 10 healthy subjects, 10 patients diagnosed with pulmonary hypertension and 10 diagnosed with hypertrophic cardiomyopathy). The proposed methods significantly outperformed the state-of-the-art in terms of registration accuracy in the experiments involving synthetic data, with mrTMM offering significant improvement over TMM. With the clinical data, both methods performed comparably to the state-of-the-art for the hippocampi and heart data sets, which contained few outliers. They outperformed the state-of-the-art for the femur data set, containing large proportions of outliers, in terms of alignment accuracy, and the quality of SSMs trained, quantified in terms of generalization, compactness and specificity.
Collapse
Affiliation(s)
- Nishant Ravikumar
- CISTIB Centre for Computational Imaging and Simulation Technologies in Biomedicine, INSIGNEO Institute for in silico Medicine, United Kingdom; Department of Mechanical Engineering, The University of Sheffield, United Kingdom.
| | - Ali Gooya
- CISTIB Centre for Computational Imaging and Simulation Technologies in Biomedicine, INSIGNEO Institute for in silico Medicine, United Kingdom; Department of Electronic and Electrical Engineering, The University of Sheffield, United Kingdom.
| | - Serkan Çimen
- CISTIB Centre for Computational Imaging and Simulation Technologies in Biomedicine, INSIGNEO Institute for in silico Medicine, United Kingdom; Department of Electronic and Electrical Engineering, The University of Sheffield, United Kingdom.
| | - Alejandro F Frangi
- CISTIB Centre for Computational Imaging and Simulation Technologies in Biomedicine, INSIGNEO Institute for in silico Medicine, United Kingdom; Department of Electronic and Electrical Engineering, The University of Sheffield, United Kingdom.
| | - Zeike A Taylor
- CISTIB Centre for Computational Imaging and Simulation Technologies in Biomedicine, INSIGNEO Institute for in silico Medicine, United Kingdom; Department of Mechanical Engineering, The University of Sheffield, United Kingdom.
| |
Collapse
|
28
|
DeMaster D, Johnson C, Juranek J, Ewing‐Cobbs L. Memory and the hippocampal formation following pediatric traumatic brain injury. Brain Behav 2017; 7:e00832. [PMID: 29299377 PMCID: PMC5745237 DOI: 10.1002/brb3.832] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/15/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Previous research indicates disruption of learning and memory in children who have experienced traumatic brain injury (TBI). Objective This research evaluates the impact of pediatric TBI on volumetric differences along the long axis of the hippocampus, a region of the brain that is critical for explicit memory. Methods Structural brain data and behavioral measures were collected 6 weeks following TBI or extracranial injury (EI), in children aged 8-15 years and from a group of age matched typically developing controls (TDC). Total hippocampal volume and hippocampal subregion volumes corresponding to hippocampal head, body, and tail were compared across groups and were examined in relation to verbal and visual memory. Results Group differences were evident such that hippocampal body volume was found to be smaller for TBI and EI groups compared to the TDC group. Analysis restricted to the TBI group indicated that hippocampal head volume was associated with severity of injury. The relation between severity of injury and hippocampal head volume is particularly important considering results from our investigation of hippocampal volume-to-memory performance relations indicating positive correlations between hippocampal head volume and performance on memory measures for both the TBI group and the TDC group. Significant negative correlations between hippocampal body volume and memory were evident for the TBI group but not EI or TDC groups. Correlations between memory performance and hippocampal tail volume were not significant for the TBI or TDC groups, although for the EI group, a positive correlation was found between hippocampal tail volume and memory. Conclusion Together these results underscore an important relation between hippocampal structure and memory function during the subacute stage of recovery from pediatric TBI.
Collapse
Affiliation(s)
- Dana DeMaster
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| | - Chad Johnson
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| | - Jenifer Juranek
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| | - Linda Ewing‐Cobbs
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| |
Collapse
|
29
|
Schultz V, Stern RA, Tripodis Y, Stamm J, Wrobel P, Lepage C, Weir I, Guenette JP, Chua A, Alosco ML, Baugh CM, Fritts NG, Martin BM, Chaisson CE, Coleman MJ, Lin AP, Pasternak O, Shenton ME, Koerte IK. Age at First Exposure to Repetitive Head Impacts Is Associated with Smaller Thalamic Volumes in Former Professional American Football Players. J Neurotrauma 2017; 35:278-285. [PMID: 28990457 DOI: 10.1089/neu.2017.5145] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Thalamic atrophy has been associated with exposure to repetitive head impacts (RHI) in professional fighters. The aim of this study is to investigate whether or not age at first exposure (AFE) to RHI is associated with thalamic volume in symptomatic former National Football League (NFL) players at risk for chronic traumatic encephalopathy (CTE). Eighty-six symptomatic former NFL players (mean age = 54.9 ± 7.9 years) were included. T1-weighted data were acquired on a 3T magnetic resonance imager, and thalamic volumes were derived using FreeSurfer. Mood and behavior, psychomotor speed, and visual and verbal memory were assessed. The association between thalamic volume and AFE to playing football and to number of years playing was calculated. Decreased thalamic volume was associated with more years of play (left: p = 0.03; right: p = 0.03). Younger AFE was associated with decreased right thalamic volume (p = 0.014). This association remained significant after adjusting for total years of play. Decreased left thalamic volume was associated with worse visual memory (p = 0.014), whereas increased right thalamic volume was associated with fewer mood and behavior symptoms (p = 0.003). In our sample of symptomatic former NFL players at risk for CTE, total years of play and AFE were associated with decreased thalamic volume. The effect of AFE on right thalamic volume was almost twice as strong as the effect of total years of play. Our findings confirm previous reports of an association between thalamic volume and exposure to RHI. They suggest further that younger AFE may result in smaller thalamic volume later in life.
Collapse
Affiliation(s)
- Vivian Schultz
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,2 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Robert A Stern
- 3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts.,4 Departments of Neurology, Neurosurgery, and Anatomy & Neurobiology, Boston University School of Medicine , Boston, Massachusetts
| | - Yorghos Tripodis
- 3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts.,5 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts
| | - Julie Stamm
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts.,6 Department of Kinesiology, University of Wisconsin , Madison, Madison, Wisconsin
| | - Pawel Wrobel
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,2 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Christian Lepage
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,7 Department of Psychology, University of Ottawa , Ottawa, Ontario, Canada
| | - Isabelle Weir
- 5 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts
| | - Jeffrey P Guenette
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,8 Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Alicia Chua
- 5 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts
| | - Michael L Alosco
- 3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts
| | - Christine M Baugh
- 3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts.,9 Interfaculty Initiative in Health Policy, Harvard University , Boston, Massachusetts
| | - Nathan G Fritts
- 3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts
| | - Brett M Martin
- 10 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts
| | - Christine E Chaisson
- 3 BU Alzheimer's Disease and CTE Center, Boston University , Boston, Massachusetts.,10 Data Coordinating Center, Boston University School of Public Health , Boston, Massachusetts
| | - Michael J Coleman
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Alexander P Lin
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,8 Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,11 Center for Clinical Spectroscopy , Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ofer Pasternak
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,8 Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Martha E Shenton
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,8 Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,12 VA Boston Healthcare System, Brockton Division, Brockton, Massachusetts.,13 Department of Psychiatry, Massachusetts General Hospital , Harvard Medical School, Boston, Massachusetts
| | - Inga K Koerte
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,2 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany .,13 Department of Psychiatry, Massachusetts General Hospital , Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
30
|
España LY, Lee RM, Ling JM, Jeromin A, Mayer AR, Meier TB. Serial Assessment of Gray Matter Abnormalities after Sport-Related Concussion. J Neurotrauma 2017; 34:3143-3152. [DOI: 10.1089/neu.2017.5002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Lezlie Y. España
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ryan M. Lee
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Josef M. Ling
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
| | | | - Andrew R. Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico
- Neurology Department, University of New Mexico School of Medicine, Albuquerque, New Mexico
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Timothy B. Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| |
Collapse
|
31
|
Zeiler FA, Donnelly J, Calviello L, Smielewski P, Menon DK, Czosnyka M. Pressure Autoregulation Measurement Techniques in Adult Traumatic Brain Injury, Part II: A Scoping Review of Continuous Methods. J Neurotrauma 2017; 34:3224-3237. [PMID: 28699412 DOI: 10.1089/neu.2017.5086] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A scoping review of the literature was performed systematically on commonly described continuous autoregulation measurement techniques in adult traumatic brain injury (TBI) to provide an overview of methodology and comprehensive reference library of the available literature for each technique. Five separate small systematic reviews were conducted for each of the continuous techniques: pressure reactivity index (PRx), laser Doppler flowmetry (LDF), near infrared spectroscopy (NIRS) techniques, brain tissue oxygen tension (PbtO2), and thermal diffusion (TD) techniques. Articles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to December 2016), and reference lists of relevant articles were searched. A two-tier filter of references was conducted. The literature base identified from the individual searches was limited, except for PRx. The total number of articles using each of the five searched techniques for continuous autoregulation in adult TBI were: PRx (28), LDF (4), NIRS (9), PbtO2 (10), and TD (8). All continuous techniques described in adult TBI are based on moving correlation coefficients. The premise behind the calculation of these moving correlation coefficients focuses on the impact of slow fluctuations in either mean arterial pressure (MAP) or cerebral perfusion pressure (CPP) on some indirect measure of cerebral blood flow (CBF), such as: intracranial pressure (ICP), LDF, NIRS signals, PbtO2, or TD CBF. The thought is the correlation between a hemodynamic driving factor, such as MAP or CPP, and a surrogate for CBF or cerebral perfusion sheds insight on the state of cerebral autoregulation. Both PRx and NIRS indices were validated experimentally against the "gold standard" static autoregulatory curve (Lassen curve) at least around the lower threshold of autoregulation. The PRx has the largest literature base supporting the association with patient outcome. Various methods of continuous autoregulation assessment are described within the adult TBI literature. Many studies exist on these various indices, suggesting an association between their values and patient morbidity/death.
Collapse
Affiliation(s)
- Frederick A Zeiler
- 1 Division of Anaesthesia, Addenbrooke's Hospital, University of Cambridge , Cambridge, United Kingdom .,2 Section of Neurosurgery, Department of Surgery, University of Manitoba , Winnipeg, Manitoba, Canada .,3 Clinician Investigator Program, University of Manitoba , Winnipeg, Manitoba, Canada
| | - Joseph Donnelly
- 4 Section of Brain Physics, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge , Cambridge, United Kingdom
| | - Leanne Calviello
- 4 Section of Brain Physics, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge , Cambridge, United Kingdom
| | - Peter Smielewski
- 4 Section of Brain Physics, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge , Cambridge, United Kingdom
| | - David K Menon
- 1 Division of Anaesthesia, Addenbrooke's Hospital, University of Cambridge , Cambridge, United Kingdom
| | - Marek Czosnyka
- 4 Section of Brain Physics, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge , Cambridge, United Kingdom
| |
Collapse
|
32
|
Hellstrøm T, Westlye LT, Sigurdardottir S, Brunborg C, Soberg HL, Holthe Ø, Server A, Lund MJ, Andreassen OA, Andelic N. Longitudinal changes in brain morphology from 4 weeks to 12 months after mild traumatic brain injury: Associations with cognitive functions and clinical variables. Brain Inj 2017; 31:674-685. [DOI: 10.1080/02699052.2017.1283537] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T. Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - L. T. Westlye
- KG Jebsen Centre for Psychosis Research/Norwegian Centre for Mental Disorder Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - S. Sigurdardottir
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norwa
- CHARM Resarch Centre for Habilitation and Rehabilitation Models & Services, Oslo, Norway
| | - C. Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - H. L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Ø. Holthe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - A. Server
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - M. J. Lund
- KG Jebsen Centre for Psychosis Research/Norwegian Centre for Mental Disorder Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - O. A. Andreassen
- KG Jebsen Centre for Psychosis Research/Norwegian Centre for Mental Disorder Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - N. Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- CHARM Resarch Centre for Habilitation and Rehabilitation Models & Services, Oslo, Norway
| |
Collapse
|
33
|
Slobounov SM, Walter A, Breiter HC, Zhu DC, Bai X, Bream T, Seidenberg P, Mao X, Johnson B, Talavage TM. The effect of repetitive subconcussive collisions on brain integrity in collegiate football players over a single football season: A multi-modal neuroimaging study. NEUROIMAGE-CLINICAL 2017; 14:708-718. [PMID: 28393012 PMCID: PMC5377433 DOI: 10.1016/j.nicl.2017.03.006] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/17/2017] [Accepted: 03/19/2017] [Indexed: 01/14/2023]
Abstract
The cumulative effect of repetitive subconcussive collisions on the structural and functional integrity of the brain remains largely unknown. Athletes in collision sports, like football, experience a large number of impacts across a single season of play. The majority of these impacts, however, are generally overlooked, and their long-term consequences remain poorly understood. This study sought to examine the effects of repetitive collisions across a single competitive season in NCAA Football Bowl Subdivision athletes using advanced neuroimaging approaches. Players were evaluated before and after the season using multiple MRI sequences, including T1-weighted imaging, diffusion tensor imaging (DTI), arterial spin labeling (ASL), resting-state functional MRI (rs-fMRI), and susceptibility weighted imaging (SWI). While no significant differences were found between pre- and post-season for DTI metrics or cortical volumes, seed-based analysis of rs-fMRI revealed significant (p < 0.05) changes in functional connections to right isthmus of the cingulate cortex (ICC), left ICC, and left hippocampus. ASL data revealed significant (p < 0.05) increases in global cerebral blood flow (CBF), with a specific regional increase in right postcentral gyrus. SWI data revealed that 44% of the players exhibited outlier rates (p < 0.05) of regional decreases in SWI signal. Of key interest, athletes in whom changes in rs-fMRI, CBF and SWI were observed were more likely to have experienced high G impacts on a daily basis. These findings are indicative of potential pathophysiological changes in brain integrity arising from only a single season of participation in the NCAA Football Bowl Subdivision, even in the absence of clinical symptoms or a diagnosis of concussion. Whether these changes reflect compensatory adaptation to cumulative head impacts or more lasting alteration of brain integrity remains to be further explored.
Collapse
Affiliation(s)
- Semyon M. Slobounov
- Concussion Neuroimaging Consortium, Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, United States
| | - Alexa Walter
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, United States
- Corresponding author: 25 Recreation Hall University Park, PA 16802, United States.25 Recreation Hall University ParkPA16802United States
| | - Hans C. Breiter
- Concussion Neuroimaging Consortium, Department of Psychiatry and Behavioral Sciences, Northwestern University, Evanston, IL 60208, United States
| | - David C. Zhu
- Concussion Neuroimaging Consortium, Department of Radiology and Psychology, Michigan State University, East Lansing, MI 48824, United States
| | - Xiaoxiao Bai
- Social, Life, and Engineering Sciences Imaging Center, The Pennsylvania State University, University Park, PA 16802, United States
| | - Tim Bream
- Athletic Department, The Pennsylvania State University, University Park, PA 16802, United States
| | - Peter Seidenberg
- Athletic Department, The Pennsylvania State University, University Park, PA 16802, United States
| | - Xianglun Mao
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, United States
| | - Brian Johnson
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, United States
| | - Thomas M. Talavage
- Concussion Neuroimaging Consortium, School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, United States
| |
Collapse
|
34
|
Wang ML, Li WB. Cognitive impairment after traumatic brain injury: The role of MRI and possible pathological basis. J Neurol Sci 2016; 370:244-250. [PMID: 27772768 DOI: 10.1016/j.jns.2016.09.049] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 09/01/2016] [Accepted: 09/23/2016] [Indexed: 01/26/2023]
Abstract
Traumatic brain injury (TBI) is closely related to increased incidence of cognitive impairment from the acute phase to chronic phase. At present, the pathological mechanism leading to cognitive impairment after TBI is still not fully understood. We hypothesize that neuron loss, diffuse axonal injury, microbleed, and blood-brain barrier (BBB) disruption altogether contribute to the development of cognitive impairment. Furthermore, the disruption of structural and functional neural network related to the cognitive function might bring about the final step in the occurrence of cognitive impairment after TBI. In this review, we summarize the role of different MRI techniques in the assessment of the pathological changes related to cognitive impairment after TBI. These MRI techniques include T1-MPRAGE sequence reflecting neuron loss, diffusion tensor imaging reflecting diffuse axonal injury, diffusion kurtosis imaging reflecting diffuse axonal injury and reactive gliosis, susceptibility weighted imaging showing microbleed, arterial spin labeling showing blood flow and dynamic contrast enhanced MRI showing BBB disruption. In the future, correlational study of multi-MRI sequences scan, pathological examination, and cognitive tests will provide valuable information for understanding the mechanism of cognitive impairment after TBI and manage TBI patients.
Collapse
Affiliation(s)
- Ming-Liang Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Wen-Bin Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China; Imaging center, Kashgar Prefecture Second People(')s Hospital, Kashgar 844000, China.
| |
Collapse
|
35
|
Banks SD, Coronado RA, Clemons LR, Abraham CM, Pruthi S, Conrad BN, Morgan VL, Guillamondegui OD, Archer KR. Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests. Arch Phys Med Rehabil 2016; 97:1254-61. [PMID: 27085849 PMCID: PMC4990202 DOI: 10.1016/j.apmr.2016.03.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVES (1) To examine differences in patient-reported outcomes, neuropsychological tests, and thalamic functional connectivity (FC) between patients with mild traumatic brain injury (mTBI) and individuals without mTBI and (2) to determine longitudinal associations between changes in these measures. DESIGN Prospective observational case-control study. SETTING Academic medical center. PARTICIPANTS A sample (N=24) of 13 patients with mTBI (mean age, 39.3±14.0y; 4 women [31%]) and 11 age- and sex-matched controls without mTBI (mean age, 37.6±13.3y; 4 women [36%]). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Resting state FC (3T magnetic resonance imaging scanner) was examined between the thalamus and the default mode network, dorsal attention network, and frontoparietal control network. Patient-reported outcomes included pain (Brief Pain Inventory), depressive symptoms (Patient Health Questionnaire-9), posttraumatic stress disorder ([PTSD] Checklist - Civilian Version), and postconcussive symptoms (Rivermead Post-Concussion Symptoms Questionnaire). Neuropsychological tests included the Delis-Kaplan Executive Function System Tower test, Trails B, and Hotel Task. Assessments occurred at 6 weeks and 4 months after hospitalization in patients with mTBI and at a single visit for controls. RESULTS Student t tests found increased pain, depressive symptoms, PTSD symptoms, and postconcussive symptoms; decreased performance on Trails B; increased FC between the thalamus and the default mode network; and decreased FC between the thalamus and the dorsal attention network and between the thalamus and the frontoparietal control network in patients with mTBI as compared with controls. The Spearman correlation coefficient indicated that increased FC between the thalamus and the dorsal attention network from baseline to 4 months was associated with decreased pain and postconcussive symptoms (corrected P<.05). CONCLUSIONS Findings suggest that alterations in thalamic FC occur after mTBI, and improvements in pain and postconcussive symptoms are correlated with normalization of thalamic FC over time.
Collapse
Affiliation(s)
- Sarah D Banks
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Rogelio A Coronado
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Lori R Clemons
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Christine M Abraham
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Education and Human Services, Lehigh University, Bethlehem, PA
| | - Sumit Pruthi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Benjamin N Conrad
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | - Victoria L Morgan
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN; Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN
| | - Oscar D Guillamondegui
- Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN.
| |
Collapse
|
36
|
Jarrett M, Tam R, Hernández-Torres E, Martin N, Perera W, Zhao Y, Shahinfard E, Dadachanji S, Taunton J, Li DKB, Rauscher A. A Prospective Pilot Investigation of Brain Volume, White Matter Hyperintensities, and Hemorrhagic Lesions after Mild Traumatic Brain Injury. Front Neurol 2016; 7:11. [PMID: 26903944 PMCID: PMC4751255 DOI: 10.3389/fneur.2016.00011] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/22/2016] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) is among the most common neurological disorders. Hemorrhagic lesions and white matter hyperintensities (WMH) are radiological features associated with moderate and severe TBI. Brain volume reductions have also been observed during the months following injury. In concussion, no signs of injury are observed on conventional magnetic resonance imaging (MRI), which may be a true feature of concussion or merely due to the limited sensitivity of imaging techniques used so far. Moreover, it is not known whether volume reductions are due to the resolution of trauma-related edema or a true volume loss. Forty-five collegiate-level ice hockey players (20 females) and 15 controls (9 females), 40 players underwent 3-T MRI for hemorrhages [multi-echo susceptibility-weighted imaging (SWI)], WMH (three-dimensional fluid-attenuated inversion recovery), and brain volume at the beginning and the end of the hockey season. Concussed athletes underwent additional imaging and neuropsychological testing at 3 days, 2 weeks, and 2 months after injury. At the end of the hockey season, brain volume was reduced compared to controls by 0.32% (p < 0.034) in the whole cohort and by 0.26% (p < 0.09) in the concussed athletes. Two weeks and 2 months after concussion, brain volume was reduced by −0.08% (p = 0.027) and −0.23% (p = 0.035), respectively. In athletes, the WMH were significantly closer to the interface between gray matter and white matter compared to controls. No significant changes in the number of WMH over the duration of the study were found in athletes. No microhemorrhages were detected as a result of concussion or playing a season of ice hockey. We conclude that mild TBI does not lead to transient increases in brain volume and no new microbleeds or WMH are detectable after concussion. Brain volume reductions appear by 2 weeks after concussion and persist until at least 2 months after concussion. Brain volume is reduced between the beginning and the end of the ice hockey season.
Collapse
Affiliation(s)
- Michael Jarrett
- UBC MRI Research Centre, University of British Columbia , Vancouver, BC , Canada
| | - Roger Tam
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | | | - Nancy Martin
- Department of Radiology, Richmond Hospital, Richmond, BC, Canada; Department of Radiology, Burnaby Hospital, Burnaby, BC, Canada; Department of Radiology, Delta Hospital, Delta, BC, Canada
| | - Warren Perera
- Medical Imaging Department, St Vincent's Hospital , Melbourne, VIC , Australia
| | - Yinshan Zhao
- Division of Neurology, Department of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - Elham Shahinfard
- Division of Neurology, Department of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - Shiroy Dadachanji
- Division of Sports Medicine, Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - Jack Taunton
- Division of Sports Medicine, Faculty of Medicine, University of British Columbia , Vancouver, BC , Canada
| | - David K B Li
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada; MS/MRI Research Group, University of British Columbia, Vancouver, BC, Canada
| | - Alexander Rauscher
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Division of Neurology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|