1
|
Zhou F, Wu L, Qian L, Kuang H, Zhan J, Li J, Cheung GL, Ding A, Gong H. The Relationship Between Cortical Morphological and Functional Topological Properties and Clinical Manifestations in Patients with Posttraumatic Diffuse Axonal Injury: An Individual Brain Network Study. Brain Topogr 2023; 36:936-945. [PMID: 37615797 DOI: 10.1007/s10548-023-00964-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/15/2023] [Indexed: 08/25/2023]
Abstract
To evaluate the altered network topological properties and their clinical relevance in patients with posttraumatic diffuse axonal injury (DAI). Forty-seven participants were recruited in this study, underwent 3D T1-weighted and resting-state functional MRI, and had single-subject morphological brain networks (MBNs) constructed by Kullback-Leibler divergence and functional brain networks (FBNs) constructed by Pearson correlation measurement interregional similarity. The global and regional properties were analyzed and compared using graph theory and network-based statistics (NBS), and the relationship with clinical manifestations was assessed. Compared with those of the healthy subjects, MBNs of patients with DAI showed a higher path length ([Formula: see text]: P = 0.021, [Formula: see text]: P = 0.011), lower clustering ([Formula: see text]: P = 0.002) and less small-worldness ([Formula: see text]: P = 0.002), but there was no significant difference in the global properties of FBNs (P: 0.161-0.216). For nodal properties of MBNs and FBNs, several regions showed significant differences between patients with DAI and healthy controls (HCs) (P < 0.05, FDR corrected). NBS analysis revealed that MBNs have more altered morphological connections in the frontal parietal control network and interhemispheric connections (P < 0.05). DAI-related global or nodal properties of MBNs were correlated with physical disability or dyscognition (P < 0.05/7, with Bonferroni correction), and the alteration of functional topology properties mediates this relationship. Our results suggested that disrupted morphological topology properties, which are mediated by FBNs and correlated with clinical manifestations of DAI, play a critical role in the short-term and medium-term phases after trauma.
Collapse
Affiliation(s)
- Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Lin Wu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Long Qian
- Department of Biomedical Engineering, College of Engineering, Peking University, No.60 Yannan Yuan, Beijing, 100871, China
| | - Hongmei Kuang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Jie Zhan
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Jian Li
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China
| | - Gerald L Cheung
- Spin Imaging Technology Co., Ltd, No.6 Fengxin Road, Nanjing, 210012, China
| | - Aimin Ding
- Department of Radiology, The First People's Hospital of Fuzhou and The Fifth Affiliated Hospital, Nanchang University, Fuzhou, 344000, China.
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China.
- Neuroimaging Laboratory, Jiangxi Medical Imaging Research Institute, Nanchang, 330006, China.
| |
Collapse
|
2
|
Lampros M, Vlachos N, Tsitsopoulos PP, Zikou AK, Argyropoulou MI, Voulgaris S, Alexiou GA. The Role of Novel Imaging and Biofluid Biomarkers in Traumatic Axonal Injury: An Updated Review. Biomedicines 2023; 11:2312. [PMID: 37626808 PMCID: PMC10452517 DOI: 10.3390/biomedicines11082312] [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: 06/01/2023] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of disability worldwide. Traumatic axonal injury (TAI) is a subtype of TBI resulting from high-impact forces that cause shearing and/or stretching of the axonal fibers in white matter tracts. It is present in almost half of cases of severe TBI and frequently associated with poor functional outcomes. Axonal injury results from axonotomy due to mechanical forces and the activation of a biochemical cascade that induces the activation of proteases. It occurs at a cellular level; hence, conventional imaging modalities often fail to display TAI lesions. However, the advent of novel imaging modalities, such as functional magnetic resonance imaging and fiber tractography, has significantly improved the detection and characteristics of TAI. Furthermore, the significance of several fluid and structural biomarkers has also been researched, while the contribution of omics in the detection of novel biomarkers is currently under investigation. In the present review, we discuss the role of imaging modalities and potential biomarkers in diagnosing, classifying, and predicting the outcome in patients with TAI.
Collapse
Affiliation(s)
- Marios Lampros
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| | - Nikolaos Vlachos
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| | - Parmenion P. Tsitsopoulos
- Department of Neurosurgery, Hippokratio General Hospital, Aristotle University of Thessaloniki School of Medicine, 54942 Thessaloniki, Greece;
| | - Anastasia K. Zikou
- Department of Radiology, University of Ioannina, 45110 Ioannina, Greece; (A.K.Z.); (M.I.A.)
| | - Maria I. Argyropoulou
- Department of Radiology, University of Ioannina, 45110 Ioannina, Greece; (A.K.Z.); (M.I.A.)
| | - Spyridon Voulgaris
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| | - George A. Alexiou
- Department of Neurosurgery, School of Medicine, University of Ioannina, St. Niarhou Avenue, 45500 Ioannina, Greece; (M.L.); (N.V.); (S.V.)
| |
Collapse
|
3
|
Role of Diffusion Tensor Imaging in the Diagnosis of Traumatic Axonal Injury in Individual Patients with a Concussion or Mild Traumatic Brain Injury: A Mini-Review. Diagnostics (Basel) 2022; 12:diagnostics12071580. [PMID: 35885486 PMCID: PMC9319429 DOI: 10.3390/diagnostics12071580] [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: 05/28/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 12/01/2022] Open
Abstract
Present review paper aims to understand role of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in diagnosis of traumatic axonal injury (TAI), induced by head trauma, in individual patients with a concussion or mild traumatic brain injury (mTBI). Precise information on presence and severity of TAI in brain is necessary for determining appropriate therapeutic strategies. Several hundred DTI-based studies have reported TAI in concussion or mTBI. Majority of these DTI-based studies have been performed in a group of patients, whereas case studies that have reported TAI in individual patients with a concussion or mTBI are fewer. Summary of these DTI-based studies for individual patients is as follows: DTI can be used as a non-invasive tool for determining presence and severity of TAI in individual patients with concussion or mTBI. However, for diagnosis of TAI in an individual patient, several conditions are required to be met: no past history of head trauma, presence of possible conditions for TAI occurrence during head trauma, development of new clinical features after head trauma, and DTI observed abnormality of a neural structure that coincides with a newly developed clinical feature. However, further studies for a more precise diagnosis of TAI in individual patients should be encouraged.
Collapse
|