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Funayama M, Hojo T, Nakagawa Y, Kurose S, Koreki A. Investigating the Link Between Subjective Depth Perception Deficits and Objective Stereoscopic Vision Deficits in Individuals With Acquired Brain Injury. Cogn Behav Neurol 2024; 37:82-95. [PMID: 38682873 DOI: 10.1097/wnn.0000000000000369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 01/03/2024] [Indexed: 05/01/2024]
Abstract
Individuals with acquired brain injury have reported subjective complaints of depth perception deficits, but few have undergone objective assessments to confirm these deficits. As a result, the literature currently lacks reports detailing the correlation between subjective depth perception deficits and objective stereoscopic vision deficits in individuals with acquired brain injury, particularly those cases that are characterized by a clearly defined lesion. To investigate this relationship, we recruited three individuals with acquired brain injury who experienced depth perception deficits and related difficulties in their daily lives. We had them take neurologic, ophthalmological, and neuropsychological examinations. We also had them take two types of stereoscopic vision tests: a Howard-Dolman-type stereoscopic vision test and the Topcon New Objective Stereo Test. Then, we compared the results with those of two control groups: a group with damage to the right hemisphere of the brain and a group of healthy controls. Performance on the two stereoscopic vision tests was severely impaired in the three patients. One of the patients also presented with cerebral diplopia. We identified the potential neural basis of these deficits in the cuneus and the posterior section of the superior parietal lobule, which play a role in vergence fusion and are located in the caudal region of the dorso-dorsal visual pathway, which is known to be crucial not only for visual spatial perception, but also for reaching, grasping, and making hand postures in the further course of that pathway.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
- Department of Rehabilitation, Edogawa Hospital, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tomohito Hojo
- Department of Rehabilitation, Edogawa Hospital, Tokyo, Japan
- Department of Rehabilitation, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | | | - Shin Kurose
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Akihiro Koreki
- Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Japan
- Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
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A model for estimating the brainstem volume in normal healthy individuals and its application to diffuse axonal injury patients. Sci Rep 2023; 13:33. [PMID: 36593347 PMCID: PMC9807567 DOI: 10.1038/s41598-022-27202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Diffuse axonal injury (DAI) is a subtype of traumatic brain injury that causes acute-phase consciousness disorders and widespread chronic-phase brain atrophy. Considering the importance of brainstem damage in DAI, a valid method for evaluating brainstem volume is required. We obtained volume measurements from 182 healthy adults by analyzing T1-weighted magnetic resonance images, and created an age-/sex-/intracranial volume-based quantitative model to estimate the normal healthy volume of the brainstem and cerebrum. We then applied this model to the volume measurements of 22 DAI patients, most of whom were in the long-term chronic phase and had no gross focal injury, to estimate the percentage difference in volume from the expected normal healthy volume in different brain regions, and investigated its association with the duration of posttraumatic amnesia (which is an early marker of injury severity). The average loss of the whole brainstem was 13.9%. Moreover, the percentage loss of the whole brainstem, and particularly of the pons and midbrain, was significantly negatively correlated with the duration of posttraumatic amnesia. Our findings suggest that injury severity, as denoted by the duration of posttraumatic amnesia, is among the factors affecting the chronic-phase brainstem volume in patients with DAI.
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Maffei C, Gilmore N, Snider SB, Foulkes AS, Bodien YG, Yendiki A, Edlow BL. Automated detection of axonal damage along white matter tracts in acute severe traumatic brain injury. Neuroimage Clin 2022; 37:103294. [PMID: 36529035 PMCID: PMC9792957 DOI: 10.1016/j.nicl.2022.103294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022]
Abstract
New techniques for individualized assessment of white matter integrity are needed to detect traumatic axonal injury (TAI) and predict outcomes in critically ill patients with acute severe traumatic brain injury (TBI). Diffusion MRI tractography has the potential to quantify white matter microstructure in vivo and has been used to characterize tract-specific changes following TBI. However, tractography is not routinely used in the clinical setting to assess the extent of TAI, in part because focal lesions reduce the robustness of automated methods. Here, we propose a pipeline that combines automated tractography reconstructions of 40 white matter tracts with multivariate analysis of along-tract diffusion metrics to assess the presence of TAI in individual patients with acute severe TBI. We used the Mahalanobis distance to identify abnormal white matter tracts in each of 18 patients with acute severe TBI as compared to 33 healthy subjects. In all patients for which a FreeSurfer anatomical segmentation could be obtained (17 of 18 patients), including 13 with focal lesions, the automated pipeline successfully reconstructed a mean of 37.5 ± 2.1 white matter tracts without the need for manual intervention. A mean of 2.5 ± 2.1 tracts resulted in partial or failed reconstructions and needed to be reinitialized upon visual inspection. The pipeline detected at least one abnormal tract in all patients (mean: 9.1 ± 7.9) and accurately discriminated between patients and controls (AUC: 0.91). The number and neuroanatomic location of abnormal tracts varied across patients and levels of consciousness. The premotor, temporal, and parietal sections of the corpus callosum were the most commonly damaged tracts (in 10, 9, and 8 patients, respectively), consistent with prior histopathological studies of TAI. TAI measures were not associated with concurrent behavioral measures of consciousness. In summary, we provide proof-of-principle evidence that an automated tractography pipeline has translational potential to detect and quantify TAI in individual patients with acute severe TBI.
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Affiliation(s)
- Chiara Maffei
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | - Natalie Gilmore
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Samuel B Snider
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea S Foulkes
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Yelena G Bodien
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Brian L Edlow
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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Abstract
Traumatic brain injury is a calamity of various causes, pathologies, and extremely varied and often complex clinical presentations. Because of its predilection for brain systems underlying cognitive and complex behavioral operations, it may cause chronic and severe psychiatric illness that requires expert management. This is more so for the modern epidemic of athletic and military brain injuries which are dominated by psychiatric symptoms. Past medical, including psychiatric, history, and comorbidities are important and relevant for formulation and management. Traumatic brain injury is a model for other neuropsychiatric disorders and may serve as an incubator of new ideas for neurodegenerative disease.
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Affiliation(s)
- Vassilis E Koliatsos
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neuropsychiatry Program, Sheppard Pratt Health System, Baltimore, MD, USA.
| | - Vani Rao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Liang Y, Tong F, Zhang L, Zhu L, Li W, Huang W, Zhao S, He G, Zhou Y. iTRAQ-based proteomic analysis discovers potential biomarkers of diffuse axonal injury in rats. Brain Res Bull 2019; 153:289-304. [PMID: 31539556 DOI: 10.1016/j.brainresbull.2019.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 08/19/2019] [Accepted: 09/13/2019] [Indexed: 12/13/2022]
Abstract
Diffuse axonal injury (DAI) is one of the most common and severe pathological consequences of traumatic brain injury (TBI). The molecular mechanism of DAI is highly complicated and still elusive, yet a clear understanding is crucial for the diagnosis, treatment, and prognosis of DAI. In our study, we used rats to establish a DAI model and applied isobaric tags for relative and absolute quantitation (iTRAQ) coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis to identify differentially expressed proteins (DEPs) in the corpus callosum. As a result, a total of 514 proteins showed differential expression between the injury groups and the control. Among these DEPs, 14 common DEPs were present at all seven time points postinjury (1, 3, 6, 12, 24, 48, and 72 h). Next, bioinformatic analysis was performed to elucidate the pathogenesis of DAI, which was found to possibly involve calcium ion-regulatory proteins (e.g., calsenilin and ryanodine receptor 2), cytoskeleton organization (e.g., peripherin, NFL, NFM, and NFH), apoptotic processes (e.g., calsenilin and protein kinase C delta type), and inflammatory response proteins (e.g., complement C3 and C-reactive protein). Moreover, peripherin and calsenilin were successfully confirmed by western blotting to be significantly upregulated during DAI, and immunohistochemical (IHC) analysis revealed that their expression increased and could be observed in axons after injury, thus indicating their potential as DAI biomarkers. Our experiments not only provide insight into the molecular mechanisms of axonal injury in rats during DAI but also give clinicians and pathologists important reference data for the diagnosis of DAI. Our findings may expand the list of DAI biomarkers and improve the postmortem diagnostic rate of DAI.
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Affiliation(s)
- Yue Liang
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Fang Tong
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Lin Zhang
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Longlong Zhu
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Wenhe Li
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China.
| | - Weisheng Huang
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Shuquan Zhao
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
| | - Guanglong He
- Institute of Forensic Science, Ministry of Public Security People's Republic of China, No. 17 Nanli Mulidi, Beijing, 100038, PR China.
| | - Yiwu Zhou
- Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
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Mielke MM, Syrjanen JA, Blennow K, Zetterberg H, Vemuri P, Skoog I, Machulda MM, Kremers WK, Knopman DS, Jack C, Petersen RC, Kern S. Plasma and CSF neurofilament light: Relation to longitudinal neuroimaging and cognitive measures. Neurology 2019; 93:e252-e260. [PMID: 31182505 PMCID: PMC6656645 DOI: 10.1212/wnl.0000000000007767] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/27/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE We aimed to (1) assess and compare baseline plasma and CSF neurofilament light (NfL) for cross-sectional and longitudinal associations with neuroimaging or cognition and (2) determine whether change in plasma NfL corresponded with change in these outcomes. METHODS Seventy-nine participants without dementia, median age 76 years, had plasma and CSF NfL, neuropsychological testing, and neuroimaging (MRI, amyloid PET, FDG-PET) at the same study visit, and a repeat visit (15 or 30 months later) with both plasma NfL and neuroimaging. Plasma NfL was measured on the Simoa-HD1 Platform and CSF NfL with an in-house ELISA. Linear mixed effects models were used to examine the associations between baseline plasma or CSF NfL and cognitive and neuroimaging outcomes adjusting for age, sex, and education. The relationship between change in plasma NfL and change in the outcomes was assessed using linear regression. RESULTS There were no cross-sectional associations between CSF or plasma NfL and any neuroimaging or cognitive measure. Longitudinally, higher baseline plasma NfL was associated with worsening in all neuroimaging measures, except amyloid PET, and global cognition. Higher baseline CSF NfL was associated with worsening in cortical thickness and diffusion MRI. The beta estimates for CSF NfL were similar to those for plasma NfL. Change in plasma NfL was associated with change in global cognition, attention, and amyloid PET. CONCLUSION Elevated baseline plasma NfL is a prognostic marker of cognitive decline and neuroimaging measures of neurodegeneration, and has similar effect sizes to baseline CSF NfL. Change in plasma NfL also tracked with short-term cognitive change.
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Affiliation(s)
- Michelle M Mielke
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK.
| | - Jeremy A Syrjanen
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Kaj Blennow
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Henrik Zetterberg
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Prashanthi Vemuri
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Ingmar Skoog
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Mary M Machulda
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Walter K Kremers
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - David S Knopman
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Clifford Jack
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Ronald C Petersen
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
| | - Silke Kern
- From the Departments of Health Sciences Research (M.M. Mielke, J.A.S., W.K.K., R.C.P., S.K.), Neurology (M.M. Mielke, D.S.K., R.C.P.), Radiology (P.V., C.J.), and Psychiatry and Psychology (M.M. Machulda), Mayo Clinic, Rochester, MN; Department of Psychiatry and Neurochemistry (K.B., H.Z., I.S., S.K.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (K.B., H.Z.), Sahlgrenska University Hospital, Mölndal, Sweden; Institute of Neurology (H.Z.), University College London, Queen Square; and UK Dementia Research Institute at UCL (H.Z.), London, UK
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7
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Lesimple B, Caron E, Lefort M, Debarle C, Pélégrini-Issac M, Cassereau D, Delphine S, Torkomian G, Battisti V, Bossale P, Galanaud D, Puybasset L, Pradat-Diehl P, Perlbarg V. Long-term cognitive disability after traumatic brain injury: Contribution of the DEX relative questionnaires. Neuropsychol Rehabil 2019; 30:1905-1924. [PMID: 31116085 DOI: 10.1080/09602011.2019.1618345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Executive functions are high-level cognitive processes commonly impaired after severe traumatic brain injury (sTBI), which may be associated with persistent anosognosia. The dysexecutive questionnaire (DEX) was designed to assess different domains of executive functioning in daily life. Two versions of the DEX exist (DEX-S completed by the patient, DEX-O completed by a relative) to compare cognitive complaints and patient's awareness. This work was aimed at studying the relevance of DEX-O for assessing daily-life limitations, the persistence of anosognosia and its association with global disability (GOSE) and magnetic resonance imaging (MRI) markers of brain alterations. Sixty-three patients (and relatives) were included within 63.4 months (±20.7) after sTBI. DEX-S and DEX-O scores were significantly positively correlated. We obtained significant correlations between DEX-S and episodic memory and phasic alert but not with executive assessment, GOSE and diffusion MRI markers. DEX-O was significantly correlated with executive function, episodic memory, attention (phasic alert sustained and divided attention), with the GOSE and the volume of the body of the corpus callosum (MRI marker). Anosognosia score (DEX-O minus DEX-S) correlated with mean diffusivity measure. These results highlight the clinical interest of DEX-O in assessing long-term disability.
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Affiliation(s)
- Blandine Lesimple
- AP-HP, Service de Neuroréanimation chirurgicale, Hôpital Pitié-Salpêtrière, Paris, France.,SAMSAH La Note Bleue, Fondation Partage et Vie, Paris, France
| | - Elsa Caron
- AP-HP, Service de Médecine Physique et Réadaptation, Hôpital Pitié-Salpêtrière, Paris, France.,dSAMSAH -SAVS, Association Guyanaise contre les Maladies Neuromusculaires, Cayenne, France
| | - Muriel Lefort
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
| | - Clara Debarle
- GRC-Sorbonne Université n°18 HanCRe, Sorbonne Université, Paris, France
| | | | - Didier Cassereau
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France.,ESPCI ParisTech, PSL Research University, Paris, France
| | - Sébastien Delphine
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France.,Institut des Neurosciences Translationnelles de Paris, IHU-A-ICM, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Grégory Torkomian
- AP-HP, Service de Neuroréanimation chirurgicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Valentine Battisti
- AP-HP, Service de Neuroréanimation chirurgicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Pierrette Bossale
- AP-HP, Service de Neuroréanimation chirurgicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Damien Galanaud
- AP-HP, Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Louis Puybasset
- AP-HP, Service de Neuroréanimation chirurgicale, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
| | - Pascale Pradat-Diehl
- AP-HP, Service de Médecine Physique et Réadaptation, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France.,GRC-Sorbonne Université n°18 HanCRe, Sorbonne Université, Paris, France
| | - Vincent Perlbarg
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France.,Bioinformatics and Biostatistics Core Facility, iCONICS, ICM, Institut du Cerveau et de la Moelle épinière, Paris, France
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8
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Wallace EJ, Mathias JL, Ward L. Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis. Brain Imaging Behav 2019; 12:1607-1621. [PMID: 29383621 DOI: 10.1007/s11682-018-9823-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI, diffusion may be altered; however the exact nature of these changes has yet to be determined. A meta-analysis was therefore conducted to determine the location and extent of changes in DTI following adult TBI. The data from 44 studies that compared the FA and/or MD/ADC data from TBI and Control participants in different regions of interest (ROIs) were analyzed. The impact of injury severity, post-injury interval (acute: ≤ 1 week, subacute: 1 week-3 months, chronic: > 3 months), scanner details and acquisition parameters were investigated in subgroup analyses, with the findings indicating that mild TBI should be examined separately to that of moderate to severe injuries. Lower FA values were found in 88% of brain regions following mild TBI and 92% following moderate-severe TBI, compared to Controls. MD/ADC was higher in 95% and 100% of brain regions following mild and moderate-severe TBI, respectively. Moderate to severe TBI resulted in larger changes in FA and MD/ADC than mild TBI. Overall, changes to FA and MD/ADC were widespread, reflecting more symmetric and a higher amount of diffusion, indicative of white matter damage.
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Affiliation(s)
- Erica J Wallace
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia
| | - Jane L Mathias
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia.
| | - Lynn Ward
- School of Psychology, Faculty of Medical & Health Sciences, University of Adelaide, Adelaide, Australia
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Ubukata S, Oishi N, Sugihara G, Aso T, Fukuyama H, Murai T, Ueda K. Transcallosal Fiber Disruption and its Relationship with Corresponding Gray Matter Alteration in Patients with Diffuse Axonal Injury. J Neurotrauma 2019; 36:1106-1114. [DOI: 10.1089/neu.2018.5823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shiho Ubukata
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- Medical Innovation Center, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Naoya Oishi
- Medical Innovation Center, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Toshihiko Aso
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
- Human Brain Research Center, Graduate School of Medicine, and Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Hidenao Fukuyama
- Beijing Institute of Technology, Beijing, China
- Research and Educational Unit of Leaders for Integrated Medical System, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Keita Ueda
- Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
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Abstract
BACKGROUND Agenesis of the corpus callosum (AgCC) involves congenital absence of all or part of the corpus callosum. Because the disorder can only be firmly diagnosed via neuroradiology, it has a short research history, and only recently has the cognitive syndrome become clear. PURPOSE Our purpose is to review the primary deficits in AgCC that constitute the core syndrome. CONCLUSIONS The cores syndrome includes: (1) reduced interhemispheric transfer of sensory-motor information; (2) reduced cognitive processing speed; and (3) deficits in complex reasoning and novel problem-solving. These domains do not appear to reflect different neuroanatomical abnormalities, but rather different domains of expression of reduced interhemispheric communication from callosal absence. IMPLICATIONS These core deficits are expressed across various domains of cognitive, behavioral, and social functioning. The impact of these deficits varies across development and may be moderated by individual factors such as co-occurrence of other neurodevelopmental conditions, general intellectual capacity, and environmental support. (JINS, 2019, 25, 324-330).
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Connor M, Karunamuni R, McDonald C, Seibert T, White N, Moiseenko V, Bartsch H, Farid N, Kuperman J, Krishnan A, Dale A, Hattangadi-Gluth JA. Regional susceptibility to dose-dependent white matter damage after brain radiotherapy. Radiother Oncol 2017; 123:209-217. [PMID: 28460824 PMCID: PMC5518466 DOI: 10.1016/j.radonc.2017.04.006] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/31/2017] [Accepted: 04/04/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Regional differences in sensitivity to white matter damage after brain radiotherapy (RT) are not well-described. We characterized the spatial heterogeneity of dose-response across white matter tracts using diffusion tensor imaging (DTI). MATERIALS AND METHODS Forty-nine patients with primary brain tumors underwent MRI with DTI before and 9-12months after partial-brain RT. Maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were generated. Atlas-based white matter tracts were identified. A secondary analysis using skeletonized tracts was also performed. Linear mixed-model analysis of the relationship between mean and max dose and percent change in DTI metrics was performed. RESULTS Tracts with the strongest correlation of FA change with mean dose were the fornix (-0.46 percent/Gy), cingulum bundle (-0.44 percent/Gy), and body of corpus callosum (-0.23 percent/Gy), p<.001. These tracts also showed dose-sensitive changes in MD and RD. In the skeletonized analysis, the fornix and cingulum bundle remained highly dose-sensitive. Maximum and mean dose were similarly predictive of DTI change. CONCLUSIONS The corpus callosum, cingulum bundle, and fornix show the most prominent dose-dependent changes following RT. Future studies examining correlation with cognitive functioning and potential avoidance of critical white matter regions are warranted.
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Affiliation(s)
- Michael Connor
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, United States
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Carrie McDonald
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, United States; Department of Psychiatry, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Tyler Seibert
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Nathan White
- Department of Radiology, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Vitali Moiseenko
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, United States
| | - Hauke Bartsch
- Department of Radiology, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Nikdokht Farid
- Department of Radiology, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Joshua Kuperman
- Department of Radiology, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Anitha Krishnan
- Department of Radiology, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Anders Dale
- Department of Radiology, University of California San Diego, La Jolla, California, United States; Department of Psychiatry, University of California San Diego, La Jolla, California, United States; Department of Neurosciences, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States
| | - Jona A Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, United States; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California, United States.
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Li C, Wu X, Qi H, Cheng Y, Zhang B, Zhou H, Lv X, Liu K, Zhang HL. Reversible splenial lesion syndrome associated with lobar pneumonia: Case report and review of literature. Medicine (Baltimore) 2016; 95:e4798. [PMID: 27684805 PMCID: PMC5265898 DOI: 10.1097/md.0000000000004798] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological disorder with unclear pathophysiology. Clinically, RESLES is defined as reversible isolated splenial lesions in the corpus callosum, which can be readily identified by magnetic resonance imaging (MRI) and usually resolve completely over a period of time. RESLES could be typically triggered by infection, antiepileptic drugs (AEDs), poisoning, etc. More factors are increasingly recognized. METHODS AND RESULTS We reported herein an 18-year-old female patient with lobar pneumonia who developed mental abnormalities during hospitalization. An isolated splenial lesion in the corpus callosum was found by head MRI and the lesion disappeared 15 days later. Based on her clinical manifestations and radiological findings, she was diagnosed with lobar pneumonia associated RESLES. We further summarize the up-to-date knowledge about the etiology, possible pathogenesis, clinical manifestations, radiological features, treatment, and prognosis of RESLES. CONCLUSION This report contributes to the clinical understanding of RESLES which may present with mental abnormalities after infection. The characteristic imaging of reversible isolated splenial lesions in the corpus callosum was confirmed in this report. The clinical manifestations and lesions on MRI could disappear naturally after 1 month without special treatment.
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Affiliation(s)
- Chunrong Li
- Neuroscience Center, Department of Neurology
| | - Xiujuan Wu
- Neuroscience Center, Department of Neurology
| | - Hehe Qi
- Neuroscience Center, Department of Neurology
| | | | - Bing Zhang
- Neuroscience Center, Department of Neurology
| | - Hongwei Zhou
- Department of Radiology, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaohong Lv
- Neuroscience Center, Department of Neurology
| | - Kangding Liu
- Neuroscience Center, Department of Neurology
- Correspondence: Kangding Liu, Hong-Liang Zhang, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Xinmin Street 71#, 130021 Changchun, China (e-mail: , )
| | - Hong-Liang Zhang
- Neuroscience Center, Department of Neurology
- Correspondence: Kangding Liu, Hong-Liang Zhang, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Xinmin Street 71#, 130021 Changchun, China (e-mail: , )
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