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Liao Y, Li Y, Wang L, Zhang Y, Sang L, Wang Q, Li P, Xiong K, Qiu M, Zhang J. The Injury Progression in Acute Blast-Induced Mild Traumatic Brain Injury in Rats Reflected by Diffusion Tensor Imaging and Immunohistochemical Examination. J Neurotrauma 2024. [PMID: 38877821 DOI: 10.1089/neu.2023.0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
Diffusion tensor imaging (DTI) has emerged as a promising neuroimaging tool for detecting blast-induced mild traumatic brain injury (bmTBI). However, lack of refined acute-phase monitoring and reliable imaging biomarkers hindered its clinical application in early diagnosis of bmTBI, leading to potential long-term disability of patients. In this study, we used DTI in a rat model of bmTBI generated by exposing to single lateral blast waves (151.16 and 349.75 kPa, lasting 47.48 ms) released in a confined bioshock tube, to investigate whole-brain DTI changes at 1, 3, and 7 days after injury. Combined assessment of immunohistochemical analysis, transmission electron microscopy, and behavioral readouts allowed for linking DTI changes to synchronous cellular damages and identifying stable imaging biomarkers. The corpus callosum (CC) and brainstem were identified as predominantly affected regions, in which reduced fractional anisotropy (FA) was detected as early as the first day after injury, with a maximum decline occurring at 3 days post-injury before returning to near normal levels by 7 days. Axial diffusivity (AD) values within the CC and brainstem also significantly reduced at 3 days post-injury. In contrast, the radial diffusivity (RD) in the CC showed acute elevation, peaking at 3 days after injury before normalizing by the 7-day time point. Damages to nerve fibers, including demyelination and axonal degeneration, progressed in lines with changes in DTI parameters, supporting a real-time macroscopic reflection of microscopic neuronal fiber injury by DTI. The most sensitive biomarker was identified as a decrease in FA, AD, and an increase in RD within the CC on the third day after injury, supporting the diagnostic utility of DTI in cases of bmTBI in the acute phase.
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Affiliation(s)
- Yalan Liao
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Yang Li
- Department of Medical Imaging, Air Force Hospital of Western Theater Command, Chengdu, China
| | - Li Wang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Ye Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Linqiong Sang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Qiannan Wang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Pengyue Li
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Kunlin Xiong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Mingguo Qiu
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
| | - Jingna Zhang
- Department of Medical Imaging, College of Biomedical Engineering, Army Medical University, Chongqing, China
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Vinh To X, Kurniawan ND, Cumming P, Nasrallah FA. A cross-comparative analysis of in vivo versus ex vivo MRI indices in a mouse model of concussion. Brain Res 2023; 1820:148562. [PMID: 37673379 DOI: 10.1016/j.brainres.2023.148562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/01/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND We present a cross-sectional, case-matched, and pair-wise comparison of structural magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and neurite orientation dispersion and density imaging (NODDI) measures in vivo and ex vivo in a mouse model of concussion, thus aiming to establish the concordance of structural and diffusion imaging findings in living brain and after fixation. METHODS We allocated 28 male mice aged 3-4 months to sham injury and concussion (CON) groups. CON mice had received a single concussive impact on day 0 and underwent MRI at day 2 (n = 9) or 7 (n = 10) post-impact, and sham control mice likewise underwent imaging at day 2 (n = 5) or 7 (n = 4). Immediately after the final scanning, we collected the perfusion-fixed brains, which were stored for imaging ex vivo 6-12 months later. We then compared the structural imaging, DTI, and NODDI results between different methods. RESULTS In vivo to ex vivo structural and DTI/NODDI findings were in notably poor agreement regarding the effects of concussion on structural integrity of the brain. COMPARISON WITH EXISTING METHODS ex vivo imaging was frequently done to study the effects of diseases and treatments, but our results showed that ex vivo and in vivo imaging can detect completely opposite and contradictory results. This is also the first study that compares in vivo and ex vivo NODDI. CONCLUSION Our findings call for caution in extrapolating translational capabilities obtained ex vivo to physiological measurements in vivo. The divergent findings may reflect fixation artefacts and the contribution of the glymphatic system changes.
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Affiliation(s)
- Xuan Vinh To
- The Queensland Brain Institute, The University of Queensland, Australia
| | | | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland; School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Fatima A Nasrallah
- The Queensland Brain Institute, The University of Queensland, Australia; Centre for Advanced Imaging, The University of Queensland, Australia.
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Huang SH, Li MJ, Yeh FC, Huang CX, Zhang HT, Liu J. Differential and correlational tractography as tract-based biomarkers in mild traumatic brain injury: A longitudinal MRI study. NMR IN BIOMEDICINE 2023; 36:e4991. [PMID: 37392139 DOI: 10.1002/nbm.4991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 07/03/2023]
Abstract
We evaluated the fiber bundles in mild traumatic brain injury (mTBI) patients using differential and correlational tractography in a longitudinal analysis. Diffusion MRI data were acquired in 34 mTBI patients at 7 days (acute stage) and 3 months or longer (chronic stage) after mTBI. Trail Making Test A (TMT-A) and Digital Symbol Substitution Test changes were used to evaluate the cognitive performance. Longitudinal correlational tractography showed decreased anisotropy in the corpus callosum during the chronic mTBI stage. The changes in anisotropy in the corpus callosum were significantly correlated with the changes in TMT-A (false discovery rate [FDR] = 0.000094). Individual longitudinal differential tractography found that anisotropy decreased in the corpus callosum in 30 mTBI patients. Group cross-sectional differential tractography found that anisotropy increased (FDR = 0.02) in white matter in the acute mTBI patients, while no changes occurred in the chronic mTBI patients. Our study confirms the feasibility of using correlational and differential tractography as tract-based monitoring biomarkers to evaluate the disease progress of mTBI, and indicates that normalized quantitative anisotropy could be used as a biomarker to monitor the injury and/or repairs of white matter in individual mTBI patients.
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Affiliation(s)
- Si-Hong Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Meng-Jun Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Bioengineering, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chu-Xin Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui-Ting Zhang
- MR Scientific Marketing, Siemens Healthineers Ltd., Wuhan, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Radiology Quality Control Center, Changsha, China
- Clinical Research Center for Medical Imaging in Hunan Province, Changsha, China
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To XV, Vegh V, Owusu-Amoah N, Cumming P, Nasrallah FA. Hippocampal demyelination is associated with increased magnetic susceptibility in a mouse model of concussion. Exp Neurol 2023; 365:114406. [PMID: 37062352 DOI: 10.1016/j.expneurol.2023.114406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Structural and functional deficits in the hippocampus are a prominent feature of moderate-severe traumatic brain injury (TBI). In this work, we investigated the potential of Quantitative Susceptibility Imaging (QSM) to reveal the temporal changes in myelin integrity in a mouse model of concussion (mild TBI). We employed a cross-sectional design wherein we assigned 43 mice to cohorts undergoing either a concussive impact or a sham procedure, with QSM imaging at day 2, 7, or 14 post-injury, followed by Luxol Fast Blue (LFB) myelin staining to assess the structural integrity of hippocampal white matter (WM). We assessed spatial learning in the mice using the Active Place Avoidance Test (APA), recording their ability to use visual cues to locate and avoid zone-dependent mild electrical shocks. QSM and LFB staining indicated changes in the stratum lacunosum-molecular layer of the hippocampus in the concussion groups, suggesting impairment of this key relay between the entorhinal cortex and the CA1 regions. These imaging and histology findings were consistent with demyelination, namely increased magnetic susceptibility to MR imaging and decreased LFB staining. In the APA test, sham animals showed fewer entries into the shock zone compared to the concussed cohort. Thus, we present radiological, histological, and behavioral findings that concussion can induce significant and alterations in hippocampal integrity and function that evolve over time after the injury.
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Affiliation(s)
- Xuan Vinh To
- The Queensland Brain Institute, The University of Queensland, Australia
| | - Viktor Vegh
- The Centre for Advanced Imaging, The University of Queensland, Australia; The ARC Centre for Innovation in Biomedical Imaging Technology, Brisbane, Australia
| | - Naana Owusu-Amoah
- The Queensland Brain Institute, The University of Queensland, Australia
| | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland; School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Fatima A Nasrallah
- The Queensland Brain Institute, The University of Queensland, Australia; The Centre for Advanced Imaging, The University of Queensland, Australia.
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Siqueira Pinto M, Winzeck S, Kornaropoulos EN, Richter S, Paolella R, Correia MM, Glocker B, Williams G, Vik A, Posti JP, Haberg A, Stenberg J, Guns PJ, den Dekker AJ, Menon DK, Sijbers J, Van Dyck P, Newcombe VFJ. Use of Support Vector Machines Approach via ComBat Harmonized Diffusion Tensor Imaging for the Diagnosis and Prognosis of Mild Traumatic Brain Injury: A CENTER-TBI Study. J Neurotrauma 2023; 40:1317-1338. [PMID: 36974359 DOI: 10.1089/neu.2022.0365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
The prediction of functional outcome after mild traumatic brain injury (mTBI) is challenging. Conventional magnetic resonance imaging (MRI) does not do a good job of explaining the variance in outcome, as many patients with incomplete recovery will have normal-appearing clinical neuroimaging. More advanced quantitative techniques such as diffusion MRI (dMRI), can detect microstructural changes not otherwise visible, and so may offer a way to improve outcome prediction. In this study, we explore the potential of linear support vector classifiers (linearSVCs) to identify dMRI biomarkers that can predict recovery after mTBI. Simultaneously, the harmonization of fractional anisotropy (FA) and mean diffusivity (MD) via ComBat was evaluated and compared for the classification performances of the linearSVCs. We included dMRI scans of 179 mTBI patients and 85 controls from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI), a multi-center prospective cohort study, up to 21 days post-injury. Patients were dichotomized according to their Extended Glasgow Outcome Scale (GOSE) scores at 6 months into complete (n = 92; GOSE = 8) and incomplete (n = 87; GOSE <8) recovery. FA and MD maps were registered to a common space and harmonized via the ComBat algorithm. LinearSVCs were applied to distinguish: (1) mTBI patients from controls and (2) mTBI patients with complete from those with incomplete recovery. The linearSVCs were trained on (1) age and sex only, (2) non-harmonized, (3) two-category-harmonized ComBat, and (4) three-category-harmonized ComBat FA and MD images combined with age and sex. White matter FA and MD voxels and regions of interest (ROIs) within the John Hopkins University (JHU) atlas were examined. Recursive feature elimination was used to identify the 10% most discriminative voxels or the 10 most discriminative ROIs for each implementation. mTBI patients displayed significantly higher MD and lower FA values than controls for the discriminative voxels and ROIs. For the analysis between mTBI patients and controls, the three-category-harmonized ComBat FA and MD voxel-wise linearSVC provided significantly higher classification scores (81.4% accuracy, 93.3% sensitivity, 80.3% F1-score, and 0.88 area under the curve [AUC], p < 0.05) compared with the classification based on age and sex only and the ROI approaches (accuracies: 59.8% and 64.8%, respectively). Similar to the analysis between mTBI patients and controls, the three-category-harmonized ComBat FA and MD maps voxelwise approach yields statistically significant prediction scores between mTBI patients with complete and those with incomplete recovery (71.8% specificity, 66.2% F1-score and 0.71 AUC, p < 0.05), which provided a modest increase in the classification score (accuracy: 66.4%) compared with the classification based on age and sex only and ROI-wise approaches (accuracy: 61.4% and 64.7%, respectively). This study showed that ComBat harmonized FA and MD may provide additional information for diagnosis and prognosis of mTBI in a multi-modal machine learning approach. These findings demonstrate that dMRI may assist in the early detection of patients at risk of incomplete recovery from mTBI.
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Affiliation(s)
- Maíra Siqueira Pinto
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
- imec-Vision Lab, University of Antwerp, Antwerp, Belgium
- μNEURO Research Center of Excellence, University of Antwerp, Antwerp, Belgium
| | - Stefan Winzeck
- BioMedIA Group, Department of Computing, Imperial College London, London, United Kingdom
- Division of Anaesthesia, Department of Medicine, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Evgenios N Kornaropoulos
- Division of Anaesthesia, Department of Medicine, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Sophie Richter
- Division of Anaesthesia, Department of Medicine, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Roberto Paolella
- imec-Vision Lab, University of Antwerp, Antwerp, Belgium
- μNEURO Research Center of Excellence, University of Antwerp, Antwerp, Belgium
- Icometrix, Leuven, Belgium
| | - Marta M Correia
- MRC Cognition and Brain Sciences Unit, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Ben Glocker
- BioMedIA Group, Department of Computing, Imperial College London, London, United Kingdom
| | - Guy Williams
- Wolfson Brain Imaging Centre, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Anne Vik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jussi P Posti
- Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Asta Haberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jonas Stenberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | | | - Arnold J den Dekker
- imec-Vision Lab, University of Antwerp, Antwerp, Belgium
- μNEURO Research Center of Excellence, University of Antwerp, Antwerp, Belgium
| | - David K Menon
- Division of Anaesthesia, Department of Medicine, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Jan Sijbers
- imec-Vision Lab, University of Antwerp, Antwerp, Belgium
- μNEURO Research Center of Excellence, University of Antwerp, Antwerp, Belgium
| | - Pieter Van Dyck
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
- mVISION, University of Antwerp, Antwerp, Belgium
| | - Virginia F J Newcombe
- Division of Anaesthesia, Department of Medicine, Department of Neurosciences, University of Cambridge, Cambridge, United Kingdom
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Grant M, Liu J, Wintermark M, Bagci U, Douglas D. Current State of Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Traumatic Brain Injury Prognostication. Neuroimaging Clin N Am 2023; 33:279-297. [PMID: 36965946 DOI: 10.1016/j.nic.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2023]
Abstract
Advanced imaging techniques are needed to assist in providing a prognosis for patients with traumatic brain injury (TBI), particularly mild TBI (mTBI). Diffusion tensor imaging (DTI) is one promising advanced imaging technique, but has shown variable results in patients with TBI and is not without limitations, especially when considering individual patients. Efforts to resolve these limitations are being explored and include developing advanced diffusion techniques, creating a normative database, improving study design, and testing machine learning algorithms. This article will review the fundamentals of DTI, providing an overview of the current state of its utility in evaluating and providing prognosis in patients with TBI.
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Affiliation(s)
- Matthew Grant
- Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA; Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA; Department of Radiology, Landstuhl Regional Medical Center, Dr Hitzelberger Straße, 66849 Landstuhl, Germany.
| | - JiaJing Liu
- Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA
| | - Max Wintermark
- Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA; Neuroradiology Department, The University of Texas Anderson Cancer Center, 1400 Pressler Street, Unit 1482, Houston, TX 77030, USA
| | - Ulas Bagci
- Radiology and Biomedical Engineering Department, Northwestern University, 737 North Michigan Drive, Suite 1600, Chicago, IL 60611, USA; Department of Computer Science, University of Central Florida, 4328 Scorpius Street, Orlando, Florida, 32816
| | - David Douglas
- Department of Radiology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA; Department of Radiology, 96th Medical Group, Eglin Air Force Base, 307 Boatner Road, Eglin Air Force Base, Florida 32542, USA
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Machine learning classification of chronic traumatic brain injury using diffusion tensor imaging and NODDI: A replication and extension study. NEUROIMAGE: REPORTS 2023; 3. [PMID: 37169013 PMCID: PMC10168530 DOI: 10.1016/j.ynirp.2023.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Individuals with acute and chronic traumatic brain injury (TBI) are associated with unique white matter (WM) structural abnormalities, including fractional anisotropy (FA) differences. Our research group previously used FA as a feature in a linear support vector machine (SVM) pattern classifier, observing high classification between individuals with and without acute TBI (i.e., an area under the curve [AUC] value of 75.50%). However, it is not known whether FA could similarly classify between individuals with and without history of chronic TBI. Here, we attempted to replicate our previous work with a new sample, investigating whether FA could similarly classify between incarcerated men with (n = 80) and without (n = 80) self-reported history of chronic TBI. Additionally, given limitations associated with FA, including underestimation of FA values in WM tracts containing crossing fibers, we extended upon our previous study by incorporating neurite orientation dispersion and density imaging (NODDI) metrics, including orientation dispersion (ODI) and isotropic volume (Viso). A linear SVM based classification approach, similar to our previous study, was incorporated here to classify between individuals with and without self-reported chronic TBI using FA and NODDI metrics as separate features. Overall classification rates were similar when incorporating FA and NODDI ODI metrics as features (AUC: 82.50%). Additionally, NODDI-based metrics provided the highest sensitivity (ODI: 85.00%) and specificity (Viso: 82.50%) rates. The current study serves as a replication and extension of our previous study, observing that multiple diffusion MRI metrics can reliably classify between individuals with and without self-reported history of chronic TBI.
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Diffusion-Weighted Imaging in Mild Traumatic Brain Injury: A Systematic Review of the Literature. Neuropsychol Rev 2023; 33:42-121. [PMID: 33721207 DOI: 10.1007/s11065-021-09485-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/09/2021] [Indexed: 12/14/2022]
Abstract
There is evidence that diffusion-weighted imaging (DWI) is able to detect tissue alterations following mild traumatic brain injury (mTBI) that may not be observed on conventional neuroimaging; however, findings are often inconsistent between studies. This systematic review assesses patterns of differences in DWI metrics between those with and without a history of mTBI. A PubMed literature search was performed using relevant indexing terms for articles published prior to May 14, 2020. Findings were limited to human studies using DWI in mTBI. Articles were excluded if they were not full-length, did not contain original data, if they were case studies, pertained to military populations, had inadequate injury severity classification, or did not report post-injury interval. Findings were reported independently for four subgroups: acute/subacute pediatric mTBI, acute/subacute adult mTBI, chronic adult mTBI, and sport-related concussion, and all DWI acquisition and analysis methods used were included. Patterns of findings between studies were reported, along with strengths and weaknesses of the current state of the literature. Although heterogeneity of sample characteristics and study methods limited the consistency of findings, alterations in DWI metrics were most commonly reported in the corpus callosum, corona radiata, internal capsule, and long association pathways. Many acute/subacute pediatric studies reported higher FA and lower ADC or MD in various regions. In contrast, acute/subacute adult studies most commonly indicate lower FA within the context of higher MD and RD. In the chronic phase of recovery, FA may remain low, possibly indicating overall demyelination or Wallerian degeneration over time. Longitudinal studies, though limited, generally indicate at least a partial normalization of DWI metrics over time, which is often associated with functional improvement. We conclude that DWI is able to detect structural mTBI-related abnormalities that may persist over time, although future DWI research will benefit from larger samples, improved data analysis methods, standardized reporting, and increasing transparency.
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Rapid Prediction and Accurate Location Selection of Mild Traumatic Brain Injury (mTBI) by Using Multiple Parameter Analysis of Diffusion Tensor Imaging (DTI): Integrating Correlational and Clinical Approaches. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7467479. [PMID: 36700239 PMCID: PMC9870681 DOI: 10.1155/2023/7467479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/25/2022] [Accepted: 12/23/2022] [Indexed: 01/19/2023]
Abstract
Background Mild traumatic brain injury (mTBI) is a widespread and serious public health problem which also causes physical and psychological suffering to patients and their families and imposes a significant economic burden on society. But it is usually very difficult to detect and provide warning of mTBI in early stage. Therefore, a novel method is urgent for the increasing demands on the accurate and rapid prediction and feature selection of mTBI. Objectives To establish a better idea of the performance of neuroimage biomarker in the acute phase of mTBI, our study adopts diffusion tensor imaging (DTI) which could present the pathophysiological changes of white matter through several parameters noninvasively and combined with behavioral experiments such as intelligence quotient test, memory, executive function, and motion function to find the relationship between DTI abnormal brain regions and behavioral abnormalities. Then, provide new method for rapid prediction and feature selection of mTBI. Methods 77 mTBI patients were admitted to the Emergency and Neurosurgery Departments of the Third Xiangya Hospital of Central South University from August 2019 to July 2021; the patients (41 males and 36 females) suffered mTBI because of car accident (36), assault (11), and fall (30). All the mTBI patients were examined through MRI scan and behavioral psychology test within 3 days after injury. MRI images and behavioral psychology tests were also collected; the correlation between the DTI biomarker and the cognitive psychological outcome was analyzed. A series of integration and computational methods were also used for fusion arithmetic and result analysis. Results Compared with the healthy control group, the patients in the acute stage of mTBI presented lower scores in the digit symbol substitution test (DSST), suggesting that mTBI patients in the acute stage had decline in information processing speed and associative learning. The difference of DTI parameters in acute stage mTBI patients was mainly manifested as increased AD and MD values in multiple brain regions, while RD and FA values have no significant difference. The most significant brain regions were bilateral corticospinal tracts (CST), bilateral posterior internal capsule lentiform nucleus, bilateral superior longitudinal fasciculus, left terminal striae, and left sagittal plane with right posterior thalamic radiation. The Pearson correlation coefficient was significantly positive correlation between AD and MD elevation in the left sagittal layer and the results of DSST and digit span in acute stage mTBI patients. Conclusions The acute phase mTBI patients performed lower score on the DSST than those in the normal control group. This neuropsychological change was associated with increased AD value and MD value in the left sagittal layer, which indicated reduction of information processing speed in mTBI patients in the acute phase. It might be related to abnormal AD value and MD value in the upper longitudinal tract, lower longitudinal tract, lower frontal occipital tract, and sagittal layer. In this study, combined with neuropsychological test and increase of the AD value and MD value in certain brain region, neurosurgeon should pay more attention to the abnormal of the upper longitudinal tract and the patients' information processing speed in the diagnosis and treatment of the acute phase mTBI patients. The study offers a much more secure and integrated method for rapid prediction and feature selection of mTBI, which could have broader clinical approaches and application prospects.
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Li X, Jia X, Liu Y, Bai G, Pan Y, Ji Q, Mo Z, Zhao W, Wei Y, Wang S, Yin B, Zhang J, Bai L. Brain dynamics in triple-network interactions and its relation to multiple cognitive impairments in mild traumatic brain injury. Cereb Cortex 2023:6969137. [PMID: 36610729 DOI: 10.1093/cercor/bhac529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 01/09/2023] Open
Abstract
Traumatic brain injury (TBI) disrupt the coordinated activity of triple-network and produce impairments across several cognitive domains. The triple-network model posits a key role of the salience network (SN) that regulates interactions with the central executive network (CEN) and default mode network (DMN). However, the aberrant dynamic interactions among triple-network and associations with neurobehavioral symptoms in mild TBI was still unclear. In present study, we used brain network interaction index (NII) and dynamic functional connectivity to examine the time-varying cross-network interactions among the triple-network in 109 acute patients, 41 chronic patients, and 65 healthy controls. Dynamic cross-network interactions were significantly increased and more variable in mild TBI compared to controls. Crucially, mild TBI exhibited an increased NII as enhanced integrations between the SN and CEN while reduced coupling of the SN with DMN. The increased NII also implied much severer and multiple domains of cognitive impairments at both acute and chronic mild TBI. Abnormities in time-varying engagement of triple-network is a clinically relevant neurobiological signature of psychopathology in mild TBI. The findings provided align with and advance an emerging perspective on the importance of aberrant brain dynamics associated with highly disparate cognitive and behavioral outcomes in trauma.
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Affiliation(s)
- Xuan Li
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Xiaoyan Jia
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yuling Liu
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Guanghui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Yizhen Pan
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Qiuyu Ji
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Zhaoyi Mo
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Wenpu Zhao
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Yixin Wei
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Bo Yin
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Jie Zhang
- Department of Radiation Medicine, School of Preventive Medicine, Air Force Medical University, Xi'an 710032, China
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
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11
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Mito R, Parker DM, Abbott DF, Makdissi M, Pedersen M, Jackson GD. White matter abnormalities characterize the acute stage of sports-related mild traumatic brain injury. Brain Commun 2022; 4:fcac208. [PMID: 36043140 PMCID: PMC9419063 DOI: 10.1093/braincomms/fcac208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/29/2022] [Accepted: 08/14/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Sports-related concussion, a form of mild traumatic brain injury, is characterized by transient disturbances of brain function. There is increasing evidence that functional brain changes may be driven by subtle abnormalities in white matter microstructure, and diffusion MRI has been instrumental in demonstrating these white matter abnormalities in vivo. However, the reported location and direction of the observed white matter changes in mild traumatic brain injury are variable, likely attributable to the inherent limitations of the white matter models used. This cross-sectional study applies an advanced and robust technique known as fixel-based analysis to investigate fibre tract-specific abnormalities in professional Australian Football League players with a recent mild traumatic brain injury. We used the fixel-based analysis framework to identify common abnormalities found in specific fibre tracts in participants with an acute injury (≤12 days after injury; n = 14). We then assessed whether similar changes exist in subacute injury (>12 days and <3 months after injury; n = 15). The control group was 29 neurologically healthy control participants. We assessed microstructural differences in fibre density and fibre bundle morphology and performed whole-brain fixel-based analysis to compare groups. Subsequent tract-of-interest analyses were performed within five selected white matter tracts to investigate the relationship between the observed tract-specific abnormalities and days since injury and the relationship between these tract-specific changes with cognitive abnormalities. Our whole-brain analyses revealed significant increases in fibre density and bundle cross-section in the acute mild traumatic brain injury group when compared with controls. The acute mild traumatic brain injury group showed even more extensive differences when compared with the subacute injury group than with controls. The fibre structures affected in acute concussion included the corpus callosum, left prefrontal and left parahippocampal white matter. The fibre density and cross-sectional increases were independent of time since injury in the acute injury group, and were not associated with cognitive deficits. Overall, this study demonstrates that acute mild traumatic brain injury is characterized by specific white matter abnormalities, which are compatible with tract-specific cytotoxic oedema. These potential oedematous changes were absent in our subacute mild traumatic brain injury participants, suggesting that they may normalize within 12 days after injury, although subtle abnormalities may persist in the subacute stage. Future longitudinal studies are needed to elucidate individualized recovery after brain injury.
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Affiliation(s)
- Remika Mito
- Florey Institute of Neuroscience and Mental Health , Melbourne, VIC 3084 , Australia
| | - Donna M Parker
- Florey Institute of Neuroscience and Mental Health , Melbourne, VIC 3084 , Australia
| | - David F Abbott
- Florey Institute of Neuroscience and Mental Health , Melbourne, VIC 3084 , Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC 3052 , Australia
| | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health , Melbourne, VIC 3084 , Australia
- Olympic Park Sports Medicine Centre , Melbourne, VIC 3004 , Australia
| | - Mangor Pedersen
- Florey Department of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC 3052 , Australia
- Department of Psychology and Neuroscience, Auckland University of Technology (AUT) , Auckland 1010 , New Zealand
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health , Melbourne, VIC 3084 , Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC 3052 , Australia
- Department of Neurology, Austin Health , Melbourne, VIC 3084 , Australia
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12
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Ly MT, Scarneo-Miller SE, Lepley AS, Coleman K, Hirschhorn R, Yeargin S, Casa DJ, Chen CM. Combining MRI and cognitive evaluation to classify concussion in university athletes. Brain Imaging Behav 2022; 16:2175-2187. [PMID: 35639240 DOI: 10.1007/s11682-022-00687-w] [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] [Accepted: 05/09/2022] [Indexed: 11/26/2022]
Abstract
Current methods of concussion assessment lack the objectivity and reliability to detect neurological injury. This multi-site study uses combinations of neuroimaging (diffusion tensor imaging and resting state functional MRI) and cognitive measures to train algorithms to detect the presence of concussion in university athletes. Athletes (29 concussed, 48 controls) completed symptom reports, brief cognitive evaluation, and MRI within 72 h of injury. Hierarchical linear regression compared groups on cognitive and neuroimaging measures while controlling for sex and data collection site. Logistic regression and support vector machine models were trained using cognitive and neuroimaging measures and evaluated for overall accuracy, sensitivity, and specificity. Concussed athletes reported greater symptoms than controls (∆R2 = 0.32, p < .001), and performed worse on tests of concentration (∆R2 = 0.07, p < .05) and delayed memory (∆R2 = 0.17, p < .001). Concussed athletes showed lower functional connectivity within the frontoparietal and primary visual networks (p < .05), but did not differ on mean diffusivity and fractional anisotropy. Of the cognitive measures, classifiers trained using delayed memory yielded the best performance with overall accuracy of 71%, though sensitivity was poor at 46%. Of the neuroimaging measures, classifiers trained using mean diffusivity yielded similar accuracy. Combining cognitive measures with mean diffusivity increased overall accuracy to 74% and sensitivity to 64%, comparable to the sensitivity of symptom report. Trained algorithms incorporating both MRI and cognitive performance variables can reliably detect common neurobiological sequelae of acute concussion. The integration of multi-modal data can serve as an objective, reliable tool in the assessment and diagnosis of concussion.
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Affiliation(s)
- Monica T Ly
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
- Department of Psychiatry, University of California San Diego, School of Medicine, San Diego, CA, USA.
| | - Samantha E Scarneo-Miller
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
- Division of Athletic Training, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Adam S Lepley
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
- School of Kinesiology, Exercise and Sport Science Initiative, University of Michigan, Ann Arbor, MI, USA
| | - Kelly Coleman
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
- Department of Health & Movement Sciences, Southern Connecticut State University, New Haven, CT, USA
| | - Rebecca Hirschhorn
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA
| | - Susan Yeargin
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Douglas J Casa
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
| | - Chi-Ming Chen
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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13
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Detection of Chronic Blast-Related Mild Traumatic Brain Injury with Diffusion Tensor Imaging and Support Vector Machines. Diagnostics (Basel) 2022; 12:diagnostics12040987. [PMID: 35454035 PMCID: PMC9030428 DOI: 10.3390/diagnostics12040987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 01/13/2023] Open
Abstract
Blast-related mild traumatic brain injury (bmTBI) often leads to long-term sequalae, but diagnostic approaches are lacking due to insufficient knowledge about the predominant pathophysiology. This study aimed to build a diagnostic model for future verification by applying machine-learning based support vector machine (SVM) modeling to diffusion tensor imaging (DTI) datasets to elucidate white-matter features that distinguish bmTBI from healthy controls (HC). Twenty subacute/chronic bmTBI and 19 HC combat-deployed personnel underwent DTI. Clinically relevant features for modeling were selected using tract-based analyses that identified group differences throughout white-matter tracts in five DTI metrics to elucidate the pathogenesis of injury. These features were then analyzed using SVM modeling with cross validation. Tract-based analyses revealed abnormally decreased radial diffusivity (RD), increased fractional anisotropy (FA) and axial/radial diffusivity ratio (AD/RD) in the bmTBI group, mostly in anterior tracts (29 features). SVM models showed that FA of the anterior/superior corona radiata and AD/RD of the corpus callosum and anterior limbs of the internal capsule (5 features) best distinguished bmTBI from HCs with 89% accuracy. This is the first application of SVM to identify prominent features of bmTBI solely based on DTI metrics in well-defined tracts, which if successfully validated could promote targeted treatment interventions.
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14
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Bostami B, Hillary FG, van der Horn HJ, van der Naalt J, Calhoun VD, Vergara VM. A Decentralized ComBat Algorithm and Applications to Functional Network Connectivity. Front Neurol 2022; 13:826734. [PMID: 35370895 PMCID: PMC8965063 DOI: 10.3389/fneur.2022.826734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Recent studies showed that working with neuroimage data collected from different research facilities or locations may incur additional source dependency, affecting the overall statistical power. This problem can be mitigated with data harmonization approaches. Recently, the ComBat method has become commonly adopted for various neuroimage modalities. While open neuroimaging datasets are becoming more common, a substantial amount of data is still unable to be shared for various reasons. In addition, current approaches require moving all the data to a central location, which requires additional resources and creates redundant copies of the same datasets. To address these issues, we propose a decentralized harmonization approach that does not create redundant copies of the original datasets and performs remote operations on the datasets separately without sharing any individual subject data, ensuring a certain level of privacy and reducing regulatory hurdles. We proposed a novel approach called "Decentralized ComBat" which can harmonize datasets separately without combining the datasets. We tested our model by harmonizing functional network connectivity datasets from two traumatic brain injury studies in a decentralized way. Also, we used simulations to analyze the performance and scalability of our model when the number of data collection sites increases. We compare the output with centralized ComBat and show that the proposed approach produces similar results, increasing the sensitivity of the functional network connectivity analysis and validating our approach. Simulations show that our model can be easily scaled to many more datasets based on the requirement. In sum, we believe this provides a powerful tool, further complementing open data and allowing for integrating public and private datasets.
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Affiliation(s)
- Biozid Bostami
- Department of Computer Science, Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Atlanta, GA, United States
- Department of Computer Science, Georgia Institute of Technology, Atlanta, GA, United States
- Department of Computer Science, Emory University, Atlanta, GA, United States
| | - Frank G. Hillary
- Department of Psychology, Penn State University, State College, PA, United States
| | - Harm Jan van der Horn
- Department of Developmental Neurology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Joukje van der Naalt
- Department of Medical Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Vince D. Calhoun
- Department of Computer Science, Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Atlanta, GA, United States
- Department of Computer Science, Georgia Institute of Technology, Atlanta, GA, United States
- Department of Computer Science, Emory University, Atlanta, GA, United States
| | - Victor M. Vergara
- Department of Computer Science, Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Atlanta, GA, United States
- Department of Computer Science, Georgia Institute of Technology, Atlanta, GA, United States
- Department of Computer Science, Emory University, Atlanta, GA, United States
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15
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Robles DJ, Dharani A, Rostowsky KA, Chaudhari NN, Ngo V, Zhang F, O'Donnell LJ, Green L, Sheikh-Bahaei N, Chui HC, Irimia A. Older age, male sex, and cerebral microbleeds predict white matter loss after traumatic brain injury. GeroScience 2022; 44:83-102. [PMID: 34704219 PMCID: PMC8811069 DOI: 10.1007/s11357-021-00459-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022] Open
Abstract
Little is known on how mild traumatic brain injury affects white matter based on age at injury, sex, cerebral microbleeds, and time since injury. Here, we study the fractional anisotropy of white matter to study these effects in 109 participants aged 18-77 (46 females, age μ ± σ = 40 ± 17 years) imaged within [Formula: see text] 1 week and [Formula: see text] 6 months post-injury. Age is found to be linearly associated with white matter degradation, likely due not only to injury but also to cumulative effects of other pathologies and to their interactions with injury. Age is associated with mean anisotropy decreases in the corpus callosum, middle longitudinal fasciculi, inferior longitudinal and occipitofrontal fasciculi, and superficial frontal and temporal fasciculi. Over [Formula: see text] 6 months, the mean anisotropies of the corpus callosum, left superficial frontal fasciculi, and left corticospinal tract decrease significantly. Independently of other predictors, age and cerebral microbleeds contribute to anisotropy decrease in the callosal genu. Chronically, the white matter of commissural tracts, left superficial frontal fasciculi, and left corticospinal tract degrade appreciably, independently of other predictors. Our findings suggest that large commissural and intra-hemispheric structures are at high risk for post-traumatic degradation. This study identifies detailed neuroanatomic substrates consistent with brain injury patients' age-dependent deficits in information processing speed, interhemispheric communication, motor coordination, visual acuity, sensory integration, reading speed/comprehension, executive function, personality, and memory. We also identify neuroanatomic features underlying white matter degradation whose severity is associated with the male sex. Future studies should compare our findings to functional measures and other neurodegenerative processes.
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Affiliation(s)
- David J Robles
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Ammar Dharani
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Kenneth A Rostowsky
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Nikhil N Chaudhari
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Van Ngo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Lauren J O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Lauren Green
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Nasim Sheikh-Bahaei
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Los Angeles, CA, 90033, USA
| | - Helena C Chui
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089, USA.
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, 90089, USA.
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16
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Cao M, Luo Y, Wu Z, Wu K, Li X. Abnormal neurite density and orientation dispersion in frontal lobe link to elevated hyperactive/impulsive behaviors in young adults with traumatic brain injury. Brain Commun 2022; 4:fcac011. [PMID: 35187485 PMCID: PMC8853727 DOI: 10.1093/braincomms/fcac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/02/2021] [Accepted: 01/27/2022] [Indexed: 11/15/2022] Open
Abstract
Traumatic brain injury is a major public health concern. A significant proportion of individuals experience post-traumatic brain injury behavioural impairments, especially in attention and inhibitory control domains. Traditional diffusion-weighted MRI techniques, such as diffusion tensor imaging, have provided tools to assess white matter structural disruptions reflecting the long-term brain tissue alterations associated with traumatic brain injury. The recently developed neurite orientation dispersion and density imaging is a more advanced diffusion MRI modality, which provides more refined characterization of brain tissue microstructures by assessing the neurite orientation dispersion and neurite density properties. In this study, neurite orientation dispersion and density imaging data from 44 young adults with chronic traumatic brain injury (who had no prior-injury diagnoses of any sub-presentation of attention deficits/hyperactivity disorder or experience of severe inattentive and/or hyperactive behaviours) and 45 group-matched normal controls were investigated, to assess the post-injury morphometrical and microstructural brain alterations and their relationships with the behavioural outcomes. Maps of fractional anisotropy, neurite orientation dispersion index and neurite density index were calculated. Vertex-wise and voxel-wise analyses were conducted for grey matter and white matter, respectively. Post hoc region-of-interest-based analyses were also performed. Compared to the controls, the group of traumatic brain injury showed significantly increased orientation dispersion index and significantly decreased neurite density index in various grey matter regions, as well as significantly decreased orientation dispersion index in several white matter regions. Brain–behavioural association analyses indicated that the reduced neurite density index of the left precentral gyrus and the reduced orientation dispersion index of the left superior longitudinal fasciculus were significantly associated with elevated hyperactive/impulsive symptoms in the patients with traumatic brain injury. These findings suggest that post-injury chronical neurite intracellular volume and angular distribution anomalies in the frontal lobe, practically the precentral area, can significantly contribute to the onset of hyperactive/impulsive behaviours in young adults with traumatic brain injury.
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Affiliation(s)
- Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA
| | - Yuyang Luo
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA
| | - Ziyan Wu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, NJ, USA
| | - Kai Wu
- Department of Electrical and Computer Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, NJ, USA
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, NJ, USA
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17
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Li MJ, Yeh FC, Huang SH, Huang CX, Zhang H, Liu J. Differential Tractography and Correlation Tractography Findings on Patients With Mild Traumatic Brain Injury: A Pilot Study. Front Hum Neurosci 2022; 16:751902. [PMID: 35126076 PMCID: PMC8811572 DOI: 10.3389/fnhum.2022.751902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Differential tractography and correlation tractography are new tractography modalities to study neuronal changes in brain diseases, but their performances in detecting neuronal injuries are yet to be investigated in patients with mild traumatic brain injury (mTBI). Here we investigated the white matter injury in mTBI patients using differential and correlation tractography. The diffusion MRI was acquired at 33 mTBI patients and 31 health controls. 7 of the mTBI patients had one-year follow-up scans, and differential tractography was used to evaluate injured fiber bundles on these 7 patients. All subjects were evaluated using digital symbol substitution test (DSST) and trail making test A (TMT-A), and the correlation tractography was performed to explore the exact pathways related to the cognitive performance. Our results showed that differential tractography revealed neuronal changes in the corpus callosum in all 7 follow-up mTBI patients with FDR between 0.007 and 0.17. Further, the correlation tractography showed that the splenium of the corpus callosum, combined with the right superior longitudinal fasciculus and right cingulum, were correlated with DSST (FDR = 0.001669) in the acute mTBI patients. The cognitive impairment findings in the acute stage and the longitudinal findings in the corpus callosum in the chronic stage of mTBI patients suggest that differential tractography and correlation tractography are valuable tools in the diagnostic and prognostic evaluation of neuronal injuries in mTBI patients.
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Affiliation(s)
- Meng-Jun Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- Department of Bioengineering, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Si-Hong Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chu-Xin Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthcare Ltd., Wuhan, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Jun Liu,
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18
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Kim E, Yoo RE, Seong MY, Oh BM. A systematic review and data synthesis of longitudinal changes in white matter integrity after mild traumatic brain injury assessed by diffusion tensor imaging in adults. Eur J Radiol 2021; 147:110117. [PMID: 34973540 DOI: 10.1016/j.ejrad.2021.110117] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/28/2021] [Accepted: 12/20/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE This study aimed to review diffusion tensor imaging studies of mild traumatic brain injury (mTBI) in adults with longitudinal acquisition of data and investigate the variability of findings in association with related factors, such as the time post-injury. METHODS Eligible studies from PubMed and EMBASE were searched to identify relevant studies for review. Of the 540 studies, 23 observational studies without intervention and with the following characteristics were included: original research in which adults with mTBI were examined, diffusion tensor imaging was acquired at least twice, white matter integrity was investigated by estimating diffusion metrics, and mode of injury was not restricted to sport- or blast-related mTBI. RESULTS Baseline scans were acquired within 3 weeks post-injury, followed by longitudinal scans within 3 months and at 12 months post-injury. During the acute/subacute period, mixed results (increase, decrease, or no significant change) of fractional anisotropy (FA) were observed compared to those in controls. Some studies reported increased FA during the acute/subacute period compared to controls, followed by normalization of FA. Decreased FA was also reported during the acute/subacute period, which lasted long into the chronic phase. In the acute phase, the mean diffusivity (MD) was greater than that in the controls. Compared to the early phase of injury, MD was reduced in the follow-up phase in most studies in the mTBI group. Insignificant differences in FA and MD have been reported in several studies. Such variability limits the clinical usefulness of diffusion tensor metrics. CONCLUSIONS There was a high variability in reported changes in white matter integrity. Decreased FA not only in acute/subacute but also in long-term period after injury may indicate long-term neurodegenerative processes after mTBI. Nevertheless, longitudinal changes in MD towards normalization suggest possible recovery. Long-term cohort studies with research initiatives should be considered to elucidate brain changes after mTBI.
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Affiliation(s)
- Eunkyung Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Roh-Eul Yoo
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Min Yong Seong
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea.
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19
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Jia X, Chang X, Bai L, Wang Y, Dong D, Gan S, Wang S, Li X, Yang X, Sun Y, Li T, Xiong F, Niu X, Yan H. A Longitudinal Study of White Matter Functional Network in Mild Traumatic Brain Injury. J Neurotrauma 2021; 38:2686-2697. [PMID: 33906419 DOI: 10.1089/neu.2021.0017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Some patients after mild traumatic brain injury (mTBI) experience microstructural damages in the long-distance white matter (WM) connections, which disrupts the functional connectome of large-scale brain networks that support cognitive function. Patterns of WM structural damage following mTBI were well documented using diffusion tensor imaging (DTI). However, the functional organization of WM and its association with gray matter functional networks (GM-FNs) and its DTI metrics remain unknown. The present study adopted resting-state functional magnetic resonance imaging to explore WM functional properties in mTBI patients (108 acute patients, 48 chronic patients, 46 healthy controls [HCs]). Eleven large-scale WM functional networks (WM-FNs) were constructed by the k-means clustering algorithm of voxel-wise WM functional connectivity (FC). Compared with HCs, acute mTBI patients observed enhanced FC between inferior fronto-occipital fasciculus (IFOF) WM-FN and primary sensorimotor WM-FNs, and cortical primary sensorimotor GM-FNs. Further, acute mTBI patients showed increased DTI metrics (mean diffusivity, axial diffusivity, and radial diffusivity) in deep WM-FNs and higher-order cognitive WM-FNs. Moreover, mTBI patients demonstrated full recovery of FC and partial recovery of DTI metrics in the chronic stage. Additionally, enhanced FC between IFOF WM-FN and anterior cerebellar GM-FN was correlated with impaired information processing speed. Our findings provide novel evidence for functional and structural alteration of WM-FNs in mTBI patients. Importantly, the convergent damage of the IFOF network might imply its crucial role in our understanding of the pathophysiology mechanism of mTBI patients.
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Affiliation(s)
- Xiaoyan Jia
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xuebin Chang
- School of Life Science and Technology, Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - Lijun Bai
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Yulin Wang
- Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Debo Dong
- School of Life Science and Technology, Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
- Institute of Neuroscience and Medicine, Brain and Behavior (INM-7), Research Center Jülich, Jülich, Germany
| | - Shuoqiu Gan
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Shan Wang
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xuan Li
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xuefei Yang
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Yinxiang Sun
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tianhui Li
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Feng Xiong
- Department of Biomedical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xuan Niu
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hao Yan
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an, China
- Department of Linguistics, Xidian University, Xi'an, China
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20
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Tayebi M, Holdsworth SJ, Champagne AA, Cook DJ, Nielsen P, Lee TR, Wang A, Fernandez J, Shim V. The role of diffusion tensor imaging in characterizing injury patterns on athletes with concussion and subconcussive injury: a systematic review. Brain Inj 2021; 35:621-644. [PMID: 33843389 DOI: 10.1080/02699052.2021.1895313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Traumatic brain injury (TBI) is a major public health problem. The majority of TBIs are in the form of mild TBI (also known as concussion) with sports-related concussion (SRC) receiving public attention in recent years.Here we have performed a systematic review of the literature on the use of Diffusion Tensor Imaging (DTI) on sports-related concussion and subconcussive injuries. Our review found different patterns of change in DTI parameters between concussed and subconcussed groups. The Fractional Anisotropy (FA) was either unchanged or increased for the concussion group, while the subconcussed group generally experienced a decrease in FA. A reverse pattern was observed for Mean Diffusivity (MD) - where the concussed group experienced a decrease in MD while the subconcussed group showed an increase in MD. However, in general, discrepancies were observed in the results reported in the literature - likely due to the huge variations in DTI acquisition parameters, and image processing and analysis methods used in these studies. This calls for more comprehensive and well-controlled studies in this field, including those that combine the advanced brain imaging with biomechancial modeling and kinematic sensors - to shed light on the underlying mechanisms behind the structural changes observed from the imaging studies.
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Affiliation(s)
- Maryam Tayebi
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Samantha J Holdsworth
- Department of Anatomy and Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Insitute, Gisborne, New Zealand
| | - Allen A Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Douglas J Cook
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Department of Surgery, Queen's University, Kingston, ON, Canada
| | - Poul Nielsen
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Tae-Rin Lee
- Advanced Institute of Convergence Technology, Seoul National University, Seoul, Republic of Korea
| | - Alan Wang
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.,Department of Anatomy and Medical Imaging & Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.,Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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21
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Turner S, Lazarus R, Marion D, Main KL. Molecular and Diffusion Tensor Imaging Biomarkers of Traumatic Brain Injury: Principles for Investigation and Integration. J Neurotrauma 2021; 38:1762-1782. [PMID: 33446015 DOI: 10.1089/neu.2020.7259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The last 20 years have seen the advent of new technologies that enhance the diagnosis and prognosis of traumatic brain injury (TBI). There is recognition that TBI affects the brain beyond initial injury, in some cases inciting a progressive neuropathology that leads to chronic impairments. Medical researchers are now searching for biomarkers to detect and monitor this condition. Perhaps the most promising developments are in the biomolecular and neuroimaging domains. Molecular assays can identify proteins indicative of neuronal injury and/or degeneration. Diffusion imaging now allows sensitive evaluations of the brain's cellular microstructure. As the pace of discovery accelerates, it is important to survey the research landscape and identify promising avenues of investigation. In this review, we discuss the potential of molecular and diffusion tensor imaging (DTI) biomarkers in TBI research. Integration of these technologies could advance models of disease prognosis, ultimately improving care. To date, however, few studies have explored relationships between molecular and DTI variables in patients with TBI. Here, we provide a short primer on each technology, review the latest research, and discuss how these biomarkers may be incorporated in future studies.
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Affiliation(s)
- Stephanie Turner
- Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA.,General Dynamics Information Technology, Falls Church, Virginia, USA
| | - Rachel Lazarus
- Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA.,General Dynamics Information Technology, Falls Church, Virginia, USA
| | - Donald Marion
- Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA.,General Dynamics Information Technology, Falls Church, Virginia, USA
| | - Keith L Main
- Defense and Veterans Brain Injury Center, Silver Spring, Maryland, USA.,General Dynamics Information Technology, Falls Church, Virginia, USA
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22
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Li Y, Liu K, Li C, Guo Y, Fang J, Tong H, Tang Y, Zhang J, Sun J, Jiao F, Zhang Q, Jin R, Xiong K, Chen X. 18F-FDG PET Combined With MR Spectroscopy Elucidates the Progressive Metabolic Cerebral Alterations After Blast-Induced Mild Traumatic Brain Injury in Rats. Front Neurosci 2021; 15:593723. [PMID: 33815036 PMCID: PMC8012735 DOI: 10.3389/fnins.2021.593723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
A majority of blast-induced mild traumatic brain injury (mTBI) patients experience persistent neurological dysfunction with no findings on conventional structural MR imaging. It is urgent to develop advanced imaging modalities to detect and understand the pathophysiology of blast-induced mTBI. Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) could detect neuronal function and activity of the injured brain, while MR spectroscopy provides complementary information and assesses metabolic irregularities following injury. This study aims to investigate the effectiveness of combining 18F-FDG PET with MR spectroscopy to evaluate acute and subacute metabolic cerebral alterations caused by blast-induced mTBI. Thirty-two adult male Sprague–Dawley rats were exposed to a single blast (mTBI group) and 32 rats were not exposed to the blast (sham group), followed by 18F-FDG PET, MRI, and histological evaluation at baseline, 1–3 h, 1 day, and 7 days post-injury in three separate cohorts. 18F-FDG uptake showed a transient increase in the amygdala and somatosensory cortex, followed by a gradual return to baseline from day 1 to 7 days post-injury and a continuous rise in the motor cortex. In contrast, decreased 18F-FDG uptake was seen in the midbrain structures (inferior and superior colliculus). Analysis of MR spectroscopy showed that inflammation marker myo-inositol (Ins), oxidative stress marker glutamine + glutamate (Glx), and hypoxia marker lactate (Lac) levels markedly elevated over time in the somatosensory cortex, while the major osmolyte taurine (Tau) level immediately increased at 1–3 h and 1 day, and then returned to sham level on 7 days post-injury, which could be due to the disruption of the blood–brain barrier. Increased 18F-FDG uptake and elevated Ins and Glx levels over time were confirmed by histology analysis which showed increased microglial activation and gliosis in the frontal cortex. These results suggest that 18F-FDG PET and MR spectroscopy can be used together to reflect more comprehensive neuropathological alterations in vivo, which could improve our understanding of the complex alterations in the brain after blast-induced mTBI.
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Affiliation(s)
- Yang Li
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Department of Medical Imaging, Air Force Hospital of Western Theater Command, Chengdu, China
| | - Kaijun Liu
- Department of Gastroenterology, Daping Hospital, Army Medical University, Chongqing, China
| | - Chang Li
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jingqin Fang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Haipeng Tong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yi Tang
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Junfeng Zhang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jinju Sun
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Fangyang Jiao
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Qianhui Zhang
- Department of Foreign Language, Army Medical University, Chongqing, China
| | - Rongbing Jin
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Kunlin Xiong
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
| | - Xiao Chen
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, China.,Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, China
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23
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Sinke MRT, Otte WM, Meerwaldt AE, Franx BAA, Ali MHM, Rakib F, van der Toorn A, van Heijningen CL, Smeele C, Ahmed T, Blezer ELA, Dijkhuizen RM. Imaging Markers for the Characterization of Gray and White Matter Changes from Acute to Chronic Stages after Experimental Traumatic Brain Injury. J Neurotrauma 2021; 38:1642-1653. [PMID: 33198560 DOI: 10.1089/neu.2020.7151] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Despite clinical symptoms, a large majority of people with mild traumatic brain injury (TBI) have normal computed tomography (CT) and magnetic resonance imaging (MRI) scans. Therefore, present-day neuroimaging tools are insufficient to diagnose or classify low grades of TBI. Advanced neuroimaging techniques, such as diffusion-weighted and functional MRI, may yield novel biomarkers that may aid in the diagnosis of TBI. Therefore, the present study had two aims: first, to characterize the development of MRI-based measures of structural and functional changes in gray and white matter regions from acute to chronic stages after mild and moderate TBI; and second, to identify the imaging markers that can most accurately predict outcome after TBI. To these aims, 52 rats underwent serial functional (resting-state) and structural (T1-, T2-, and diffusion-weighted) MRI before and 1 h, 1 day, 1 week, 1 month and 3-4 months after mild or moderate experimental TBI. All rats underwent behavioral testing. Histology was performed in subgroups of rats at different time points. Early after moderate TBI, axial and radial diffusivities were increased, and fractional anisotropy was reduced in the corpus callosum and bilateral hippocampi, which normalized over time and was paralleled by recovery of sensorimotor function. Correspondingly, histology revealed decreased myelin staining early after TBI, which was not detected at chronic stages. No significant changes in individual outcome measures were detected after mild TBI. However, multivariate analysis showed a significant additive contribution of diffusion parameters in the distinction between control and different grades of TBI-affected brains. Therefore, combining multiple imaging markers may increase the sensitivity for TBI-related pathology.
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Affiliation(s)
- Michel R T Sinke
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Willem M Otte
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078.,UMC Utrecht Brain Center, Department of Child Neurology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Anu E Meerwaldt
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Bart A A Franx
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Mohamed H M Ali
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Fazle Rakib
- Department of Chemistry and Earth Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Annette van der Toorn
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Caroline L van Heijningen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Christel Smeele
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Tariq Ahmed
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Erwin L A Blezer
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. ORCID ID: 0000-0002-8185-9209; 0000-0002-4623-4078
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24
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To XV, Nasrallah FA. A roadmap of brain recovery in a mouse model of concussion: insights from neuroimaging. Acta Neuropathol Commun 2021; 9:2. [PMID: 33407949 PMCID: PMC7789702 DOI: 10.1186/s40478-020-01098-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022] Open
Abstract
Concussion or mild traumatic brain injury is the most common form of traumatic brain injury with potentially long-term consequences. Current objective diagnosis and treatment options are limited to clinical assessment, cognitive rest, and symptom management, which raises the real danger of concussed patients being released back into activities where subsequent and cumulative injuries may cause disproportionate damages. This study conducted a cross-sectional multi-modal examination investigation of the temporal changes in behavioural and brain changes in a mouse model of concussion using magnetic resonance imaging. Sham and concussed mice were assessed at day 2, day 7, and day 14 post-sham or injury procedures following a single concussion event for motor deficits, psychological symptoms with open field assessment, T2-weighted structural imaging, diffusion tensor imaging (DTI), neurite orientation density dispersion imaging (NODDI), stimulus-evoked and resting-state functional magnetic resonance imaging (fMRI). Overall, a mismatch in the temporal onsets and durations of the behavioural symptoms and structural/functional changes in the brain was seen. Deficits in behaviour persisted until day 7 post-concussion but recovered at day 14 post-concussion. DTI and NODDI changes were most extensive at day 7 and persisted in some regions at day 14 post-concussion. A persistent increase in connectivity was seen at day 2 and day 14 on rsfMRI. Stimulus-invoked fMRI detected increased cortical activation at day 7 and 14 post-concussion. Our results demonstrate the capabilities of advanced MRI in detecting the effects of a single concussive impact in the brain, and highlight a mismatch in the onset and temporal evolution of behaviour, structure, and function after a concussion. These results have significant translational impact in developing methods for the detection of human concussion and the time course of brain recovery.
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25
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Mahan MY, Rafter DJ, Truwit CL, Oswood M, Samadani U. Evaluation of diffusion measurements reveals radial diffusivity indicative of microstructural damage following acute, mild traumatic brain injury. Magn Reson Imaging 2020; 77:137-147. [PMID: 33359428 DOI: 10.1016/j.mri.2020.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/25/2020] [Accepted: 12/20/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE Mild TBI, characterized by microstructural damage, often undetectable on conventional imaging techniques, is a pervasive condition that disturbs brain function and can potentially result in long-term deficits. Deciphering the underlying microstructural damage in mild TBI is crucial for establishing a reliable diagnosis and enabling effective therapeutics. Efforts to capture this damage have been extensive, but results have been inconsistent and incomplete. METHODS To that effect, we set out to examine the shape of the diffusion tensor in mild TBI during the acute phase of injury. We inspected diffusivity and geometric measurements describing the diffusion tensor's shape and compared mild TBI (N = 34, 20.4-66.6 yo) measurements with those from healthy control (N = 42, 20.7-67.2 yo) participants using voxelwise tract-based spatial statistics. Subsequently, to explore associations between the diffusion measurements in mild TBI, we performed nonparametric statistics and machine learning techniques. RESULTS Overall, mild TBI displayed a diffuse increase in Dλ2, Dλ3, Dradial, Dmean, and Cspherical, with a diffuse decrease in Afractional, Amode, and Clinear, in addition to no change in Daxial or Cplanar. Most notably, our results provide evidence for Dradial as a potential biomarker for microstructural damage, specifically its main component Dλ2, based on their performance in discriminating between mild TBI and control groups. Afractional was also found to be important for discriminating between groups. CONCLUSION Our results revealed the importance of a diffusion measurement often overlooked, Dradial, in assessing TBI and suggest differentiating diffusion measurements has the potential utility to detect variations in the underlying pathophysiology after injury.
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Affiliation(s)
- Margaret Y Mahan
- Department of Biomedical Informatics and Computational Biology, University of Minnesota, 101 Pleasant St SE, Minneapolis, MN 55455, USA.
| | - Daniel J Rafter
- Department of Biomedical Informatics and Computational Biology, University of Minnesota, 101 Pleasant St SE, Minneapolis, MN 55455, USA
| | - Charles L Truwit
- Diagnostic Imaging, Philips Global, 6655 Wedgwood Rd N #105, Maple Grove, MN 55311, USA; Department of Radiology, Hennepin Healthcare, 701 Park Ave, Minneapolis, MN 55415, USA.
| | - Mark Oswood
- Department of Radiology, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA; Department of Radiology, Hennepin Healthcare, 701 Park Ave, Minneapolis, MN 55415, USA.
| | - Uzma Samadani
- Department of Biomedical Informatics and Computational Biology, University of Minnesota, 101 Pleasant St SE, Minneapolis, MN 55455, USA; Department of Neurosurgery, Minneapolis VA Medical Center, 1 Veterans Drive, Minneapolis, MN 55417, USA.
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26
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Trillingsgaard Naess-Schmidt E, Udby Blicher J, Møller Thastum M, Ulrikka Rask C, Wulff Svendsen S, Schröder A, Høgh Tuborgh A, Østergaard L, Sangill R, Lund T, Nørhøj Jespersen S, Roer Pedersen A, Hansen B, Fristed Eskildsen S, Feldbaek Nielsen J. Microstructural changes in the brain after long-term post-concussion symptoms: A randomized trial. J Neurosci Res 2020; 99:872-886. [PMID: 33319932 DOI: 10.1002/jnr.24773] [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] [Received: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 01/17/2023]
Abstract
A recent randomized controlled trial in young patients with long-term post-concussion symptoms showed that a novel behavioral intervention "Get going After concussIoN" is superior to enhanced usual care in terms of symptom reduction. It is unknown whether these interventional effects are associated with microstructural brain changes. The aim of this study was to examine whether diffusion-weighted MRI indices, which are sensitive to the interactions between cellular structures and water molecules' Brownian motion, respond differently to the interventions of the above-mentioned trial and whether such differences correlate with the improvement of post-concussion symptoms. Twenty-three patients from the intervention group (mean age 22.8, 18 females) and 19 patients from the control group (enhanced usual care) (mean age 23.9, 14 females) were enrolled. The primary outcome measure was the mean kurtosis tensor, which is sensitive to the microscopic complexity of brain tissue. The mean kurtosis tensor was significantly increased in the intervention group (p = 0.003) in the corpus callosum but not in the thalamus (p = 0.78) and the hippocampus (p = 0.34). An increase in mean kurtosis tensor in the corpus callosum tended to be associated with a reduction in symptoms, but this association did not reach significance (p = 0.059). Changes in diffusion tensor imaging metrics did not differ between intervention groups and were not associated with symptoms. The current study found different diffusion-weighted MRI responses from the microscopic cellular structures of the corpus callosum between patients receiving a novel behavioral intervention and patients receiving enhanced usual care. Correlations with improvement of post-concussion symptoms were not evident.
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Affiliation(s)
- Erhard Trillingsgaard Naess-Schmidt
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.,Department of Clinical Health, Aarhus University, Aarhus, Denmark
| | - Jakob Udby Blicher
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Mille Møller Thastum
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.,Department of Clinical Health, Aarhus University, Aarhus, Denmark
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne Wulff Svendsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Schröder
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Astrid Høgh Tuborgh
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
| | - Leif Østergaard
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.,Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Ryan Sangill
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Torben Lund
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Sune Nørhøj Jespersen
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.,Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
| | - Asger Roer Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.,Department of Clinical Health, Aarhus University, Aarhus, Denmark
| | - Brian Hansen
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Simon Fristed Eskildsen
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Jørgen Feldbaek Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark.,Department of Clinical Health, Aarhus University, Aarhus, Denmark
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27
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Cavanagh JF, Rieger RE, Wilson JK, Gill D, Fullerton L, Brandt E, Mayer AR. Joint analysis of frontal theta synchrony and white matter following mild traumatic brain injury. Brain Imaging Behav 2020; 14:2210-2223. [PMID: 31368085 PMCID: PMC6992511 DOI: 10.1007/s11682-019-00171-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Some of the most disabling aspects of mild traumatic brain injury (mTBI) include lingering deficits in executive functioning. It is known that mTBI can damage white matter tracts, but it remains unknown how this structural brain damage translates into cognitive deficits. This experiment utilized theta band phase synchrony to identify the dysfunctional neural operations that contribute to cognitive problems following mTBI. Sub-acute stage (< 2 weeks) mTBI patients (N = 52) and healthy matched controls (N = 32) completed a control-demanding task with concurrent EEG. Structural MRI was also collected. While there were no performance-specific behavioral differences between groups in the dot probe expectancy task, the degree of theta band phase synchrony immediately following injury predicted the degree of symptom recovery two months later. Although there were no differences in fractional anisotropy (FA) between groups, joint independent components analysis revealed that a smaller network of lower FA-valued voxels contributed to a diminished frontal theta phase synchrony network in the mTBI group. This finding suggests that frontal theta band markers of cognitive control are sensitive to sub-threshold structural aberrations following mTBI.
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Affiliation(s)
- James F Cavanagh
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA.
| | - Rebecca E Rieger
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - J Kevin Wilson
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - Darbi Gill
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - Lynne Fullerton
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 116025, Albuquerque, NM, 87131, USA
| | - Emma Brandt
- Department of Neuroscience, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
| | - Andrew R Mayer
- Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, MSC03 2220, Albuquerque, NM, 87131, USA
- Mind Research Network, 1101 Yale Blvd NE, Albuquerque, NM, 87106, USA
- Departments of Neurology and Psychiatry, University of New Mexico Health Sciences Center, 1101 Yale Blvd, University of New Mexico, MSC 084740, Albuquerque, NM, 87131, USA
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28
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Abstract
This article focuses on 3 concepts that continue to be investigated in the search for the holy grail of concussion-a valid diagnostic test. Imaging advances are discussed with optimism that functional MRI and diffusion tensor imaging may be available clinically. Biomarkers and the use of genetic tests are covered. Sideline accelerometer use may help steer discussions of head trauma risk once technology exists to accurately estimate acceleration of the brain. In the meantime, strategies including allowing athletes to be substituted out of games for an evaluation and video review in elite sports can improve recognition of sports-related concussion.
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Affiliation(s)
- Hamish Kerr
- Sports Medicine, Department of Medicine, Albany Medical College, 1019 New Loudon Road, Cohoes, NY 12047, USA.
| | - Bjørn Bakken
- Department of Medicine, Albany Medical Center, 1019 New Loudon Road, Cohoes, NY 12047, USA
| | - Gregory House
- Department of Family and Community Medicine, Albany Medical Center, 391 Myrtle Avenue, Albany, NY 12208, USA
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29
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Wang Z, Zhang M, Sun C, Wang S, Cao J, Wang KKW, Gan S, Huang W, Niu X, Zhu Y, Sun Y, Bai L. Single Mild Traumatic Brain Injury Deteriorates Progressive Interhemispheric Functional and Structural Connectivity. J Neurotrauma 2020; 38:464-473. [PMID: 30931824 DOI: 10.1089/neu.2018.6196] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The present study examined dynamic interhemispheric structural and functional connectivity in mild traumatic brain injury (mTBI) patients with longitudinal observations from early subacute to chronic stages within 1 year of injury. Forty-two mTBI patients and 42 matched healthy controls underwent clinical and neuropsychological evaluations, diffusion tensor imaging, and resting-state functional magnetic resonance imaging. All mTBI patients were initially evaluated within 14 d post-injury (T-1) and at 3 months (T-2) and 6-12 months (T-3) follow-ups. Separate transcallosal fiber tracts in the corpus callosum (CC) with respect to their specific interhemispheric cortical projections were derived with fiber tracking and voxel-mirrored homotopic connectivity analyses. With diffusion tensor imaging-based tractography, five vertical segments of the CC (I-V) were distinguished. Correlation analyses were performed to evaluate relationships between structural and functional imaging measures as well as imaging indices and neuropsychological measures. The loss of integrity in the CC demonstrated saliently persistent and time-dependent regional specificity after mTBI. The impairment spanned multiple segments from CC II at T-1 and CC I, II, VI, and V at T-2 to all subregions at T-3. Moreover, loss of interhemispheric structural connectivity through the CC corresponded well to regions presenting altered interhemispheric functional connectivity. Decreased functional connectivity in the dorsolateral prefrontal cortex thereafter contributed to poor executive function in mTBI patients. The current study provides further evidence that the CC is a sign to interhemispheric highways underpinning the widespread cerebral pathology typifying mTBI syndrome.
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Affiliation(s)
- Zhuonan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ming Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chuanzhu Sun
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Jieli Cao
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Kevin K W Wang
- Program for Neurotrauma, Neuroproteomics, and Biomarker Research, Departments of Emergency Medicine, Psychiatry, and Neuroscience, University of Florida, Gainesville, Florida, USA
| | - Shuoqiu Gan
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenmin Huang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Xuan Niu
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanan Zhu
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yingxiang Sun
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
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Makita K, Takiguchi S, Naruse H, Shimada K, Morioka S, Fujisawa TX, Shimoji K, Tomoda A. White matter changes in children and adolescents with reactive attachment disorder: A diffusion tensor imaging study. Psychiatry Res Neuroimaging 2020; 303:111129. [PMID: 32585578 DOI: 10.1016/j.pscychresns.2020.111129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/23/2020] [Accepted: 06/12/2020] [Indexed: 01/02/2023]
Abstract
Childhood maltreatment is associated with altered brain structure and function and is a major risk factor for psychopathology, including reactive attachment disorder (RAD). However, whether changes to white matter microstructural integrity are associated with RAD is unclear. We used diffusion tensor imaging (DTI) to assess group differences in fractional anisotropy (FA) in patients with RAD (n = 25; mean age = 13.2) to typically developing (TD) controls (n = 33; mean age = 13.0). To further interpret differences in FA, additional parameters such as mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were assessed. We found that FA values in the body of corpus callosum (CC) and in the projection and thalamic pathways, including the posterior limb of the internal capsule and corona radiata (anterior, posterior, and superior), were significantly higher in the RAD than in the TD group. Additionally, RAD group showed significantly lower RD values in the body of the CC and abovementioned pathways than TD group. Our findings indicate that RAD is associated with altered structure of the CC and projection and thalamic pathways, which may play a role in emotion regulation. The aberrant development of these tracts in RAD may reflect stress-related psychophysiological responses.
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Affiliation(s)
- Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Shinichiro Takiguchi
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Hiroaki Naruse
- Division of Physical Therapy and Rehabilitation, University of Fukui Hospital, Fukui, Japan
| | - Koji Shimada
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Shigemi Morioka
- Department of Pediatrics, Fukui Aiiku Hospital, Fukui, Japan
| | - Takashi X Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
| | - Keigo Shimoji
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan; Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan; Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan; Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan.
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31
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Bai L, Bai G, Wang S, Yang X, Gan S, Jia X, Yin B, Yan Z. Strategic white matter injury associated with long-term information processing speed deficits in mild traumatic brain injury. Hum Brain Mapp 2020; 41:4431-4441. [PMID: 32657510 PMCID: PMC7502829 DOI: 10.1002/hbm.25135] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/07/2020] [Accepted: 06/26/2020] [Indexed: 12/21/2022] Open
Abstract
Deficits in information processing speed (IPS) are among the earliest and most prominent cognitive manifestations in mild traumatic brain injury (mTBI). We investigated the impact of white matter fiber location on IPS outcome in an individual basis assessment. A total of 112 acute mild TBI with all CT negative underwent brain DTI and blood sampling for inflammation cytokines within 7 days postinjury and 72 age‐ and sex matched healthy controls with same assessments were enrolled. IPS outcome was assessed by the trail making test at 6–12 month postinjury in mild TBI. Fractional anisotropy (FA) features were extracted using a novel lesion‐load analytical strategy to capture spatially heterogeneous white matter injuries and minimize implicit assumptions of uniform injury across diverse clinical presentations. Acute mild TBI exhibited a general pattern of increased and decreased FA in specific white matter tracts. The power of acute FA measures to identify patients developing IPS deficits with 92% accuracy and further improved to 96% accuracy by adding inflammation cytokines. The classifiers predicted individual's IPS and working memory ratings (r = .74 and .80, respectively, p < .001). The thalamo‐cortical circuits and commissural tracts projecting or connecting frontal regions became important predictors. This prognostic model was also verified by an independent replicate sample. Our findings highlighted damage to frontal interhemispheric and thalamic projection fiber tracts harboring frontal‐subcortical neuronal circuits as a predictor for processing speed performance in mild TBI.
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Affiliation(s)
- Lijun Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, China
| | - Guanghui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, China
| | - Xuefei Yang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, China
| | - Shuoqiu Gan
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, China
| | - Xiaoyan Jia
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi' an Jiaotong University, Xi'an, China
| | - Bo Yin
- Department of Neurosurgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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32
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To XV, Benetatos J, Soni N, Liu D, Mehari Abraha H, Yan W, Panagiotopoulou O, Nasrallah FA. Ultra-High-Field Diffusion Tensor Imaging Identifies Discrete Patterns of Concussive Injury in the Rodent Brain. J Neurotrauma 2020; 38:967-982. [PMID: 32394788 DOI: 10.1089/neu.2019.6944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Although concussions can result in persistent neurological post-concussion symptoms, they are typically invisible on routine magnetic resonance imaging (MRI) scans. Our study aimed to investigate the use of ultra-high-field diffusion tensor imaging (UHF-DTI) in discerning severity-dependent microstructural changes in the mouse brain following a concussion. Twenty-three C57BL/6 mice were randomly allocated into three groups: the low concussive (LC, n = 9) injury group, the high concussive (HC, n = 6) injury group, and the sham control (SC, n = 7) group. Mice were perfused on day 2 post-injury, and the brains were scanned on a 16.4T MRI scanner with UHF-DTI and neurite orientation dispersion imaging (NODDI). Finite element analysis (FEA) was performed to determine the pattern and extent of the physical impact on the brain tissue. MRI findings were correlated with histopathological analysis in a subset of mice. In the LC group, increased fractional anisotropy (FA) and decreased orientation dispersion index (ODI) but limited neurite density index (NDI) changes were found in the gray matter, and minimal changes to white matter (WM) were observed. The HC group presented increased mean diffusivity (MD), decreased NDI, and decreased ODI in the WM and gray matter (GM); decreased FA was also found in a small area of the WM. WM changes were associated with WM degeneration and neuroinflammation. FEA showed varying region-dependent degrees of stress, in line with the different imaging findings. This study provides evidence that UHF-DTI combined with NODDI can detect concussions of variable intensities. This has significant implications for the diagnosis of concussion in humans.
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Affiliation(s)
- Xuan Vinh To
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Joseph Benetatos
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Neha Soni
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Dedao Liu
- Department of Mechanical and Aerospace Engineering, Faculty of Engineering, Department of Anatomy and Developmental Biology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Hyab Mehari Abraha
- Monash Biomedicine Discovery Institute, Department of Anatomy and Developmental Biology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Wenyi Yan
- Department of Mechanical and Aerospace Engineering, Faculty of Engineering, Department of Anatomy and Developmental Biology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Olga Panagiotopoulou
- Monash Biomedicine Discovery Institute, Department of Anatomy and Developmental Biology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Fatima A Nasrallah
- The Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia.,The Center for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia
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33
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Barth C, Lonning V, Gurholt TP, Andreassen OA, Myhre AM, Agartz I. Exploring white matter microstructure and the impact of antipsychotics in adolescent-onset psychosis. PLoS One 2020; 15:e0233684. [PMID: 32470000 PMCID: PMC7259775 DOI: 10.1371/journal.pone.0233684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/10/2020] [Indexed: 01/11/2023] Open
Abstract
White matter abnormalities are well-established in adult patients with psychosis. Less is known about abnormalities in the rarely occurring adolescent early onset psychosis (EOP). In particular, whether antipsychotic medication might impact white matter microstructure is not known. Using 3T diffusion weighted imaging, we investigated differences in white matter microstructure and the impact of antipsychotic medication status in medicated (n = 11) and unmedicated (n = 11) EOP patients relative to healthy controls (n = 33), aged between 12–18 years. Using Tract-based Spatial Statistics, we calculate case-control differences in scalar diffusion measures, i.e. fractional anisotropy (FA), axial diffusion (AD) and radial diffusion (RD), and investigated their association with antipsychotic medication in patients. We found significantly lower FA in the left genu of the corpus callosum, the left anterior corona radiata (ACR) and the right superior longitudinal fasciculus in EOP patients relative to healthy controls. AD values were also lower in the left ACR, largely overlapping with the FA findings. Mean FA in the left ACR was significantly associated with antipsychotic medication status (Cohen's d = 1.37, 95% CI [0.01, 2.68], p = 0.008), showing higher FA values in medicated compared to unmedicated EOP patients. The present study is the first to link antipsychotic medication status to altered regional FA in the left ACR, a region hypothesized to contribute to the etiology of psychosis. Replications are warranted to draw firm conclusions about putatively enhancing effects of antipsychotic medication on white matter microstructure in adolescent-onset psychosis.
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Affiliation(s)
- Claudia Barth
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | - Vera Lonning
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tiril Pedersen Gurholt
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne M. Myhre
- Child & Adolescent Mental Health Research Unit, Oslo University Hospital, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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34
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Venkatasubramanian PN, Keni P, Gastfield R, Li L, Aksenov D, Sherman SA, Bailes J, Sindelar B, Finan JD, Lee J, Bailes JE, Wyrwicz AM. Diffusion Tensor Imaging Detects Acute and Subacute Changes in Corpus Callosum in Blast-Induced Traumatic Brain Injury. ASN Neuro 2020; 12:1759091420922929. [PMID: 32403948 PMCID: PMC7238783 DOI: 10.1177/1759091420922929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
There is a critical need for understanding the progression of neuropathology in blast-induced traumatic brain injury using valid animal models to develop diagnostic approaches. In the present study, we used diffusion imaging and magnetic resonance (MR) morphometry to characterize axonal injury in white matter structures of the rat brain following a blast applied via blast tube to one side of the brain. Diffusion tensor imaging was performed on acute and subacute phases of pathology from which fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity were calculated for corpus callosum (CC), cingulum bundle, and fimbria. Ventricular volume and CC thickness were measured. Blast-injured rats showed temporally varying bilateral changes in diffusion metrics indicating persistent axonal pathology. Diffusion changes in the CC suggested vasogenic edema secondary to axonal injury in the acute phase. Axonal pathology persisted in the subacute phase marked by cytotoxic edema and demyelination which was confirmed by ultrastructural analysis. The evolution of pathology followed a different pattern in the cingulum bundle: axonal injury and demyelination in the acute phase followed by cytotoxic edema in the subacute phase. Spatially, structures close to midline were most affected. Changes in the genu were greater than in the body and splenium; the caudal cingulum bundle was more affected than the rostral cingulum. Thinning of CC and ventriculomegaly were greater only in the acute phase. Our results reveal the persistent nature of blast-induced axonal pathology and suggest that diffusion imaging may have potential for detecting the temporal evolution of blast injury.
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Affiliation(s)
- Palamadai N Venkatasubramanian
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Prachi Keni
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Roland Gastfield
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Limin Li
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Daniil Aksenov
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Sydney A Sherman
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Julian Bailes
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Brian Sindelar
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - John D Finan
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - John Lee
- Department of Pathology, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Julian E Bailes
- Department of Neurosurgery, NorthShore University HealthSystem, Evanston, Illinois, United States
| | - Alice M Wyrwicz
- Center for Basic M.R. Research, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois, United States
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Rheault F, De Benedictis A, Daducci A, Maffei C, Tax CMW, Romascano D, Caverzasi E, Morency FC, Corrivetti F, Pestilli F, Girard G, Theaud G, Zemmoura I, Hau J, Glavin K, Jordan KM, Pomiecko K, Chamberland M, Barakovic M, Goyette N, Poulin P, Chenot Q, Panesar SS, Sarubbo S, Petit L, Descoteaux M. Tractostorm: The what, why, and how of tractography dissection reproducibility. Hum Brain Mapp 2020; 41:1859-1874. [PMID: 31925871 PMCID: PMC7267902 DOI: 10.1002/hbm.24917] [Citation(s) in RCA: 48] [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] [Received: 08/22/2019] [Revised: 11/23/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
Investigative studies of white matter (WM) brain structures using diffusion MRI (dMRI) tractography frequently require manual WM bundle segmentation, often called "virtual dissection." Human errors and personal decisions make these manual segmentations hard to reproduce, which have not yet been quantified by the dMRI community. It is our opinion that if the field of dMRI tractography wants to be taken seriously as a widespread clinical tool, it is imperative to harmonize WM bundle segmentations and develop protocols aimed to be used in clinical settings. The EADC-ADNI Harmonized Hippocampal Protocol achieved such standardization through a series of steps that must be reproduced for every WM bundle. This article is an observation of the problematic. A specific bundle segmentation protocol was used in order to provide a real-life example, but the contribution of this article is to discuss the need for reproducibility and standardized protocol, as for any measurement tool. This study required the participation of 11 experts and 13 nonexperts in neuroanatomy and "virtual dissection" across various laboratories and hospitals. Intra-rater agreement (Dice score) was approximately 0.77, while inter-rater was approximately 0.65. The protocol provided to participants was not necessarily optimal, but its design mimics, in essence, what will be required in future protocols. Reporting tractometry results such as average fractional anisotropy, volume or streamline count of a particular bundle without a sufficient reproducibility score could make the analysis and interpretations more difficult. Coordinated efforts by the diffusion MRI tractography community are needed to quantify and account for reproducibility of WM bundle extraction protocols in this era of open and collaborative science.
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Affiliation(s)
- Francois Rheault
- Sherbrooke Connectivity Imaging Laboratory (SCIL)Université de SherbrookeSherbrookeCanada
| | - Alessandro De Benedictis
- Neurosurgery Unit, Department of Neuroscience and NeurorehabilitationBambino Gesù Children's Hospital, IRCCSRomeItaly
| | | | - Chiara Maffei
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General Hospital and Harvard Medical SchoolBostonMA
| | - Chantal M. W. Tax
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of PsychologyCardiff UniversityCardiffUK
| | - David Romascano
- Signal Processing Lab (LTS5)École Polytechnique Fédérale de LausanneLausanneSwitzerland
| | | | | | | | - Franco Pestilli
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIN
| | - Gabriel Girard
- Signal Processing Lab (LTS5)École Polytechnique Fédérale de LausanneLausanneSwitzerland
| | - Guillaume Theaud
- Sherbrooke Connectivity Imaging Laboratory (SCIL)Université de SherbrookeSherbrookeCanada
| | | | - Janice Hau
- Brain Development Imaging Laboratories, Department of PsychologySan Diego State UniversitySan DiegoCAUSA
| | - Kelly Glavin
- Learning Research & Development Center (LRDC)University of PittsburghPittsburghPAUSA
| | | | - Kristofer Pomiecko
- Learning Research & Development Center (LRDC)University of PittsburghPittsburghPAUSA
| | - Maxime Chamberland
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of PsychologyCardiff UniversityCardiffUK
| | - Muhamed Barakovic
- Signal Processing Lab (LTS5)École Polytechnique Fédérale de LausanneLausanneSwitzerland
| | | | - Philippe Poulin
- Sherbrooke Connectivity Imaging Laboratory (SCIL)Université de SherbrookeSherbrookeCanada
| | | | | | - Silvio Sarubbo
- Division of Neurosurgery, Emergency Department, "S. Chiara" HospitalAzienda Provinciale per i Servizi Sanitari (APSS)TrentoItaly
| | - Laurent Petit
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives ‐ UMR 5293, CNRSCEA University of BordeauxBordeauxFrance
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Laboratory (SCIL)Université de SherbrookeSherbrookeCanada
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36
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Raposo Pereira F, McMaster MTB, Schellekens A, Polderman N, de Vries YDAT, van den Brink W, van Wingen GA. Effects of Recreational GHB Use and Multiple GHB-Induced Comas on Brain Structure and Impulsivity. Front Psychiatry 2020; 11:166. [PMID: 32300311 PMCID: PMC7142256 DOI: 10.3389/fpsyt.2020.00166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/21/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND AIMS The regular use of gamma-hydroxybutyrate acid (GHB) can induce GHB-induced comas. Other substance use disorders are associated with alterations in brain structure and impulsivity. Here we aim to investigate if these are also modulated by either regular GHB use or GHB-induced comas. METHODS In a sample of human males, structural and diffusion neuroimaging data were collected for 27 GHB users with ≥4 GHB-induced comas (GHB-Coma), 27 GHB users without GHB-induced comas (GHB-NoComa), and 27 polydrug users who never used GHB (No-GHB). The structural brain parameters were analyzed macroscopically using voxel-based morphometry and microscopically using tract-based spatial statistics (TBSS) and tractography. Impulsivity was assessed with the Barrat Impulsivity Scale. RESULTS In comparison to the other two groups, the GHB-Coma group showed a higher fractional anisotropy in the body of the corpus callosum and a lower mean diffusivity in the forceps minor (i.e., whole-brain TBSS analysis). No macrostructural differences nor microstructural differences, as assessed with tractography, were observed. The GHB-Coma group also reported higher impulsivity, which was more strongly associated with white matter volume and fractional anisotropy in tracts involved in impulse control (post-hoc analysis). GHB use per se was associated neither with differences in brain structure nor with impulsivity. CONCLUSIONS The results suggest that multiple GHB-induced comas, but not GHB use per se, are associated with microstructural alterations in white matter and with higher self-reported impulsivity, which in turn was associated with white matter tracts involved in impulse control.
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Affiliation(s)
- Filipa Raposo Pereira
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Minni T. B. McMaster
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Centre (Radboudumc), Nijmegen, Netherlands
- Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, Netherlands
| | - Nikki Polderman
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Yvon D. A. T. de Vries
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Guido A. van Wingen
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
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Jung M, Takiguchi S, Hamamura S, Mizuno Y, Kosaka H, Tomoda A. Thalamic Volume Is Related to Increased Anterior Thalamic Radiations in Children with Reactive Attachment Disorder. Cereb Cortex 2020; 30:4238-4245. [PMID: 32147718 DOI: 10.1093/cercor/bhaa051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Reactive attachment disorder (RAD) is associated with childhood maltreatment and affects approximately 1% of the general population. Recent data suggest that childhood maltreatment is associated with brain alterations in white and gray matter. However, the neural mechanisms of RAD-related brain alterations remain unknown. Herein, we evaluated the white matter pathways and gray matter volumes in 31 and 41 age-matched children with RAD and typical development (TD), respectively, by analyzing T1- and diffusion-weighted images. An increased fractional anisotropy (FA) and axial diffusivity in the anterior thalamic radiations (ATR) and an increased volume in the bilateral pallidum and right thalamus were observed in children with RAD compared with those with TD. Moreover, the volume of the thalamus was associated with increased ATR FA in children with RAD. Our study confirmed the existence of atypical neurodevelopment processes in the thalamus, pallidum, and ATR in children with RAD and highlighted an interdependent relationship between the alterations in the thalamus and ATR. These findings may help to improve our understanding of the comprehensive neural mechanisms of RAD.
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Affiliation(s)
- Minyoung Jung
- Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Biomedical Imaging Research Center, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui 910-1193, Japan
| | - Shinichiro Takiguchi
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Eiheiji, Fukui 910-1193, Japan
| | - Shoko Hamamura
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Eiheiji, Fukui 910-1193, Japan
| | - Yoshifumi Mizuno
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Hirotaka Kosaka
- Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Eiheiji, Fukui 910-1193, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui 910-1193, Japan.,Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Eiheiji, Fukui 910-1193, Japan
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Soni N, Vegh V, To XV, Mohamed AZ, Borges K, Nasrallah FA. Combined Diffusion Tensor Imaging and Quantitative Susceptibility Mapping Discern Discrete Facets of White Matter Pathology Post-injury in the Rodent Brain. Front Neurol 2020; 11:153. [PMID: 32210907 PMCID: PMC7067826 DOI: 10.3389/fneur.2020.00153] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/18/2020] [Indexed: 12/12/2022] Open
Abstract
Early loss of white matter microstructure integrity is a significant cause of long-term neurological disorders following traumatic brain injury (TBI). White matter abnormalities typically involve axonal loss and demyelination. In-vivo imaging tools to detect and differentiate such microstructural changes are not well-explored. This work utilizes the conjoint potential offered by advanced magnetic resonance imaging techniques, including quantitative susceptibility mapping (QSM) and diffusion tensor imaging (DTI), to discern the underlying white matter pathology at specific time points (5 h, 1, 3, 7, 14, and 30 days) post-injury in the controlled cortical impact mouse model. A total of 42 animals were randomized into six TBI groups (n = 6 per group) and one sham group (n = 6). Histopathology was performed to validate in-vivo findings by performing myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP) immunostaining for the assessment of changes to myelin and astrocytes. After 5 h of injury radial diffusivity (RD) was increased in white matter without a significant change in axial diffusivity (AxD) and susceptibility values. After 1 day post-injury RD was decreased. AxD and susceptibility changes were seen after 3 days post-injury. Susceptibility increases in white matter were observed in both ipsilateral and contralateral regions and persisted for 30 days. In histology, an increase in GFAP immunoreactivity was observed after 3 days post-injury and remained high for 30 days in both ipsilateral and contralateral white matter regions. A loss in MBP signal was noted after 3 days post-injury that continued up to 30 days. In conclusion, these results demonstrate the complementary ability of DTI and QSM in discerning the micro-pathological processes triggered following TBI. While DTI revealed acute and focal white matter changes, QSM mirrored the temporal demyelination in the white matter tracts and diffuse regions at the chronic state.
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Affiliation(s)
- Neha Soni
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Viktor Vegh
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Xuan Vinh To
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Abdalla Z Mohamed
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Karin Borges
- Faculty of Medicine, School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Fatima A Nasrallah
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
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Fan J, Milosevic R, Li J, Bai J, Zhang Y. The impact of neuroimaging advancement on neurocognitive evaluation in pediatric brain tumor survivors: A review. BRAIN SCIENCE ADVANCES 2020. [DOI: 10.1177/2096595820902565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pediatric brain tumors are a type of tumors that are commonly present in children and young adults. With the improvement of treatment, the quality of life, especially the cognitive functioning, is gaining increasingly more attention. Apart from cognitive evaluations, neuroimaging studies begin to play an important part in neurocognitive functioning investigation. In this way, the brain tissue changes caused by tumor variables (including tumor location and tumor size) and treatment variables (including surgery, chemotherapy and radiotherapy) can be detected by neuroimaging. Recent advancement of neuroimaging techniques, such as functional-MRI (fMRI) and diffusion tensor imaging (DTI), made great contributions to understanding cognitive dysfunction and quantifying the effects of tumor variables and treatment variables. In recent years, laminar-fMRI provided a potentially valuable tool for examining the exact origins of neural activity and cognitive function. On the other hand, molecular fMRI might guide diagnosis and treatment of brain disease in the future by using new biomarkers, and DTI can detect white matter changes and obtain some anatomically specific information.
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Affiliation(s)
- Juan Fan
- Yuquan Hosipital, Tsinghua University, Beijing 100040, China
| | | | - Jiefei Li
- Yuquan Hosipital, Tsinghua University, Beijing 100040, China
| | - Jianjun Bai
- Yuquan Hosipital, Tsinghua University, Beijing 100040, China
| | - Yuqi Zhang
- Yuquan Hosipital, Tsinghua University, Beijing 100040, China
- School of Medicine, Tsinghua University, Beijing 100084, China
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40
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Venkatasubramanian PN, Pina-Crespo JC, Mathews K, Rigby PH, Smith M, Duckworth JL, Wyrwicz AM, Spiess J. Initial Biphasic Fractional Anisotropy Response to Blast-Induced Mild Traumatic Brain Injury in a Mouse Model. Mil Med 2020; 185:243-247. [PMID: 32074348 PMCID: PMC7029837 DOI: 10.1093/milmed/usz307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Blast-induced mild traumatic brain injury was generated in a mouse model using a shock tube to investigate recovery and axonal injury from single blast. Methods A supersonic helium wave hit the head of anesthetized male young adult mice with a reflected pressure of 69 psi for 0.2 ms on Day 1. Subsequently, the mice were cardioperfused on Days 2, 5, or 12. The isolated brains were subjected to diffusion tensor imaging. Reduced fractional anisotropy (FA) indicated axonal injury. Results After single blast, FA showed a biphasic response in the corpus callosum with decrease on Days 2 and 12 and increase on Day 5. Conclusions Blast-induced mild traumatic brain injury in a mouse model follows a biphasic FA response within 12 days after a single blast similar to that reported for human subjects.
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Affiliation(s)
| | - Juan C Pina-Crespo
- Sanford Burnham Prebys Medical Discovery Institute, 10901 N. Torrey Pines Rd, La Jolla, CA 92037
| | - Kiran Mathews
- L3 Applied Technologies, 10180 Barnes Canyon Rd, San Diego, CA 92121
| | - Paul H Rigby
- L3 Applied Technologies, 10180 Barnes Canyon Rd, San Diego, CA 92121
| | - Matthew Smith
- Northshore University Health System, 1001 University Place, Evanston, IL 60201
| | - Josh L Duckworth
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814
| | - Alice M Wyrwicz
- Northshore University Health System, 1001 University Place, Evanston, IL 60201
| | - Joachim Spiess
- Sanford Burnham Prebys Medical Discovery Institute, 10901 N. Torrey Pines Rd, La Jolla, CA 92037.,Cortrop Inc., 271 Cerro Street, Encinitas, CA 92024
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41
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Mohamed AZ, Corrigan F, Collins-Praino LE, Plummer SL, Soni N, Nasrallah FA. Evaluating spatiotemporal microstructural alterations following diffuse traumatic brain injury. Neuroimage Clin 2019; 25:102136. [PMID: 31865019 PMCID: PMC6931220 DOI: 10.1016/j.nicl.2019.102136] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diffuse traumatic brain injury (TBI) is known to lead to microstructural changes within both white and grey matter detected in vivo with diffusion tensor imaging (DTI). Numerous studies have shown alterations in fractional anisotropy (FA) and mean diffusivity (MD) within prominent white matter tracts, but few have linked these to changes within the grey matter with confirmation via histological assessment. This is especially important as alterations in the grey matter may be predictive of long-term functional deficits. METHODS A total of 33 male Sprague Dawley rats underwent severe closed-head TBI. Eight animals underwent tensor-based morphometry (TBM) and DTI at baseline (pre-TBI), 24 hours (24 h), 7, 14, and 30 days post-TBI. Immunohistochemical analysis for the detection of ionised calcium-binding adaptor molecule 1 (IBA1) to assess microglia number and percentage of activated cells, β-amyloid precursor protein (APP) as a marker of axonal injury, and myelin basic protein (MBP) to investigate myelination was performed at each time-point. RESULTS DTI showed significant alterations in FA and RD in numerous white matter tracts including the corpus callosum, internal and external capsule, and optic tract and in the grey-matter in the cortex, thalamus, and hippocampus, with the most significant effects observed at 14 D post-TBI. TBM confirmed volumetric changes within the hippocampus and thalamus. Changes in DTI were in line with significant axonal injury noted at 24 h post-injury via immunohistochemical analysis of APP, with widespread microglial activation seen within prominent white matter tracts and the grey matter, which persisted to 30 D within the hippocampus and thalamus. Microstructural alterations in MBP+ve fibres were also noted within the hippocampus and thalamus, as well as the cortex. CONCLUSION This study confirms the widespread effects of diffuse TBI on white matter tracts which could be detected via DTI and extends these findings to key grey matter regions, with a comprehensive investigation of the whole brain. In particular, the hippocampus and thalamus appear to be vulnerable to ongoing pathology post-TBI, with DTI able to detect these alterations supporting the clinical utility in evaluating these regions post-TBI.
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Affiliation(s)
- Abdalla Z Mohamed
- Queensland Brain Institute, The University of Queensland, Building 79, Upland Road, Saint Lucia, Brisbane, QLD 4072, Australia
| | - Frances Corrigan
- Head Injury Laboratory, Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Lyndsey E Collins-Praino
- Cognition, Aging and Neurodegenerative Disease Laboratory (CANDL), Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Stephanie L Plummer
- Translational Neuropathology Laboratory, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Neha Soni
- Queensland Brain Institute, The University of Queensland, Building 79, Upland Road, Saint Lucia, Brisbane, QLD 4072, Australia
| | - Fatima A Nasrallah
- Queensland Brain Institute, The University of Queensland, Building 79, Upland Road, Saint Lucia, Brisbane, QLD 4072, Australia.
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Hristopulos DT, Babul A, Babul S, Brucar LR, Virji-Babul N. Disrupted Information Flow in Resting-State in Adolescents With Sports Related Concussion. Front Hum Neurosci 2019; 13:419. [PMID: 31920584 PMCID: PMC6920175 DOI: 10.3389/fnhum.2019.00419] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/12/2019] [Indexed: 11/30/2022] Open
Abstract
Children and youths are at a greater risk of concussions than adults, and once injured, take longer to recover. A key feature of concussion is an increase in functional connectivity, yet it remains unclear how changes in functional connectivity relate to the patterns of information flow within resting state networks following concussion and how these relate to brain function. We applied a data-driven measure of directed effective brain connectivity to compare the patterns of information flow in healthy adolescents and adolescents with subacute concussion during the resting state condition. Data from 32 healthy adolescents (mean age =16 years) and 21 concussed adolescents (mean age = 15 years) within 1 week of injury were included in the study. Five minutes of resting state data EEG were collected while participants sat quietly with their eyes closed. We applied the information flow rate to measure the transfer of information between the EEG time series of each individual at different source locations, and therefore between different brain regions. Based on the ensemble means of the magnitude of normalized information flow rate, our analysis shows that the dominant nexus of information flow in healthy adolescents is primarily left lateralized and anterior-centric, characterized by strong bidirectional information exchange between the frontal regions, and between the frontal and the central/temporal regions. In contrast, adolescents with concussion show distinct differences in information flow marked by a more left-right symmetrical, albeit still primarily anterior-centric, pattern of connections, diminished activity along the central-parietal midline axis, and the emergence of inter-hemispheric connections between the left and right frontal and the left and right temporal regions of the brain. We also find that the statistical distribution of the normalized information flow rates in each group (control and concussed) is significantly different. This paper is the first to describe the characteristics of the source space information flow and the effective connectivity patterns between brain regions in healthy adolescents in juxtaposition with the altered spatial pattern of information flow in adolescents with concussion, statistically quantifying the differences in the distribution of the information flow rate between the two populations. We hypothesize that the observed changes in information flow in the concussed group indicate functional reorganization of resting state networks in response to brain injury.
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Affiliation(s)
- Dionissios T Hristopulos
- Telecommunication Systems Research Institute, Technical University of Crete, Chania, Greece.,School of Mineral Resources Engineering, Technical University of Crete, Chania, Greece
| | - Arif Babul
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | - Shazia'Ayn Babul
- Rockefeller College, Princeton University, Princeton, NJ, United States
| | - Leyla R Brucar
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Naznin Virji-Babul
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Stojanovski S, Nazeri A, Lepage C, Ameis S, Voineskos AN, Wheeler AL. Microstructural abnormalities in deep and superficial white matter in youths with mild traumatic brain injury. Neuroimage Clin 2019; 24:102102. [PMID: 31795058 PMCID: PMC6889799 DOI: 10.1016/j.nicl.2019.102102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/23/2019] [Accepted: 11/19/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Diffusion Tensor Imaging (DTI) studies of traumatic brain injury (TBI) have focused on alterations in microstructural features of deep white matter fibers (DWM), though post-mortem studies have demonstrated that injured axons are often observed at the gray-white matter interface where superficial white matter fibers (SWM) mediate local connectivity. OBJECTIVES To examine microstructural alterations in SWM and DWM in youths with a history of mild TBI and examine the relationship between white matter alterations and attention. METHODS Using DTIDWM fractional anisotropy (FA) and SWM FA in youths with mild TBI (TBI, n=63) were compared to typically developing and psychopathology matched control groups (n=63 each). Following tract-based spatial statistics, SWM FA was assessed by applying a probabilistic tractography derived SWM mask, and DWM FA was captured with a white matter fiber tract mask. Voxel-wise z-score calculations were used to derive a count of voxels with abnormally high and low FA for each participant. Analyses examined DWM and SWM FA differences between TBI and control groups, the relationship between attention and DWM and SWM FA and the relative susceptibility of SWM compared to DWM FA to alterations associated with mild TBI. RESULTS Case-based comparisons revealed more voxels with low FA and fewer voxels with high FA in SWM in youths with mild TBI compared to both control groups. Equivalent comparisons in DWM revealed a similar pattern of results, however, no group differences for low FA in DWM were found between mild TBI and the control group with matched psychopathology. Slower processing speed on the attention task was correlated with the number of voxels with low FA in SWM in youths with mild TBI. CONCLUSIONS Within a sample of youths with a history of mild TBI, this study identified abnormalities in SWM microstructure associated with processing speed. The majority of DTI studies of TBI have focused on long-range DWM fiber tracts, often overlooking the SWM fiber type.
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Affiliation(s)
- Sonja Stojanovski
- Neuroscience and Mental Health Program, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Arash Nazeri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Stephanie Ameis
- Neuroscience and Mental Health Program, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Neuroscience and Mental Health Program, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada.
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Garner R, La Rocca M, Vespa P, Jones N, Monti MM, Toga AW, Duncan D. Imaging biomarkers of posttraumatic epileptogenesis. Epilepsia 2019; 60:2151-2162. [PMID: 31595501 PMCID: PMC6842410 DOI: 10.1111/epi.16357] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 12/14/2022]
Abstract
Traumatic brain injury (TBI) affects 2.5 million people annually within the United States alone, with over 300 000 severe injuries resulting in emergency room visits and hospital admissions. Severe TBI can result in long-term disability. Posttraumatic epilepsy (PTE) is one of the most debilitating consequences of TBI, with an estimated incidence that ranges from 2% to 50% based on severity of injury. Conducting studies of PTE poses many challenges, because many subjects with TBI never develop epilepsy, and it can be more than 10 years after TBI before seizures begin. One of the unmet needs in the study of PTE is an accurate biomarker of epileptogenesis, or a panel of biomarkers, which could provide early insights into which TBI patients are most susceptible to PTE, providing an opportunity for prophylactic anticonvulsant therapy and enabling more efficient large-scale PTE studies. Several recent reviews have provided a comprehensive overview of this subject (Neurobiol Dis, 123, 2019, 3; Neurotherapeutics, 11, 2014, 231). In this review, we describe acute and chronic imaging methods that detect biomarkers for PTE and potential mechanisms of epileptogenesis. We also describe shortcomings in current acquisition methods, analysis, and interpretation that limit ongoing investigations that may be mitigated with advancements in imaging techniques and analysis.
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Affiliation(s)
- Rachael Garner
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Marianna La Rocca
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Paul Vespa
- Division of Neurosurgery, Department of Neurology, University of California Los Angeles School of Medicine, Los Angeles, CA, United States
| | - Nigel Jones
- Van Cleef Centre for Nervous Diseases, Department of Neuroscience, Monash University, Clayton, VIC, Australia
| | - Martin M. Monti
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Dominique Duncan
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
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Zhang CH, Ma ZZ, Huo BB, Lu YC, Wu JJ, Hua XY, Xu JG. Diffusional plasticity induced by electroacupuncture intervention in rat model of peripheral nerve injury. J Clin Neurosci 2019; 69:250-256. [PMID: 31477463 DOI: 10.1016/j.jocn.2019.08.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/02/2019] [Accepted: 08/18/2019] [Indexed: 11/29/2022]
Abstract
Electroacupuncture (EA) is an adjuvant therapy for peripheral nerve injury (PNI). Both peripheral and central alterations contribute to the rehabilitation process. We employed diffusion tensor imaging (DTI) to investigate the diffusion plasticity of afferent and efferent pathways caused by EA in model of peripheral nerve injury and reparation. Twenty-four rats were divided into three groups: normal group, model group and intervention group. Rats of the model group and the intervention group underwent sciatic nerve transection and anastomosis. EA intervention was performed on the intervention group at ST-36 and GB-30 for three months. Gait assessment and DTI were conducted at days post-operative (DPO) 30, 60 and 90. We selected corticospinal tract, spinothalamic tract and internal capsule as regions of interest and analyzed diffusion metrics including fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD). FA values and RD values displayed significant differences or obvious tendency while AD values maintained a stable level. RD values displayed better indicative performance than FA in internal capsule. The intervention group presented significant correlation between RD values and Regularity Index (RI) during the intervention period. The effect of EA on peripheral nerve injury repairing rats appeared to be accelerated recovery process of sensory and motor neural pathway. We proposed that RD was a potential in vivo indicator for structural plasticity caused by EA and PNI.
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Affiliation(s)
- Chen-Hao Zhang
- Center of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen-Zhen Ma
- Center of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bei-Bei Huo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ye-Chen Lu
- Center of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia-Jia Wu
- Center of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Trauma and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian-Guang Xu
- Center of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Hirad AA, Bazarian JJ, Merchant-Borna K, Garcea FE, Heilbronner S, Paul D, Hintz EB, van Wijngaarden E, Schifitto G, Wright DW, Espinoza TR, Mahon BZ. A common neural signature of brain injury in concussion and subconcussion. SCIENCE ADVANCES 2019; 5:eaau3460. [PMID: 31457074 PMCID: PMC6685720 DOI: 10.1126/sciadv.aau3460] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
The midbrain is biomechanically susceptible to force loading from repetitive subconcussive head impacts (RSHI), is a site of tauopathy in chronic traumatic encephalopathy (CTE), and regulates functions (e.g., eye movements) often disrupted in concussion. In a prospective longitudinal design, we demonstrate there are reductions in midbrain white matter integrity due to a single season of collegiate football, and that the amount of reduction in midbrain white matter integrity is related to the amount of rotational acceleration to which players' brains are exposed. We then replicate the observation of reduced midbrain white matter integrity in a retrospective cohort of individuals with frank concussion, and further show that variance in white matter integrity is correlated with levels of serum-based tau, a marker of blood-brain barrier disruption. These findings mean that noninvasive structural MRI of the midbrain is a succinct index of both clinically silent white matter injury as well as frank concussion.
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Affiliation(s)
- Adnan A. Hirad
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Clinical and Translational Science, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Jeffrey J. Bazarian
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Kian Merchant-Borna
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Frank E. Garcea
- Center for Visual Sciences, University of Rochester, Rochester, NY 14642, USA
- Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
| | - Sarah Heilbronner
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - David Paul
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Eric B. Hintz
- Division of Neurosurgery, San Antonio Military Medical Center, San Antonio, TX 78234, USA
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Giovanni Schifitto
- Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - David W. Wright
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Tamara R. Espinoza
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Bradford Z. Mahon
- Center for Visual Sciences, University of Rochester, Rochester, NY 14642, USA
- Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA
- Carnegie Mellon Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Jang I, Chun IY, Brosch JR, Bari S, Zou Y, Cummiskey BR, Lee TA, Lycke RJ, Poole VN, Shenk TE, Svaldi DO, Tamer GG, Dydak U, Leverenz LJ, Nauman EA, Talavage TM. Every hit matters: White matter diffusivity changes in high school football athletes are correlated with repetitive head acceleration event exposure. NEUROIMAGE-CLINICAL 2019; 24:101930. [PMID: 31630026 PMCID: PMC6807364 DOI: 10.1016/j.nicl.2019.101930] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 06/29/2019] [Accepted: 07/09/2019] [Indexed: 11/29/2022]
Abstract
Recent evidence of short-term alterations in brain physiology associated with repeated exposure to moderate intensity subconcussive head acceleration events (HAEs), prompts the question whether these alterations represent an underlying neural injury. A retrospective analysis combining counts of experienced HAEs and longitudinal diffusion-weighted imaging explored whether greater exposure to incident mechanical forces was associated with traditional diffusion-based measures of neural injury—reduced fractional anisotropy (FA) and increased mean diffusivity (MD). Brains of high school athletes (N = 61) participating in American football exhibited greater spatial extents (or volumes) experiencing substantial changes (increases and decreases) in both FA and MD than brains of peers who do not participate in collision-based sports (N = 15). Further, the spatial extents of the football athlete brain exhibiting traditional diffusion-based markers of neural injury were found to be significantly correlated with the cumulative exposure to HAEs having peak translational acceleration exceeding 20 g. This finding demonstrates that subconcussive HAEs induce low-level neurotrauma, with prolonged exposure producing greater accumulation of neural damage. The duration and extent of recovery associated with periods in which athletes do not experience subconcussive HAEs now represents a priority for future study, such that appropriate participation and training schedules may be developed to minimize the risk of long-term neurological dysfunction. Brain volumes evidencing injury are larger in football athletes than controls. Spatial extent of decreased FA correlates with head acceleration event exposure. Spatial extent of increased MD correlates with head acceleration event exposure.
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Affiliation(s)
- Ikbeom Jang
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States of America.
| | - Il Yong Chun
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Jared R Brosch
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Sumra Bari
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Yukai Zou
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America; College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States of America
| | - Brian R Cummiskey
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Taylor A Lee
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Roy J Lycke
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Victoria N Poole
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Trey E Shenk
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Diana O Svaldi
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Gregory G Tamer
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Larry J Leverenz
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States of America
| | - Eric A Nauman
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America; School of Mechanical Engineering, Purdue University, West Lafayette, IN, United States of America; Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Thomas M Talavage
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States of America; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
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48
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Hoogenboom WS, Rubin TG, Ye K, Cui MH, Branch KC, Liu J, Branch CA, Lipton ML. Diffusion Tensor Imaging of the Evolving Response to Mild Traumatic Brain Injury in Rats. J Exp Neurosci 2019; 13:1179069519858627. [PMID: 31308735 PMCID: PMC6613065 DOI: 10.1177/1179069519858627] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/29/2019] [Indexed: 12/30/2022] Open
Abstract
Mild traumatic brain injury (mTBI), also known as concussion, is a serious public health challenge. Although most patients recover, a substantial minority suffers chronic disability. The mechanisms underlying mTBI-related detrimental effects remain poorly understood. Although animal models contribute valuable preclinical information and improve our understanding of the underlying mechanisms following mTBI, only few studies have used diffusion tensor imaging (DTI) to study the evolution of axonal injury following mTBI in rodents. It is known that DTI shows changes after human concussion and the role of delineating imaging findings in animals is therefore to facilitate understanding of related mechanisms. In this work, we used a rodent model of mTBI to investigate longitudinal indices of axonal injury. We present the results of 45 animals that received magnetic resonance imaging (MRI) at multiple time points over a 2-week period following concussive or sham injury yielding 109 serial observations. Overall, the evolution of DTI metrics following concussive or sham injury differed by group. Diffusion tensor imaging changes within the white matter were most noticeable 1 week following injury and returned to baseline values after 2 weeks. More specifically, we observed increased fractional anisotropy in combination with decreased radial diffusivity and mean diffusivity, in the absence of changes in axial diffusivity, within the white matter of the genu corpus callosum at 1 week post-injury. Our study shows that DTI can detect microstructural white matter changes in the absence of gross abnormalities as indicated by visual screening of anatomical MRI and hematoxylin and eosin (H&E)-stained sections in a clinically relevant animal model of mTBI. Whereas additional histopathologic characterization is required to better understand the neurobiological correlates of DTI measures, our findings highlight the evolving nature of the brain’s response to injury following concussion.
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Affiliation(s)
- Wouter S Hoogenboom
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Department of Clinical Investigation, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Todd G Rubin
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Kenny Ye
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Min-Hui Cui
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Kelsey C Branch
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Jinyuan Liu
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Craig A Branch
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Department of Physiology and Biophysics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Michael L Lipton
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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49
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Fan J, Milosevic R, Li J, Bai J, Zhang Y. The impact of neuroimaging advancement on neurocognitive evaluation in pediatric brain tumor survivors: A review. BRAIN SCIENCE ADVANCES 2019. [DOI: 10.26599/bsa.2019.9050008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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50
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Yin B, Li DD, Huang H, Gu CH, Bai GH, Hu LX, Zhuang JF, Zhang M. Longitudinal Changes in Diffusion Tensor Imaging Following Mild Traumatic Brain Injury and Correlation With Outcome. Front Neural Circuits 2019; 13:28. [PMID: 31133818 PMCID: PMC6514143 DOI: 10.3389/fncir.2019.00028] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 04/01/2019] [Indexed: 11/13/2022] Open
Abstract
The chronic consequences of traumatic brain injury (TBI) may contribute to the increased risk for early cognitive decline and dementia, primarily due to diffusion axonal injury. Previous studies in mild TBI (mTBI) have been controversial in describing the white matter tract integrity changes occurring at acute and subacute post-injury. In this prospective longitudinal study, we aim to investigate the longitudinal changes of white matter (WM) using diffusion tensor imaging (DTI) and their correlations with neuropsychological tests. Thirty-three patients with subacute mTBI and 31 matched healthy controls were studied with an extensive imaging and clinical battery. Neuroimaging was obtained within 7 days post-injury for acute scans and repeated at 1 and 3 months post-injury. Using a region-of-interest-based approach, tract-based spatial statistics was used to conduct voxel-wise analysis on diffusion changes in mTBI and was compared to those of healthy matched controls, scanned during the same time period and rescanned with an interval similar to that of patients. We found decreased fractional anisotropy (FA) values in the left anterior limb of internal capsule (ALIC) and right inferior fronto-occipital fasciculus (IFOF) during the 7 days post-injury, which showed longitudinal evidence of recovery following 1 month post-injury. Increased FA values in these two tracts at 1 month post-injury were positively associated with better performance on cognitive information processing speed at initial assessment. By contrast, there were also some tracts (right anterior corona radiata, forceps major, and body of corpus callosum) exhibiting the continuing loss of integrity sustaining even beyond 3 months, which can predict the persisting post-concussion syndromes. Continuing loss of structural integrity in some tracts may contribute to the persistent post-concussion syndromes in mTBI patients, suggesting certain tracts providing an objective biomarker for tracking the pathological recovery process following mTBI.
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Affiliation(s)
- Bo Yin
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dan-Dong Li
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huan Huang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Cheng-Hui Gu
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guang-Hui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liu-Xun Hu
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jin-Fei Zhuang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ming Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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